Grade Progression and Intrapatient Tumor Heterogeneity as Potential Contributors to Resistance in Gastroenteropancreatic Neuroendocrine Tumors

• Published in: Cancers Vol. 15; no. 14; p. 3712
• Main Authors: Varghese, Diana Grace, Del Rivero, Jaydira, Bergsland, Emily
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.07.2023; MDPI
• Subjects: Antimitotic agents; Antineoplastic agents; Biology; Biopsy; Chemotherapy; Classification; Development and progression; differentiation; Drug resistance; gastroenteropancreatic (GEP) neuroendocrine neoplasm (NEN); grade; grade progression; heterogeneity; Lanreotide; Liver; Lungs; Medical prognosis; Metastases; Metastasis; neuroendocrine tumor (NET); Neuroendocrine tumors; Pancreas; Patients; Response rates; Review; Small intestine; Somatostatin; Ki-67 index; grade migration; differentiation; grade; neuroendocrine tumor (NET); gastroenteropancreatic (GEP) neuroendocrine neoplasm (NEN); neuroendocrine carcinoma; grade progression; heterogeneity
• ISSN: 2072-6694; 2072-6694
• DOI: 10.3390/cancers15143712

Gastroenteropancreatic neuroendocrine neoplasms (NENs) are a heterogenous group of tumors that are incurable when metastatic, regardless of grade. The aim of this article is to understand tumor heterogeneity and grade progression as possible contributors to drug resistance in gastroentropancreatic neuroendocrine tumors (GEP-NETs). Heterogeneity has been observed in the genetic, pathological, and imaging features of these tumors at baseline. Diagnostic challenges related to tumor sampling and the potential for changes in grade over time further confound our ability to optimize therapy for patients. A better understanding of NEN biology and tumor heterogeneity at baseline and over time could lead to the development of new therapeutic avenues.