NETCast Hybrid Neuroendocrine Cancers: Pathology, Grade Transformation, and Emerging Therapies
Dec 22, 2025
Renuka Iyer, a neuroendocrine tumor expert and Chief of GI Oncology at Roswell Park, discusses the importance of expert pathology reviews and accurate NET classification. Shagufta Shaheen, a GI medical oncologist at Stanford, highlights the management of mixed neuroendocrine neoplasms and therapy-driven dedifferentiation. Aman Chauhan, Director of the Neuroendocrine Tumor Program in Miami, shares insights on novel therapies, including DLL3-targeted strategies and CAR-T early trials, revealing exciting advances in the treatment landscape.
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Confirm Pathology Before Treatment
- Get expert pathology review for all neuroendocrine tumor diagnoses and request re-biopsy if tissue is insufficient.
- Confirm Ki-67, grade, and separate components before choosing therapy or enrolling in trials.
MiNENs Behave As Dual Components
- MiNENs contain two distinct components that should be reported and graded separately with percent composition.
- Treat the tumor based on the more aggressive component and use multidisciplinary review and molecular data to guide therapy.
Use Tissue NGS Plus Liquid Monitoring
- Obtain tissue-based NGS ideally with macrodissection of each component when feasible to identify divergent drivers.
- Use liquid biopsy to monitor overall tumor evolution and to track which clone is dominant at progression.