CAR-T and Radioligand Therapies for Treatment of NETS

The specialists discussed the future of neuroendocrine tumor (NET) therapy, highlighting emerging modalities such as CAR T-cell therapy and antibody-drug conjugates. Dr. Arshad emphasized that CAR T therapy, though early in development for NETs, has the potential to transform the treatment landscape by targeting tumor-specific antigens such as somatostatin receptors or CDH17, which are also expressed in other GI cancers. Early experience from hematologic malignancies shows deep, antigen-directed responses, but translating this to solid tumors presents challenges including antigen heterogeneity and oO-tumor toxicity. Strategies to overcome these hurdles include careful antigen selection, engineered safety switches, regional delivery, dose titration, and rigorous monitoring for CRS and neurotoxicity. While NETs have lagged behind other cancers in these innovations, there is significant potential for rapid progress, with ongoing research in cell-based therapies and antibody-drug conjugates poised to expand treatment options for patients who have exhausted conventional therapies like SSAs, PRRT, and targeted agents.