Immunotherapy in Neuroendocrine Neoplasms: A Diamond to Cut

Area of Science:

• Oncology
• Immunology

Background:

• Neuroendocrine neoplasms (NENs) incidence is increasing, necessitating novel therapeutic strategies.
• Current immunotherapies, including immune checkpoint inhibitors, show limited efficacy as monotherapy in unselected NENs.
• Combination immunotherapies and emerging strategies like bispecific antibodies and cell therapy are under investigation.

Purpose of the Study:

• To highlight the critical need for new therapeutic strategies in NENs, particularly immunotherapy.
• To review the current status and challenges of immunotherapy in NENs.
• To emphasize the importance of molecular profiling for guiding immunotherapy selection and improving treatment efficacy.

Main Methods:

• Review of current literature on NENs and immunotherapy.
• Analysis of the efficacy of single-agent and combination immunotherapies.
• Discussion of emerging immunotherapeutic approaches and the need for predictive biomarkers.

Main Results:

• Immune checkpoint inhibitors have shown modest activity in NENs.
• The efficacy of immunotherapy combinations is not consistently confirmed, even in high-grade NENs.
• No validated predictive immune biomarkers currently exist for NENs.

Conclusions:

• Developing predictive immune biomarkers through comprehensive tumor molecular profiling is essential for patient selection in NEN immunotherapy.
• International collaboration is required to integrate molecular profiling into clinical trials for NENs.
• Personalized immunotherapy approaches are crucial to improve treatment outcomes for NEN patients.