Pulmonary neuroendocrine neoplasms: the molecular landscape, therapeutic challenges, and diagnosis and management strategies

The Lancet Oncology, Journal Year: 2025, Volume and Issue: 26(1), P. e13 - e33

Published: Jan. 1, 2025

Language: Английский

---

Artificial intelligence for diagnosis and predictive biomarkers in Non-Small cell lung cancer Patients: New promises but also new hurdles for the pathologist

Lung Cancer, Journal Year: 2025, Volume and Issue: 200, P. 108110 - 108110

Published: Jan. 27, 2025

Language: Английский

---

Staging Gallium-68 DOTATATE PET/CT Imaging in Neuroendocrine Tumors: Relationship between Measured SUVmax of the Primary Tumor and the Pathological Grade and Ki-67 Proliferation Index

Hitit Medical Journal, Journal Year: 2025, Volume and Issue: 7(1), P. 101 - 108

Published: Feb. 25, 2025

Objective: To determine whether the maximum standardized uptake value (SUVmax) of primary lesion measured via Ga-68 DOTATATE PET/CT imaging can be used to predict histological grade and Ki-67 proliferation index in treatment-naïve neuroendocrine tumors (NETs). Material Method: A total 57 patients diagnosed with NET who underwent between January 2021 April 2024 were retrospectively evaluated. Patient data including age, histopathology, tumor localization, size, index, grade, SUVmax values from same recorded. Histological grades 2 3 pooled into a single group (grade 2&3). Results: The mean age was 49.44 ± 17.20 years. most common biopsy locations liver (28.07%), stomach (21.05%), pancreas (19.30%). Median 5 (interquartile range: 2–8). Grade 1 present 19 (33.33%), 35 (61.40%), (5.26%). positively correlated size mitotic count. Patients 2&3 had significantly higher older compared those tumors. For predicting tumors, an area under ROC curve 0.669 (95% CI: 0.526–0.811, p=0.039), which yielded overall accuracy 64.91%, 57.89% sensitivity, 78.95% specificity, 84.62% positive predictive value, 48.39% negative at cut-off >12.5. Conclusion: Initial NETs demonstrated that is index. threshold >12.5 g/ml shown distinguish early stage high value.

Language: Английский

---

Pathological & radiological variables in the diagnosis of bronchopulmonary carcinoids (BPCs) with a focus on Antigen Kiel 67 (Ki-67) proliferation index

Lung Cancer, Journal Year: 2025, Volume and Issue: 202, P. 108493 - 108493

Published: March 11, 2025

Language: Английский

---

Peptide receptor radionuclide therapy with somatostatin analogs beyond gastroenteropancreatic neuroendocrine tumors

Journal of Neuroendocrinology, Journal Year: 2025, Volume and Issue: unknown

Published: March 10, 2025

Abstract First isolated by Brazeau et al. in 1972, somatostatin (SST) is a neuropeptide known for regulating various signaling pathways through its specific cell surface receptors. Somatostatin receptors (SSTRs) comprise family of five G protein‐coupled that are widely distributed across the human body and expressed tumor types. The growing understanding their clinical potential led to introduction both cold radiolabeled analogs (SSAs), which have revolutionized management several cancers, especially neuroendocrine tumors. As direct consequence, advances peptide receptor radionuclide therapy (PRRT) over last 30 years approval 177 Lu‐DOTATATE treatment gastroenteropancreatic tumors (GEPNETs). Theoretically, any cancer patients whose express SSTR, as demonstrated vivo SSTR‐based molecular imaging, could be candidates PRRT, those with limited options. However, evidence on efficacy PRRT non‐GEPNET SSTR‐expressing limited, mainly derived from small retrospective studies. Given therapeutic options advanced/metastatic patients, there clear need randomized trials formally approve SSAs who may benefit this treatment, particularly certain types neoplasms such lung carcinoids, paragangliomas, meningiomas, where high rates disease control (up 80%) can achieved. In addition, emerging supports combination therapies, alpha emitters, non‐SSTR‐based beyond GEPNET. This review aims provide comprehensive overview PRRT's role cancers GEPNET, exploring new possibilities future directions most SSTR highly expressing

Language: Английский

---

Application of Radiomics for Differentiating Lung Neuroendocrine Neoplasms

Diagnostics, Journal Year: 2025, Volume and Issue: 15(7), P. 874 - 874

Published: March 31, 2025

Background/Objectives: Lung neuroendocrine neoplasms (NENs) are a heterogeneous group of tumors requiring accurate differentiation from non-small cell lung cancer (NSCLC) for effective treatment. Conventional computed tomography (CT) lacks pathognomonic features to distinguish these subtypes. Radiomics, which extracts quantitative imaging features, offers potential solution. Methods: This retrospective multicenter study included 301 patients with histologically confirmed who underwent native CT scans. The dataset comprised 150 NSCLC cases (75 adenocarcinomas, 75 squamous carcinomas) and 151 NENs SCLC, 60 carcinoids, 16 large carcinomas). Tumors were manually segmented, 107 radiomics extracted. Dimensionality reduction feature selection performed using Pearson correlation analysis LASSO regression. Decision tree random forest classifiers trained evaluated 70:30 training-testing split. Model performance was assessed the area under receiver operating characteristic curve (AUC), accuracy, precision, recall, F1-score. Results: model differentiating achieved an AUC 0.988 on test set, accuracy 97.8%. distinguishing SCLC other attained 0.860 82.6%. First-order textural key discriminators. Conclusions: Radiomics-based machine learning models demonstrated high diagnostic in subclassifying NENs. These findings highlight as non-invasive, tool diagnosis, warranting further validation larger studies.

Language: Английский

---

Absence of orthopaedia homeobox protein (OTP) expression is associated with disease spread and adverse outcome in pulmonary carcinoid tumour patients

Virchows Archiv, Journal Year: 2024, Volume and Issue: unknown

Published: June 19, 2024

Abstract Pulmonary carcinoid (PC) tumours typically have a good prognosis, although metastases occur, and the disease may progress after long period of time. Expression orthopaedia homeobox protein (OTP) has been recognized as possible independent prognostic marker in PCs. Immunohistochemical (IHC) OTP expression associated with better but staining yet to be implemented routine clinical diagnostics. In response this, two new monoclonal antibodies were recently developed. This retrospective study included 164 PC patients operated on at Helsinki University Hospital between 1990 2020. Tissue microarray slides, prepared from formalin-fixed paraffin-embedded primary tumour samples, stained IHC using one polyclonal novel antibodies. Absence was shorter disease-specific survival (DSS) progression ( p < 0.001). Patients without had 5-year DSS 73–79%, whereas 91–94% expression, depending antibody. univariable Cox regression model, absence adverse outcome along atypical histological subtype, metastatic disease, Ki-67 proliferation index > 1%, larger size. multivariable only lymph node involvement time diagnosis risk worse prognosis. All three showed concordance each other. Our findings support role an PCs applicability use

Language: Английский

---

Pulmonary large cell neuroendocrine carcinoma — diagnostic and therapeutic clinical dilemmas

Oncology in Clinical Practice, Journal Year: 2024, Volume and Issue: unknown

Published: July 4, 2024

Pulmonary large cell neuroendocrine carcinoma (LCNEC) belongs to a heterogeneous group of lung cancers that show morphological, ultrastructural, and immunohistochemical similarities but differ in etiopathogenesis, molecular profile, clinical course, prognosis, treatment. The prognosis for pulmonary LCNEC is extremely poor, median overall survival usually does not exceed one year. According the 2015 classification World Health Organization, LCNECs belong tumors, along with typical atypical carcinoid tumors small cancer (SCLC). optimal therapeutic approach patients has yet been determined. Accurate diagnosis crucial, management algorithms should be developed on basis multicenter prospective trials. This review presents diagnosing criteria reviews effectiveness available options.

Language: Английский

---

Neuroendocrine tumors of the lung: state of the art

Deleted Journal, Journal Year: 2024, Volume and Issue: 17(1), P. 2 - 8

Published: Feb. 9, 2024

Zusammenfassung Neuroendokrine Neoplasien (NEN) machen zirka ein Fünftel aller Lungenmalignome aus, meist liegt dabei das kleinzellige Bronchuskarzinom (SCLC) vor. Die gut differenzierten neuroendokrinen Tumoren (NET) der Lunge (auch als Lungenkarzinoide bezeichnet) sind hingegen selten. Prognose ist im Allgemeinen günstig, mit 10-Jahres-Überlebensraten von 60 % für typische Karzinoide (NET G1) und 20 atypische G2) metastasierten Stadium. Klinisch gesehen können NET – wenn auch selten hormonelle Syndrome aufweisen (beispielsweise Karzinoidsyndrom oder Cushing-Syndrom). Interessanterweise haben diese eine niedrige Mutationsrate, wobei am häufigsten Epigenetik-relevante Gene mutiert sind. Zu den Behandlungsstrategien Lungen-NET gehören die chirurgische Resektion (als potenziell kurative Intervention lokalisierten Stadium), Watch-and-wait-Vorgehen in ausgewählten Fällen systemische Therapieoptionen. Everolimus einzige zugelassene Therapie führte Placebo-kontrollierten Zulassungsstudie zu einer Verlängerung des progressionsfreien Überlebens (PFS; medianes PFS 9,2 Monate unter versus 3,6 Placebo-Kohorte). Trotz fehlender formeller Zulassung dieser Indikation Somatostatinanaloga weitere Leitlinien empfohlene (wie Peptidrezeptor-Radionuklidtherapie) eingesetzt werden, sofern Somatostatin-Rezeptorbesatz vorliegt. Weitere Behandlungsoptionen vor allem Chemotherapien, z. B. Temozolomid- Oxaliplatin-basierte Kombinationen, während Immuntherapien molekular gematchte Therapien bisher keine relevanten Effekte gezeigt haben.

---

Pathological & Radiological Variables in the Diagnosis of Bronchopulmonary Carcinoids (Bpcs) with a Focus on Antigen Kiel 67 (Ki-67) Proliferation Index

Published: Jan. 1, 2024

Language: Английский

---