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5. Use and perceived utility of [18 F]FDG PET/CT in neuroendocrine neoplasms: A consensus report from the European Neuroendocrine Tumor Society (ENETS) Advisory Board Meeting 2022.

Author

Ambrosini, V, Caplin, M, Castaño, JP, Christ, E, Denecke, T, Deroose, CM, Dromain, C, Falconi, M, Grozinsky-Glasberg, S, Hicks, RJ, Hofland, J, Kjaer, A, Knigge, UP, Kos-Kudla, B, Koumarianou, A, Krishna, B, Lamarca, A, Pavel, M, Reed, NS, Scarpa, A, Srirajaskanthan, R, Sundin, A, Toumpanakis, C, Prasad, V, Ambrosini, V, Caplin, M, Castaño, JP, Christ, E, Denecke, T, Deroose, CM, Dromain, C, Falconi, M, Grozinsky-Glasberg, S, Hicks, RJ, Hofland, J, Kjaer, A, Knigge, UP, Kos-Kudla, B, Koumarianou, A, Krishna, B, Lamarca, A, Pavel, M, Reed, NS, Scarpa, A, Srirajaskanthan, R, Sundin, A, Toumpanakis, C, and Prasad, V

Abstract

Somatostatin receptor (SST) PET/CT is the gold standard for well-differentiated neuroendocrine tumours (NET) imaging. Higher grades of neuroendocrine neoplasms (NEN) show preferential [18F]FDG (FDG) uptake, and even low-grade NET may de-differentiate over time. FDG PET/CT's prognostic role is widely accepted; however, its impact on clinical decision-making remains controversial and its use varies widely. A questionnaire-based survey on FDG PET/CT use and perceived decision-making utility in NEN was submitted to the ENETS Advisory Board Meeting attendees (November 2022, response rate = 70%). In 3/15 statements, agreement was higher than 75%: (i) FDG was considered useful in NET, irrespective of grade, in case of mis-matched lesions (detectable on diagnostic CT but negative/faintly positive on SST PET/CT), especially if PRRT is contemplated (80%); (ii) in NET G3 if curative surgery is considered (82%); and (iii) in NEC prior to surgery with curative intent (98%). FDG use in NET G3, even in the presence of matched lesions, as a baseline for response assessment was favoured by 74%. Four statements obtained more than 60% consensus: (i) FDG use in NET G3 if locoregional therapy is considered (65%); (ii) in neuroendocrine carcinoma before initiating active therapy as a baseline for response assessment (61%); (iii) biopsy to re-assess tumour grade prior to a change in therapeutic management (68%) upon detection of FDG-positivity on the background of a prior G1-2 NET; (iv) 67% were in favour to reconsider PRRT to treat residual SST-positive lesions after achieving complete remission on FDG of the SST-negative disease component. Multidisciplinary opinion broadly supports the use of FDG PET/CT for characterisation of disease biology and to guide treatment selection across a range of indications, despite the lack of full consensus in many situations. This may reflect existing clinical access due to lack of reimbursement or experience with this investigation, which should be add

Published
2024

11. Cellular dynamics and their impact on outcome in patients with mantle cell lymphoma during treatment with chimeric antigen receptor (CAR) T cells

Author

Weiss, R., primary, Fernandez, C. P., additional, Boldt, A., additional, Hoffmann, S., additional, Krauss, S., additional, Bach, E., additional, Kirchberg, J., additional, Kurch, L., additional, Merz, M., additional, Metzeler, K., additional, Herling, C., additional, Jentzsch, M., additional, Schwind, S., additional, Petermann, N., additional, Franz, P., additional, Herling, M., additional, Denecke, T., additional, Sabri, O., additional, Fricke, S., additional, Kluge, R., additional, Sack, U., additional, Franke, G., additional, Koehl, U., additional, Platzbecker, U., additional, Georgi, T., additional, and Vucinic, V., additional

Published
2023
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17. Standards und Entwicklungen in der Behandlung von Cholangiokarzinomen

Author

Wege, H., Denecke, T., Petersen, C., Seehofer, D., and Sinn, M.

Abstract

Gallengangskarzinome werden entsprechend ihrer Lokalisation in distale, perihiläre und intrahepatische Cholangiokarzinome (CCA) unterteilt. Neben unterschiedlichen Risikofaktoren spiegelt diese Unterteilung auch jeweils spezifische Mutationsprofile wider. Eine definitive Diagnose kann schwierig sein, ist bei typischen morphologischen Befunden in der Bildgebung vor einer kurativ intendierten Resektion aber nicht unbedingt erforderlich. Aufgrund der häufig erforderlichen sehr komplexen hepatobiliären chirurgischen Eingriffe und der Vielzahl an transduktalen, angiographischen und perkutanen lokoregionären Therapieverfahren sollten Patienten mit CCA an einem Zentrum mit entsprechender Expertise vorgestellt werden. Mehrere Phase-III-Studien haben die Wirksamkeit einer adjuvanten Chemotherapie untersucht, die aktuell mit Capecitabin oder im Rahmen der ACTICCA-1-Studie erfolgen soll. Auch für die onkologische Systemtherapie liegen für die Erstlinientherapie mit Gemcitabin/Cisplatin in der ABC-02-Studie und für die Zweitlinientherapie mit Oxaliplatin und 5‑Fluorouracil in der ABC-06-Studie positive Ergebnisse aus prospektiven und randomisierten Studien vor, sodass hier Standards definiert werden können. Aktuell untersuchen laufende Studien die Wirksamkeit irinotecanbasierter Regime in der Zweitlinie sowie Kombinationstherapien mit Checkpointinhibitoren in der Erstlinie. Die höchste und vielversprechendste Studienaktivität findet zur zielgerichteten Therapie bei Nachweis spezifischer Mutationen statt, die sich für intra- und extrahepatische CCA unterschieden. Positive Daten liegen bereits für intrahepatische CCA mit Mutationen in der Isocitratdehydrogenase 1 vor. Hier ist Ivosidenib als Zweitlinientherapie wirksam.

Published
2024
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21. European Neuroendocrine Tumor Society 2023 guidance paper for functioning pancreatic neuroendocrine tumour syndromes.

Author

Hofland, Johannes, Falconi, Massimo, Christ, Emanuel, Castaño, Justo P., Faggiano, Antongiulio, Lamarca, Angela, Perren, Aurel, Petrucci, Simona, Prasad, Vikas, Ruszniewski, Philippe, Thirlwell, Christina, Vullierme, Marie‐Pierre, Welin, Staffan, Bartsch, Detlef K., Begum, N., Capdevila, J., Couvelard, A., De Mestier, L., Denecke, T., and Fazio, N.

Subjects
NEUROENDOCRINE tumors, INSULINOMA, PANCREATIC tumors, SYNDROMES, CARCINOID, MEDICAL personnel
Abstract

This ENETS guidance paper aims to provide practical advice to clinicians for the diagnosis, treatment and follow‐up of functioning syndromes in pancreatic neuroendocrine tumours (NET). A NET‐associated functioning syndrome is defined by the presence of a clinical syndrome combined with biochemical evidence of inappropriately elevated hormonal levels. Different hormonal syndromes can be encountered in pancreatic NET patients, including insulinoma, gastrinoma as well as the rare glucagonoma, VIPoma, ACTHoma, PTHrPoma, carcinoid syndrome, calcitoninoma, GHRHoma and somatostatinoma. The recommendations provided in this paper focus on the biochemical, genetic and imaging work‐up as well as therapeutic management of the individual hormonal syndromes in well‐differentiated, grade 1‐3, functioning NET with the primary tumour originating in the pancreas, and for specific subtypes also in the duodenum. [ABSTRACT FROM AUTHOR]

Published
2023
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25. Definitions and treatment of oligometastatic oesophagogastric cancer according to multidisciplinary tumour boards in Europe

Author

Kroese, T.E. van Hillegersberg, R. Schoppmann, S. Deseyne, P.R.A.J. Nafteux, P. Obermannova, R. Nordsmark, M. Pfeiffer, P. Hawkings, M.A. Smyth, E. Markar, S. Hanna, G.B. Cheong, E. Chaudry, A. Elme, A. Adenis, A. Piessen, G. Gani, C. Bruns, C.J. Moehler, M. Liakakos, T. Reynolds, J. Morganti, A. Rosati, R. Castoro, C. D'Ugo, D. Roviello, F. Bencivenga, M. de Manzoni, G. Jeene, P. van Sandick, J.W. Muijs, C. Slingerland, M. Nieuwenhuijzen, G. Wijnhoven, B. Beerepoot, L.V. Kolodziejczyk, P. Polkowski, W.P. Alsina, M. Pera, M. Kanonnikoff, T.F. Nilsson, M. Guckenberger, M. Monig, S. Wagner, D. Wyrwicz, L. Berbee, M. Gockel, I. Lordick, F. Griffiths, E.A. Verheij, M. van Rossum, P.S.N. van Laarhoven, H.W.M. Rosman, C. Rütten, H. Gootjes, E.C. Vonken, F.E.M. van Dieren, J.M. Vollebergh, M.A. van der Sangen, M. Creemers, G.-J. Zander, T. Schlößer, H. Cascinu, S. Mazza, E. Nicoletti, R. Damascelli, A. Slim, N. Passoni, P. Cossu, A. Puccetti, F. Barbieri, L. Fanti, L. Azzolini, F. Ventoruzzo, F. Szczepanik, A. Visa, L. Reig, A. Roques, T. Harrison, M. Ciseł, B. Pikuła, A. Skórzewska, M. Vanommeslaeghe, H. Van Daele, E. Pattyn, P. Geboes, K. Callebout, E. Ribeiro, S. van Duijvendijk, P. Tromp, C. Sosef, M. Warmerdam, F. Heisterkamp, J. Vera, A. Jordá, E. López-Mozos, F. Fernandez-Moreno, M.C. Barrios-Carvajal, M. Huerta, M. de Steur, W. Lips, I. Diez, M. Castro, S. O'Neill, R. Holyoake, D. Hacker, U. Denecke, T. Kuhnt, T. Hoffmeister, A. Kluge, R. Bostel, T. Grimminger, P. Jedlička, V. Křístek, J. Pospíšil, P. Mourregot, A. Maurin, C. Starling, N. Chong, I. OMEC working group

Abstract

Background: Consensus about the definition and treatment of oligometastatic oesophagogastric cancer is lacking. Objective: To assess the definition and treatment of oligometastatic oesophagogastric cancer across multidisciplinary tumour boards (MDTs) in Europe. Material and methods: European expert centers (n = 49) were requested to discuss 15 real-life cases in their MDT with at least a medical, surgical, and radiation oncologist present. The cases varied in terms of location and number of metastases, histology, timing of detection (i.e. synchronous versus metachronous), primary tumour treatment status, and response to systemic therapy. The primary outcome was the agreement in the definition of oligometastatic disease at diagnosis and after systemic therapy. The secondary outcome was the agreement in treatment strategies. Treatment strategies for oligometastatic disease were categorised into upfront local treatment (i.e. metastasectomy or stereotactic radiotherapy), systemic therapy followed by restaging to consider local treatment or systemic therapy alone. The agreement across MDTs was scored to be either absent/poor (

Published
2022

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