Narrative Review of Immunotherapy in Gastroentero-Pancreatic Neuroendocrine Neoplasms
Round 1
Reviewer 1 Report
Thank you for the interesting review.
I miss more introduction. Why is it interesting to investigate immune therapy in GEP-NENs? It is not clear.
You describe NEN G3, but not NET G3 and NEC. Is there a difference in effect?
Please describe the studies from Table 1 more thoroughly.
More comment:
- The aim of the paper is to report the studies on GEP-NENs and immune therapy. The strength is that has included all studies. The weaknesses is that there are only few studies, the studies are relatively small, and that there is no information on overall survival, but only PFS.
- +3. The Introduction needs to be more thorough. It is not clear why immune therapy is interesting in NEN.
- The NEN G3 pools NET G3 and NEC. Is it possible to divide the two tumor entities with respect to response to immune therapy?
- The studies in Table 1 are not described as much, please elaborate on the studies and the results.
- I miss a paragraph where the scientific limitations of the studies are described. Preferably before "Conclusion".
Author Response
Comments and responses
I miss more introduction. Why is it interesting to investigate immune therapy in GEP-NENs? It is not clear.
Response: Thank you for the reviews. We have elaborated the introduction and special focus on the role of immunotherapy in GEP-NEN.
You describe NEN G3, but not NET G3 and NEC. Is there a difference in effect?
Response: Thank you for your comments. In the review, most studies don't differentiate between neuroendocrine carcinoma (NEC) and neuroendocrine tumors (NET), so we will focus our review on NEN and elaborate on the selected cohort.
Please describe the studies from Table 1 more thoroughly.
Response: Your comments are greatly appreciated. Table 1 elaborated with more information added in the text.
More comment:
- The aim of the paper is to report the studies on GEP-NENs and immune therapy. The strength is that has included all studies. The weaknesses is that there are only few studies, the studies are relatively small, and that there is no information on overall survival, but only PFS.
Response: Thank you so much for your comments
2. The Introduction needs to be more thorough. It is not clear why immune therapy is interesting in NEN.
Response: The intriguing avenue for the role of immunotherapy in NEN added in the introduction.
3. The NEN G3 pools NET G3 and NEC. Is it possible to divide the two tumor entities with respect to response to immune therapy?
Response: Thank you for your comments. In the review, most studies don't differentiate between neuroendocrine carcinoma (NEC) and neuroendocrine tumors (NET), so we will focus our review on NEN and elaborate on the selected cohort.
4. The studies in Table 1 are not described as much, please elaborate on the studies and the results.
Response: The studies with available data described in the Table 1.
5. I miss a paragraph where the scientific limitations of the studies are described. Preferably before "Conclusion".
Response: Scientific limitation section added in the manuscript.
Reviewer 2 Report
Congratulations to the authors for their strenuous effort to retrieve all current bibliography on immunotherapy regarding NENs and for their comprehensive review. The manuscript has been evaluated as a narrative review, based on the SANRA quality assessment scale (Baethge 2019, doi: 10.1186/s41073-019-0064-8). Here follow my comments:
1) The title should include the identification "a narrative review (of)...".
2) The importance of the research topic has been adequately justified in the Introduction.
3) The authors have made a concrete statement on the purpose of the article.
4) Description of the literature search (i.e. years of consideration, language, publication status, study design, databases of coverage, etc.) is lacking - I would suggest that you add a relevant paragraph between the Introduction and Section 2 (Tumor Microenvironment...) for this purpose.
5) Referencing is adequate, comprehensive, and non-self-referencing.
6) Scientific reasoning is adequate, thorough, and based on appropriate scientific data.
7) Data presentation is also adequate -- credits, particularly for the comprehensive Table 1! Although this is not a meta-analysis, I would suggest creating Forrest plots for ORR, PFS, and OS (for whichever studies relevant data is available) for reasons of comparability and better visualization for the reader.
Author Response
Comments and responses
The manuscript has been evaluated as a narrative review, based on the SANRA quality assessment scale (Baethge 2019, doi: 10.1186/s41073-019-0064-8). Here follow my comments:
- The title should include the identification "a narrative review (of)...".
Response: We appreciate your comments. Changes made to the title.
- The importance of the research topic has been adequately justified in the Introduction.
Response: Thank you for your valuable comments.
- The authors have made a concrete statement on the purpose of the article.
Response: Thank you for your comments.
- Description of the literature search (i.e. years of consideration, language, publication status, study design, databases of coverage, etc.) is lacking - I would suggest that you add a relevant paragraph between the Introduction and Section 2 (Tumor Microenvironment...) for this purpose.
Response: Description of literature search added as section 2 in the draft.
- Referencing is adequate, comprehensive, and non-self-referencing.
Response: Thank you for your valuable comments.
- Scientific reasoning is adequate, thorough, and based on appropriate scientific data.
Response: Thank so much you for your comments.
- Data presentation is also adequate -- credits, particularly for the comprehensive Table 1! Although this is not a meta-analysis, I would suggest creating Forrest plots for ORR, PFS, and OS (for whichever studies relevant data is available) for reasons of comparability and better visualization for the reader.
Response: Since we are just presenting published data, we are not able to analyze it ourselves.
Round 2
Reviewer 1 Report
Thank you for the revised manuscript. I am pleased and have no further comments.
Reviewer 2 Report
All reviewers' comments have been appropriately and effectively addressed.
