Panelists: Simron Singh, MD, Odette Cancer Centre; Jonathan R. Strosberg, MD Moffitt Cancer Center
Simron Singh, MD: Are there any other unmet needs that you haven’t seen advances on that you’d like to see advances on, Jon, in the years to come?
Jonathan R. Strosberg, MD: Undoubtedly, the poorly differentiated neuroendocrine carcinomas are the highest area of unmet need. We still have the same platinum/etoposide regimen that has been used for the last 3 or 4 decades, and, as of yet, we have no second-line therapy. As we just discussed, immunotherapy has been a bit of a disappointment so far. There may be some other data coming out of Asia suggesting a higher response rate, but I think those patients may have been selected more for PD-L1 [programmed death-ligand 1] positivity. Maybe it’s just a different population that’s being evaluated there. In my opinion, that’s the greatest area of need.
Simron Singh, MD: I would agree. I think the poorly differentiated neuroendocrine carcinomas are definitely where we have gaps. That patient group really needs new effective treatments. In terms of immunotherapy, maybe I’m a bit more of a glass half full person, but I still see potential. As we’re understanding the inflammatory milieu of neuroendocrine tumors, I’m excited to see if there is potential.
So this has been great, Jon. I think this has been incredibly informative. Before we end this discussion, I just wanted to know if there is anything else that we haven’t mentioned that you think is important to our audience when we’re discussing neuroendocrine tumors?
Jonathan R. Strosberg, MD: I think we’ve covered all of the important topics. We’ve emphasized the importance of multidisciplinary care and the fact that there is an expanding number of treatments. This is really a disease where patients benefit from centers that treat a large number of patients and have access to different treatments that may not be available in the community. I think that would be the take-home message for this dialogue.
Simron Singh, MD: I agree. One of the things that is important to emphasize is the heterogeneity of neuroendocrine tumors and the importance of trying to understand the different characteristics that define each patient’s neuroendocrine tumor. We need to treat each patient as an individual and understand that no 2 neuroendocrine tumors may be quite alike. We have to tailor our treatment accordingly to get the results that we want.
So Jon, thank you very much for all of your contributions. This has been an excellent discussion. On behalf of Jon and myself, we thank the audience for joining us and hope you found this OncLive Peer Exchange® to be useful and very informative.