oncothor.bsky.social - Profile | ThreadSky | a Reddit-style client for Bluesky

PRRT + PARP inhibitors in advanced NETs? To date, no trials have convincingly shown that PRRT + drug X (whatever that may be) is better than PRRT alone. The addition of PARPi seems to add little early toxicity but larger trials needed to show efficacy. jnm.snmjournals.org/content/earl...

submitted 6 days ago • 0 comments

Who doesn't like good clinical reviews...? As my rectal cancer practice shrinks (and my NET/CUP/PDAC practice grows), I find this a great and practical, even as a seasoned GI oncologist. www.sciencedirect.com/science/arti...

submitted 10 days ago • 0 comments

Preparing for the ENETS annual conference next month. Here is a simplified vision of what might be the future in the world of radioligand therapy for NETs (RLT which I now prefer over PRRT as a term...). Need better predictors of efficacy and tox I have never been good at predicting...

submitted 11 days ago • 0 comments

Do you want to know what is happening in radioligand therapy for patients with neuroendocrine tumors? What is hot and what is not...? if so this team (which has not yet migrated over to BlueSky...) has you covered... 😀 onlinelibrary.wiley.com/doi/10.1111/...

submitted 13 days ago • 0 comments

If you needed a reminder of the poor outcomes of patients with NECs, here you go. The current approach of platinum/etoposide yields the same disappointing results as in prior studies and outcomes of 2nd line therapy are poor. Better therapy sorely needed.

submitted 13 days ago • 0 comments

This is a valuable study on the changing epidemiology of colorectal NENs. Not surprisingly, there is increase in the incidence of well diff NETs but the incidence of NECs remains the same. Also not surprisingly, outcomes of colorectal NECs are poor. #oncsky

submitted 13 days ago • 0 comments

Liver resection in patients with high-grade neuroendocrine neoplasms, should that be considered...? Pts with G3 NET & NEC certainly have inferior outcomes but some may benefit from surgical debulking. Who are these patients? How can we better select? #oncsky www.sciencedirect.com/science/arti...

submitted 16 days ago • 0 comments

Performance of FDG PET in patients with CUP. Sensitivity and PPV were 58% and 92% and FDG PET therefore reasonable upfront imaging study. Others have reported similar findings but in our CUP clinic, the utility seems less. I would guess <30% sensitivity... www.thieme-connect.com/products/ejo...

submitted 16 days ago • 0 comments

Response assessment following PRRT in patients with metastatic NETs. Not as simple as one might have thought... Response heterogeneity in all patients in this small study. jnm.snmjournals.org/content/earl...

submitted 20 days ago • 0 comments

What to do with carcinoid crisis? 🦓 A frequent concern for patients with #NETs having surgery We put together an international 🌎🌍🌏 multidisciplinary expert consensus statement 📢 Now open for feedback! Sign-up here 🔗 surveymonkey.com/r/periopcarc... 📆 Open until March 3rd!

submitted 21 days ago • 1 comment

Is the other ALT, alternative lengthening of telomeres, ready for routine use in pts w/ resected panc NETs...? I think so. In this study of large pNETs (≥3cm), ALT+ provided added prognostic info on recurrence but was not associated with OS. #oncsky onlinelibrary.wiley.com/doi/10.1111/...

submitted 21 days ago • 1 comment

Type 2 DM (DM2) and new-onset DM2 are associated with higher risk of pan NETs but longstanding DM2 was not. Nonsignificant association with family hx of PDAC and inverse association with alcohol use. No association with smoking, obesity and aspirin use. erc.bioscientifica.com/view/journal...

submitted 22 days ago • 0 comments

Can the therapy of grade 3 neuroendocrine neoplasms be distilled down to a single slide? Not sure, but here is my attempt for the upcoming NANETS Regional Conference in Mexico City next weekend... Lots of low-ish quality data and I left out the NABNEC data on nab-pacli + carbo.

submitted 24 days ago • 0 comments

Functional imaging in NECs and much more... Check out this excellent paper. Lots of goodies in here such as >90% of NECs and G3 NETs FDG PET pos. Also, 66% of NECs pos on SSTR PET. What does that mean? The SSTR is not (yet) a good NEC target. erc.bioscientifica.com/view/journal...

submitted 25 days ago • 0 comments

Here is an excellent review on cervical NECs, a deadly disease often affecting young women. A paper dedicated to the late Dr. Michael Frumovitz, a true expert on this rare entity. www.sciencedirect.com/science/arti...

submitted 25 days ago • 1 comment

It is not surprising to see that not all G2 panc NETs are created equal. Why would pNET w/ Ki67 of 4% behave the same as 20%. Indeed, they don't. Time to split up the G2 to G2a and G2b w/ 12% cutoff? G2b clearly more aggressive, more mets etc. link.springer.com/article/10.1...

submitted 32 days ago • 0 comments

Unusual NET imaging this week: Tiny small bowel NET with metastasis to the right masticator space... Also a reminder that tiny sbNET primaries can have substantial mesenteric nodal mets. Stable without therapy but lanreotide was discontinued to to recurrent hypoglycemic episodes.

submitted 34 days ago • 1 comment

It’s a beautiful day in the Mayo neighborhood…

submitted 35 days ago • 0 comments

Just a reminder that NETs are radiosensitive tumors. Locally advanced, nonmetastatic, unresectable (extensive vascular involvement, cavernous portal vein transformation) G2 pancreatic NET (Ki67 9%). CAPTEM x12 with good partial response, followed by CRT with capecitabine. 23 mos post CRT #OncSky

submitted 36 days ago • 0 comments

Take good history and do a physical exam before ordering tests…

submitted 36 days ago • 0 comments

Another stressful morning commute… Soundtrack provided by Sturgill Simpson… 🤠

submitted 36 days ago • 1 comment

New epidemiology data on gastroenteropancreatic NETs (GEP-NETs) in the US. As I have said before and will continue saying, the incidence keeps rising (probably mostly from better diagnostic methods). jamanetwork.com/journals/jam...

submitted 41 days ago • 0 comments

Aspirin as an adjuvant therapy following resection and standard adjuvant chemo in colorectal cancer...? No statistical improvement in the primary endpoint, DFS but HR was 0.91 [CI 0.73-1.13] in this population and with this dose. Dead concept or not...? www.sciencedirect.com/science/arti...

submitted 41 days ago • 0 comments

Adjuvant chemo for resected intrahepatic cholangiocarcinoma (ICC)...? Yea or nay...? Admittedly, not an RCT but certainly not supportive of adj chemo. The baseline characteristics/risks may be subtly different among the groups. Data from NCDB + 2 institutions. link.springer.com/article/10.1...

submitted 43 days ago • 0 comments

Do you find fibrolamellar HCC as fascinating as I do...? Even if you do not, this is the review you need when it comes to diagnosing them... www.sciencedirect.com/science/arti...

submitted 43 days ago • 0 comments

I am not but are you...?

submitted 49 days ago • 0 comments

Want to know more about carcinoid heart disease (CHD)? If so, you might find this webinar by members the Mayo CHD team informative. Dr's. Juan Crestanello (Cardiothoracic Surgery), S. Allen Luis (Cardiology) and then an oncologist... cveducation.mayo.edu/lp/videos?vi...

submitted 54 days ago • 0 comments

Does radiosensitizing capecitabine improve the efficacy of PRRT in progressive GEPNETs...? This small phase II RCT does not suggest so and I remain thoroughly unconvinced that adding chemo to PRRT does anything beneficial. Big kudos to this team! jnm.snmjournals.org/content/earl...

submitted 55 days ago • 0 comments

Cystic panc NETs seem to have better prognosis than solid pNETs. Certainly not new info but by far the largest study I have seen and very clinically relevant. Can we observe localized cystic pNETs 3 cm and smaller...? oce.ovid.com/article/0000...

submitted 55 days ago • 0 comments

Avelumab in high-grade NETs and NECs. Although some stability was observed, the ORR was only 5% and the PFS 1.9 months. In line with other single-agent ICI trials in NECs. Hard to interpret this as a real clinical benefit if you ask me... Unimpressive... aacrjournals.org/clincancerre...

submitted 55 days ago • 0 comments

Raise your hand if you are surprised about this... I have never been as unsurprised by the results of a research paper... jamanetwork.com/journals/jam...

submitted 55 days ago • 0 comments

Need info on the rare acinar cell carcinoma of the pancreas (PACC)? 48% with resectable tumors and 5-yr OS following resection was 72% Outcomes of pts w/ metastatic and unresectable PACC are poor, 5-yr OS of 21%, seemingly better than PDAC. ascopubs.org/doi/pdf/10.1... #OncSky #HPBSky

submitted 57 days ago • 1 comment

Sometimes I feel like I only need to read the headline... 😄 www.bbc.com/news/article...

submitted 57 days ago • 1 comment

VIPoma... or not...? 60ish yo patient, worsening loose stools up to 5x/d, sometimes watery, most days of the month ≤ 3 BMs. Imaging below. VIP level 204 (ref:<89). EUS biopsy: Grade 1 NET. No mets but no SSTR PET yet. A few questions: 1) VIPoma or not? 2) Need for SSTR PET?

submitted 58 days ago • 1 comment

If anyone needs a good fig on nodal mets in panc NETs and how size affects the risk, here you go. Nothing new, no surprises there. Bigger tumors/higher grade -> more nodal mets. Some other goodies in there too... www.sciencedirect.com/science/arti...

submitted 62 days ago • 0 comments

My highly selected and heavily biased review of the tea and coffee literature continues. ☕️🫖 Now it also seems to prevent head and neck cancer. I will just stop at the abstract. That's all I need to know... 😀 acsjournals.onlinelibrary.wiley.com/doi/full/10....

submitted 66 days ago • 0 comments

🦓 Appendiceal NETs - exceedingly rare stage IV From single-centre at Moffitt 👥124 over 15 years ‼️10 stage IV👉🏻 8 synchronous Spread is rare - worth putting patients through right hemicolectomy ? Just in time for @nanets.bsky.social experts statement pubmed.ncbi.nlm.nih.gov/39705801/ 😃

submitted 73 days ago • 1 comment

Should I be staying in my lane of medical oncology…? Should a middle aged medical oncologist who still reads medicine outside of his specialty see a professional for help…? 😜 I still think clinical medicine is the best job in the world, regardless of your specialty…

submitted 72 days ago • 0 comments

Happy shortest commuting day of the year, for me at least as I was not working this weekend. The days are getting longer, or so I am told…

submitted 73 days ago • 0 comments

Can Rb1 and p53 IHC differentiate between G3 NETs and NECs? Not perfectly accurate but helpful still. 77% of G3 NETs w/ normal staining but only 6% of NECs. Small cell NECs more likely w/ Rb1 loss than large cell. link.springer.com/article/10.1...

submitted 76 days ago • 0 comments

Trends in the Management and Outcomes of Neuroendocrine Liver Metastases (NELM): Improving OS over time - 5- and 10-years OS 77.5% and 58.1% respectively and multimodal therapy strategies assouciated with better outcomes. In line with what we have seen. oce.ovid.com/article/0000...

submitted 76 days ago • 0 comments

My🔝 10 📝 of 2⃣0⃣2⃣4⃣ (cont'd) NETTER 2 in @TheLancet RCT - ☢️ PRRT vs long-acting SSA in G2/3 advanced GEP-NETs ⬆️ PFS by >12 months median HR 0.28 (0.18–0.42) Across all sub-groups 💥 New standard of care for 2025? 🦓 www.thelancet.com/journals/lan...

submitted 77 days ago • 1 comment