Neuroendocrine
tumors (NETs) describe a heterogeneous group of
tumors with a wide range of morphologic, functional, and behavioral characteristics. Pancreatic
neuroendocrine tumors (
pNET) are a subset of NETs which are increasing in incidence and prevalence. These
tumors are generally slow growing and behave in an indolent fashion. However, when these
tumors spread they can be life threatening and difficult to treat with current modalities. In 2011, the landscape of treatment for
pNET was changed with the approval of two targeted agents,
sunitinib and
everolimus, the first new
therapies for this disease in over 20 years. Data from these clinical trials and extensive preclinical work into the underlying molecular pathways in
neuroendocrine tumors has generated intense interest in the quest to identify additional effective agents in this challenging disease. At the 2012 American Society of Clinical Oncology (ASCO) Annual Meeting, several researchers presented updated data regarding the use of targeted agents, alternative chemotherapeutic agents and combinations of these in the treatment of
pNET. Corrie et al. (Abstract #4121) reported data from a
chemotherapy clinical trial replacing
5-FU with
capecitabine and evaluating the addition of
cisplatin in NETs. Several authors reviewed the addition of the anti
VEGF monoclonal antibody bevacizumab into combination
therapy. Ducreux et al (Abstract #4036) presented results from a trial of
chemotherapy plus
bevacizumab while Firdaus et al. (Abstract #4127) reported the results of combination
therapy with
octreotide,
bevacizumab, and
pertuzumab. Hobday et al. (Abstract #4048) reported positive results of an interim analysis of combination
therapy with an mTOR inhibitor and
bevacizumab. Kulke et al (Abstract #4125) reported the results of a clinical trial utilizing an antibody targeting the
insulin growth factor receptor. Finally, Vinik et al. (Abstract #4118) provided updated survival data form the seminal phase III trial that led to approval of
sunitinib in the treatment of
pNET. The authors review and summarize these abstracts in this article.