Use of Molecular Profiling to Guide Treatment Decisions in Patients with Neuroendocrine Tumors: Preliminary Results.
This case series demonstrates the potential of molecular profiling to improve selection of antitumor therapies in the treatment of patients with neuroendocrine and carcinoid tumors. Carcinoid tumors resected at one institution over a 3-year period were sent for molecular profiling to guide choice of treatment. Potentially beneficial therapies were identified based on the measured expression of 20 proteins and oncogenes and a comprehensive review of the chemotherapy response literature. The clinical charts of 41 patients were reviewed retrospectively, and 12 were selected as representatives of the range of effects molecular profiling has on carcinoid treatment. Their presentation, molecular profile results, treatment, and disease progression is reviewed in the following case series. A total of nine patients were treated with drugs identified as potentially beneficial by molecular profile reports. These include capecitabine, 5-fluorouracil, temozolomide, oxaliplatin, and gemcitabine. Based on clinical symptoms, serum markers of disease, and radiographic evidence five of nine patients responded to treatment, two had mixed responses, and two did not respond to treatment. At this early juncture, our critique of molecular profiling for neuroendocrine tumors is favorable, as a significant number of our patients responded to drugs identified by molecular profiling as potentially beneficial.
Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Holt S
HS
Cutler
Paul
P
Ogando
Joshua H
JH
Uhr
Dani O
DO
Gonzalez
Richard R P
RR
Warner
Celia M
CM
Divino
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000235:genetics / Q000378:metabolism*; D002276:Carcinoid Tumor / Q000188:drug therapy / Q000235:genetics / Q000378:metabolism / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D000066491:Clinical Decision-Making / Q000379:methods*; D004067:Digestive System Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000378:metabolism / Q000601:surgery; D018450:Disease Progression; D005260:Female; D020869:Gene Expression Profiling; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000378:metabolism / Q000601:surgery; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000188:drug therapy* / Q000235:genetics / Q000378:metabolism / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor