Resistant Gastroenteropancreatic Neuroendocrine Tumors

Dear Colleagues,

From their first histologic description in 1867 to defining their genetic basis, neuroendocrine tumors (NE) have generated much controversy with respect to their classification, clinical behavior and complex biomarkers.  Advances in NE biology over the last century include the discovery and description of the NE cells that are present in all embryonic germ layers.  Kulchitsky, enterochromaffin-like (ECL), islet and Merkel cells comprise the NE system of the lung, gastrointestinal, pancreas and skin, respectively.  Common characteristics of NE cells include the expression of the somatostatin receptor and the release of bioactive amines and peptides including serotonin, histamine, kinins, gastrin, insulin, glucagon, vasoactive intestinal peptide, somatostatin, ghrelin and other substances that may give rise to paraneoplastic syndromes such as ectopic ACTH, PTHrp and ADH.  Linking these bioactive substances to specific clinical syndromes has resulted in the basis of our understanding of the pathophysiology. Now, after advances in both the basic and clinical sciences, including nucleic acid and protein chemistry and genomics, there is a comprehensive understanding of GEPNETs resulting in improved outcomes.  Advances in pathology, procedural techniques, imaging, medical and radiation therapeutics, GEPNETs patients are commonly managed by multi-specialty teams focused on the unique characteristics of NETs.  As we move into the next decade of GEPNETs, the challenges now include the recognition and management of refractory disease.  This Special Issue of Cancers is focused on identifying and targeting molecular pathways of resistance, reporting original clinical research and reviewing the clinical management of GEPNETs 'beyond the first line'.

Dr. Lowell B. Anthony
Guest Editor

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