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Erik Mittra, MD, PhD, Professor of Diagnostic Radiology Oregon Health and Science University, discusses neuroendocrine tumors.

A neuroendocrine neoplasm is a type of neuroendocrine tumor that usually develops in the digestive tract or in the lungs. In some cases, a neuroendocrine neoplasm develops in another part of the body, such as the pancreas, testicle, or ovary. In later stages, symptoms may vary depending on where the tumor is located. The tumor may produce hormone-like substances that spread to the body and cause symptoms of carcinoid syndrome, such as flushing of the face and chest, diarrhea, and trouble breathing. People with a lung neuroendocrine neoplasm are less likely to have carcinoid syndrome, but may experience coughing, wheezing, or pneumonia. The tumor may also cause various symptoms if it has spread to other parts of the body. The cause of neuroendocrine neoplasms is unknown.

Diagnosis is challenging because of its rarity of the condition as well as the vagueness and heterogeneity of symptom presentation. Patients may go three to five years before receiving an accurate diagnosis, causing upwards of 50% of patients to be diagnosed with metastatic disease. Early diagnosis is key to proper management as current therapies work best and provide better disease control before metastatic disease, are more available, and cause less side effects than those for later stages of disease. Neuroendocrine specialists are the most common referral for patients with these tumors and can provide personalized approaches to treatment.

Dr. Mittra presented data on the current radiopharmaceutical treatment landscape for neuroendocrine tumors and the 2025 ENDO meeting. Currently, there is one approved therapy for this indication, Lutathera. Lutathera is a targeted radiation therapy that attacks cancer cells by binding to specific hormone receptors and delivering cell-killing radiation. While there is a good amount of clinical experience with the treatment, Dr. Mittra explains that there is still research being done on the treatment. He expects these studies to lead to more treatment options for patients with neuroendocrine tumors.

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