Ep. 74 Systemic Therapy Strategies for Treating…

About this episode

What first-line therapies should be considered for patients with higher-grade, metastatic neuroendocrine tumors (NETs)? In this new episode of BackTable Tumor Board, Drs. Lingling Du, Chih-Yi Liao, and Robert Ramirez discuss the use of systemic or radioligand therapies for metastatic well-differentiated NETs. --- Get the BackTable app https://www.backtable.com/app --- This podcast is supported by Novartis https://www.novartis.com/ --- Timestamps 00:00 - Introduction 02:31 - NGS Testing in NETs 05:45 - Starting with Somatostatin Analog (SSA) 08:01 - NETTER-2 Trial and Front-Line PRRT 11:58 - High Dose SSA After Progression 14:59 - Sequencing Systemic Therapy Options 18:56 - Picking the Right PRRT Candidate 21:28 - PRRT: Responses, Toxicities & Risks 31:58 - Lung NET Treatment Strategy 34:16 - Using Immunotherapy for Low-Grade NET 36:05 - First-Line Treatment for Poorly Differentiated Extrapulmonary Neuroendocrine Carcinoma 41:40 - What’s Next: Ongoing Clinical Trials --- More about this episode The doctors cover the use of next generation sequencing for newly diagnosed patients, highlighting that although results rarely changes upfront management, it can occasionally reveal actionable findings such as high tumor mutation burden and mismatch repair deficiency. In addition to NGS, care should prioritize imaging, pathology review, and multidisciplinary collaboration and planning. They then review several clinical trials, including the NETTER-2 and CLARNET FORTE trials to evaluate the role of peptide receptor radionuclide therapy (PRRT) and somatostatin analog (SSA) therapy while considering sequencing of multimodal treatments. The episode wraps up with ongoing and future clinical trials investigating other potential therapies for NETs. --- Resources Phase 3 NETTER-2 Trial https://pubmed.ncbi.nlm.nih.gov/38851203/ Phase 2 CLARINET FORTE Trial https://pubmed.ncbi.nlm.nih.gov/34597974/ Corticosteroid Prophylaxis for for Patient with Neuroendocrine Tumors https://pmc.ncbi.nlm.nih.gov/articles/PMC12609636/ Phase 3 CABINET Trial (Alliance A021602) https://pubmed.ncbi.nlm.nih.gov/41524552/ SWOG S2012 Trial https://www.asco.org/abstracts-presentations/213198 DAREON-Lung-1 Trial https://clinicaltrials.gov/study/NCT07472517 212-lead VMT-ɑ-NET Safety Study https://clinicaltrials.gov/study/NCT06148636 RayzeBio Phase 3 ACTION-1 Study https://www.ncf.net/clinical-trials-1/action-1%3A-alpha-prrt-with-ac-225-in-gep-nets RayzeBio Phase I RYZ401 Trial https://clinicaltrials.gov/study/NCT07165132 Phase I & II CHM-2101 Trial https://ascopubs.org/doi/10.1200/JCO.2026.44.16_suppl.2536 --- BackTable Tumor Board is the go-to multidisciplinary podcast for medical oncologists, surgical oncologists, and other healthcare professionals that play an active role in cancer care. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app