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

Author:

Varghese Diana Grace1,Del Rivero Jaydira1ORCID,Bergsland Emily2ORCID

Affiliation:

1. Developmental Therapeutics Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 94158, USA

2. UCSF Helen Diller Family Comprehensive Cancer Center and Department of Medicine, University of California, San Francisco (UCSF), San Francisco, CA 94158, USA

Abstract

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.

Publisher

MDPI AG

Subject

Cancer Research,Oncology

Reference95 articles.

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3. Overview of the 2022 WHO Classification of Neuroendocrine Neoplasms;Rindi;Endocr. Pathol.,2022

4. WHO Classification of Tumours Editorial Board (2022). WHO Classification of Endocrine and Neuroendocrine Tumours, IARC.

5. Neuroendocrine Tumor Heterogeneity Adds Uncertainty to the World Health Organization 2010 Classification: Real-World Data from the Spanish Tumor Registry (R-GETNE);Capdevila;Oncologist,2018

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