Neuroendocrine Tumors: Future Directions in Care

Matthew H. Kulke, MD: We really have multiple very promising directions right now to go in the neuroendocrine tumor field. One of those promising directions is peptide receptor radionuclide therapy. We have seen very exciting initial results in randomized trials. This type of therapy is increasingly used. One question is, how can you make PRRT, or peptide receptor radionuclide therapy, work even better? We probably have a number of ways this can happen. The other exciting area is one that we have been touching on already, and that is getting a better understanding of what is happening in the tumor microenvironment of neuroendocrine tumors. Why is it that they do not seem to be particularly responsive to immunotherapy alone? As we get a better understanding of what is going on in the immune environment, we will probably become a little bit smarter about how to use immunotherapy. Already we are seeing quite encouraging results with combinations of VEGF inhibitors and immunotherapy, certainly in tumors outside of the neuroendocrine tumor area. Given that we already know how effective VEGF inhibition can be in both pancreatic neuroendocrine tumors and now extrapancreatic neuroendocrine tumors, that looks like a really exciting direction to go in down the road.

Transcript edited for clarity.