Neuroendocrine SPORE Overview

Neuroendocrine Spore Graphic

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Researchers at Holden Comprehensive Cancer Center at the University of Iowa have received a five-year, $10.67 million Specialized Programs of Research Excellence (SPORE) grant to study neuroendocrine tumors. This is the first and only SPORE grant ever awarded to fund research on neuroendocrine tumors.

Sue O’Dorisio, MD, PhD, professor of pediatrics in the division of pediatric hematology/oncology of the Stead Family Department of Pediatrics and the University of Iowa Stead Family Children’s Hospital, is the Principal Investigator on the SPORE.

This is the second SPORE-funded research grant for Holden Comprehensive Cancer Center at the University of Iowa.

What are neuroendocrine tumors and why do we need to study them?

Neuroendocrine tumors (NETs) are slow-growing cancers that can occur in any organ that has endocrine cells. Sometimes Neuroendocrine tumors are called carcinoid tumors. They are found in both adults and children but more commonly occur in adults. They most appear most often in the small intestine, appendix, pancreas, and lungs but can also be found in the thyroid, breast, ovaries and prostate.

NETs are difficult to diagnose and many patients have vague symptoms such as abdominal pain, flushing, or diarrhea for eight or nine years before the correct diagnosis is made. Unfortunately, the tumors have often metastasized or spread to other parts of the body. Because NETs are slow-growing, they don’t respond to most chemotherapy drugs, and very few of the new targeted drugs are effective. Surgery is the only cure and once the NET has metastasized, it is difficult to remove the complete tumor.

The SPORE grant is trying to understand the molecular biology of NETs so that it is possible to diagnose the cancers earlier and create new treatments.

What is a SPORE?

Specialized Programs of Research Excellence (SPORE) is a program from the National Cancer Institute that promotes collaborative, multidisciplinary research. SPORE grants often involve basic scientists and clinicians and they support project aimed at preventing, detecting, diagnosing, and treating cancer better. SPORE grants are funded through the National Cancer Institute (NCI), part of the National Institutes of Health.

What will the SPORE grant fund?

The funds from the SPORE grant will be focused on four major projects. Researchers at Holden Comprehensive Cancer Center are playing significant roles in the new highly collaborative NET SPORE and come from the departments of Pediatrics, Internal Medicine, Surgery, Radiology, Pharmacology, Pathology, Radiation Oncology, Epidemiology, Biostatistics, Chemistry, and Biomedical Engineering. Although many people will be involved in the SPORE, some the key people are listed under each project below.

Project 1: Theranostics

The first project will fund the design and development of a new peptide – an amino acid compound that will bind to hormone receptors on NETs. UI researchers have identified hormone receptors on NETs already. By adding a peptide which is radioactive, the tumor will light up on a PET image for patients, allowing clinicians to spot the tumors easier. Once the FDA approves the peptide, the SPORE will also fund the testing of the peptide.

Project 2: Molecular Mechanisms and Biomarkers

UI clinicians and researchers have already identified what appears to be the driver mutation in pancreatic NETs. The second project funded by the SPORE will study why that particular gene mutation enables pancreatic NETs to multiply and resist chemotherapy. The researchers in this project are also developing a clinical test to identify pancreatic NETs before they spread to the liver so that the tumor can be removed with surgery.

Project 3: A Genomic Approach to Improved Diagnosis and Treatment of Neuroendocrine Tumors

The third project will study levels of expression of genes in small bowel and pancreatic neuroendocrine tumors in order to identify new targets for diagnosis and treatment. They will also try to identify the predisposing genes in cases of familial tumors, and also look at how levels of gene expression correlate with protein expression in these tumors.

Project 4: New Approaches to Improve Effective Radionuclide Targeted Treatments

The fourth project provides funds for a clinical trial to test a new therapy for small intestine NETs. These NETs can be targeted with two radioactive drugs. Researchers are designing a clinical trial to see if we can use these drugs, nuclear physics principles, and new imaging techniques to maximize the drug dose to a tumor while minimizing toxicity to the kidneys and bone marrow.

The SPORE grant also provides support for research services that will be used by each of the four projects such as developing a neuroendocrine tumor bank, collecting tumor specimens from both the Iowa Neuroendocrine Tumor Clinic and from hospitals around Iowa, California, and Hawaii to help investigators perform experiments on NETs, assisting with designing and recruiting patients for clinical trials, and analyzing the experimental data.

How are neuroendocrine tumors treated?

There are multiple treatment options. Each neuroendocrine diagnosis is different. Our doctors and staff in our Neuroendocrine Cancer Program work with you and create a treatment program that will best fit for you and your cancer. At Holden Comprehensive Cancer Center, we use peptide receptor radionuclide therapy (PRRT), a molecular therapy used to treat neuroendocrine tumors (NETs).

Learn more about the projects funded by the neuroendocrine SPORE.