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Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

1714 - The Commonwealth Neuroendocrine Tumour Collaboration (CommNETs) and North American Neuroendocrine Tumor Society (NANETS) Endorsement and Update of European Neuroendocrine Tumor Society (ENETS) Best Practice Consensus for Lung Neuroendocrine Tumors (LNET)

Date

21 Oct 2018

Session

Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

Presenters

Eva Segelov

Citation

Annals of Oncology (2018) 29 (suppl_8): viii467-viii478. 10.1093/annonc/mdy293

Authors

E. Segelov1, E. Bergsland2, C. Card3, T. Hope4, P. Kunz5, D. Laidley6, B. Lawrence7, S. Leyden8, M. Michael9, L. Modahl10, S. Myrehaug11, S. Padda12, R. Pommier13, R. Ramirez14, M. Soulen15, J. Strosberg16, A. Thawer17, B. Wei18, S. Singh11

Author affiliations

  • 1 Oncology, Monash University and Monash Health, 3168 - Clayton/AU
  • 2 Division Of Hematology/oncology, University of California, San Francisco/US
  • 3 Oncology, Tom Baker Cancer Centre, Calgary/CA
  • 4 Biomedical Imaging, University of California San Francisco, San Francisco/US
  • 5 School Of Medicine, Stanford University, California/US
  • 6 Division Of Nuclear Medicine, London health Sciences Centre, London/CA
  • 7 Oncology, University of Auckland Faculty of Medical & Health Sciences, 1703 - Auckland/NZ
  • 8 Management, Unicorn Foundation, Blairgowrie/AU
  • 9 Medical Oncology, Peter MacCallum Cancer Centre, 3000 - Melbourne/AU
  • 10 Auckland City Hospital, Auckland Radiology Group, Auckland/NZ
  • 11 Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto/CA
  • 12 Stanford Cancer Institute, Stanford University School of Medicine, California/US
  • 13 Oncology, Oregon Health & Science University, Portland/US
  • 14 Oncology, Ochsner Medical Centre, Jefferson/US
  • 15 University Of Pennsylvania, Abramson Cancer Centre, Philadephia/US
  • 16 Gi Oncology, H. Lee Moffitt Cancer Center University of South Florida, 33612 - Tampa/US
  • 17 Odette Cancer Center, Sunnybrook Health Sciences Centre, M4N 3M5 - Toronto/CA
  • 18 Oncology, University of Alabama-Birmingham Medical Centre, Birmingham/US
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Resources

Abstract 1714

Background

Despite LNETs increasing in incidence and prevalence, little data exists about natural history and response to various therapies. Management is often based on expert opinion and extrapolation from other NETS. CommNETS and NANETS undertook a rigorous consensus process to endorse and update the 2015 ENETS guidelines (1).

Methods

An endorsement approach based on the AGREE II processes (2) was undertaken by a 4 nation, 22 member CommNETS/NANETS panel, including experts from: surgery, pulmonology, medical and radiation oncology, nuclear medicine, pathology, pharmacy and patients/advocates. Two members assessed content and quality of the 52 ENETS statements using the Rigour of Development subscale. A systematic literature and abstract search since 2013 was conducted. Topic experts reviewed relevant ENETS statements and new data, using a patient-centered care perspective and a LNET-specific focus, to provide justification for endorsement or modification and to define a single important unanswered question. Statements were subsequently discussed by the entire panel at a face-to-face meeting and graded using Oxford criteria (3).

Results

230 relevant new studies were identified. Of the 20 ENETS statements relating to management strategies, 4 were endorsed, 16 modified and 3 added (see table). A set of important unanswered questions will inform future studies.Table: 1322P

TherapyMain change
Surgeryupdated techniques for localized disease modified followup protocol expanded indication for liver cytoreduction
Adjuvantnot recommended
Locoregionaloptional for slow growing disease
Hormoneprophylaxis of carcinoid crisis added
PRRTbroadened to all SSTR-expressing tumours
Chemotherapynewer data on temozolomide-based regimens included
Targetedevidence for everolimus upgraded new statement, not supporting use of anti-angiogenics
Radiotherapypalliative use for local symptoms added

Conclusions

Through the consensus process, guidelines for LNETS were updated to include recent evidence and practice changes. The guidelines provide clear, evidenced based statements to harmonise treatment of LNETS internationally. Refs: 1.Caplin, Ann Oncology (2015):1604-1620. 2. http://www.agreetrust.org/resource-centre/agree-ii-as-a-practice-guideline-development-framework/ (30.4.18) 3. http://www.cebm.net/index.aspx?o=5653 (30.4.18).

Clinical trial identification

Legal entity responsible for the study

Australian Gastrointestinal Trials Group.

Funding

Ipsen Pty Ltd.

Editorial Acknowledgement

Disclosure

E. Segelov: Attendeded Advisory board: Ipsen Global. Ipsen funds CommNETS through an unrestricted grant to AGITG. This work was carried out by CommNETS. There was no involvement of Ipsen in any aspect of this research. All other authors have declared no conflicts of interest.

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