The NET Cancer community has adopted the zebra as our mascot, and international symbol. NET Cancers are often presented with symptoms of far more common illnesses such as Crohn’s Disease, irritable bowel syndrome, asthma, and rosacea. When diagnosing patients who present with varying symptoms, we need doctors to remember that when they hear hoof beats it could also be a ZEBRA… therefore –
“When you hear hoofbeats, sometimes it’s a ZEBRA”
What is NET Cancer?
Neuroendocrine tumors (NETs) can occur in any organ that has endocrine cells. Sometimes Neuroendocrine tumors are called carcinoid tumors. In excess of 100,000 people living with NET cancer in the United States.
- They are found in both adults and children.
- They appear most often in the small intestine, appendix, pancreas, and lungs but can also be found in the thyroid, breast, ovaries and prostate.
- NETs are difficult to diagnose and many patients have vague symptoms such as abdominal pain, flushing, or diarrhea for eight or nine years before the correct diagnosis is made.
- Tumors have often metastasized by the time they are diagnosed.
- NETs don’t respond to most chemotherapy drugs, and very few of the new targeted drugs are effective. Surgery is the only cure and once the NET has metastasized, it is difficult to remove the complete tumor.
What does more research on NET cancer mean?
Dana-Farber's Program in Neuroendocrine and Carcinoid Tumors
This program plays a critical role in developing and delivering novel treatments to combat neuroendocrine tumors in patients worldwide. Under the direction of Matthew Kulke, MD, MMSc and clinical director Jennifer Chan, MD, MPH, the Program's team of prominent physician-scientists is making significant progress in the fight against these tumors, expediting the development of new and more powerful therapies and treatment options for patients.
Matthew Kulke, MD
Director, Program in Neuroendocrine
and Carcinoid Tumors
Jennifer Chan, MD, MPH
Clinical Director, Program in Neuroendocrine
and Carcinoid Tumors
PIONEERING CLINICAL BREAKTHROUGHS
Kulke was closely involved in several key clinical studies that helped the drugs everolimus and sunitinib gain Food and Drug Administration approval in 2011—the first new drugs for the treatment of neuroendocrine tumors in nearly 30 years.
Today, the team at Dana-Farber continues to develop new drugs to safely and effectively treat patients with neuroendocrine tumors. Researchers are currently investigating several novel strategies to halt the process of angiogenesis—during which tumors grow and spread through the formation of new blood vessels—including a new clinical trial of aflibercept, an angiogenesis inhibitor.
In separate studies, researchers are also evaluating the safety and efficacy of somatostatin analogs, drugs that target tumor growth and excessive hormone secretion, and telotristat, a new drug that holds promise in controlling certain symptoms caused by carcinoid tumors.
TESTING NOVEL COMBINATION THERAPIES
Kulke and his team are testing various drug combinations to identify new targeted treatments for patients. In one recent study, they discovered that everolimus and the chemotherapy temozolomide can safely be used in combination.
Additionally, Dana-Farber investigators are leading an international clinical trial to evaluate a combination of everolimus and bevacizumab, an angiogenesis inhibitor. Their goal is to determine if this therapeutic strategy can effectively treat advanced or metastatic neuroendocrine tumors that cannot be removed surgically—ultimately providing patients with a new treatment option that was not previously available.
UNCOVERING MOLECULAR AND GENETIC DRIVERS
Our program has established the country’s largest database of neuroendocrine tumor samples, which investigators are using to better understand the underlying biology of these tumors.
For example, researchers recently studied vascular endothelial growth factor (VEGF), a protein that plays a key role in stimulating angiogenesis. They were able to identify the VEGF subtypes that are most closely associated with challenging tumors, as well as the subtypes that best respond to bevacizumab. With this knowledge, Dana-Farber physician-scientists are closer to identifying new ways to target and halt neuroendocrine tumor growth.