Preface – NANETS 2022

© private - Mauro Cives, MD, Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", Bari, Italy

© private – Mauro Cives, MD, Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, Bari, Italy

Dear colleagues,

Members of the professional neuroendocrine community gathered at the North American Neuroendocrine Tumor Society (NANETS) Symposium that took place in Washington, D.C., from 27th to 29th October 2022 to discuss new therapeutic options and the future of neuroendocrine tumor research.  The scientific program, featuring 16 oral- and 91 poster presentations, made the NANETS tagline “educating medical and professional researchers in the diagnosis and treatment of NET disease, and supporting research and innovation in the field”, more than just a slogan.

This report features three of the most actively investigated areas in the field: advances in peptide receptor radionuclide therapy (PRRT), potential applications of “passive” and “active” immunotherapy and novel biomarkers.

Not surprisingly, PRRT has been a major topic of discussion at this year’s Symposium. Head-to-head investigations comparing PRRT to other approved agents are starting to answer some of the most burning questions in the field, and the results of the COMPOSE trial, comparing the β-emitter 177Lu-DOTATOC to the best standard of care will certainly shape the treatment algorithm of the next decades. The growing interest in α-emitter therapy was reflected in a number of presentations, with preliminary data on 212Pb-DOTAMTATE supporting the potential of α-emitters to improve the efficacy of PRRT. Combinations of PRRT with epigenetic agents or drugs targeting the DNA repair pathways are under active scrutiny, and some preclinical studies are summarized here.

The latest advances in immunotherapy for NETs, despite the disappointing activity of immune checkpoint inhibitors as monotherapy, are also highlighted in this report. Here, the combination of tislelizumab plus surufatinib showed encouraging antitumor activity, while the future of oncolytic viruses appears potentially promising, as indicated by preliminary data from early-phase trials and preclinical studies presented at NANETS. Other novel immunotherapies presented include anti-SSTR CAR T cells, a survivin-targeting vaccine, and a hormone-based BiTE.

Finally, this report focuses on the importance of finding reliable biomarkers that can predict the response to standard treatments. In MEN1-mut/DAXX-wt pancreatic NET patients, the MEN1 mutation was positively associated with CAPTEM response compared to other genomic profiles. Moreover, a novel method, known as optical genome mapping (OGM) that allows for the identification of genomic structural variants in metastatic NETs was presented. Of note, OGM combined with short-read sequencing technologies, may be a promising tool to improve the molecular characterization of NETs.

Once again, the NANETS Symposium highlighted the importance of multidisciplinarity and collaborations for accelerating cutting-edge NET research – establishing new standards of care with an eye to even better outcomes for diagnosing and treating NET patients.

We hope you enjoy reading this special memo inOncology issue.

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