Cives M, Porta C, Palmirotta R. Mixed neuroendocrine non-neuroendocrine tumors: The quest for evidence. World J Gastrointest Oncol 2024; 16(12): 4532-4536 [DOI: 10.4251/wjgo.v16.i12.4532]
Corresponding Author of This Article
Raffaele Palmirotta, MD, PhD, Associate Professor, Senior Researcher, Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, Piazza G. Cesare 11, Bari 70124, Italy. raffaelepalmirotta@gmail.com
Research Domain of This Article
Oncology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Dec 15, 2024; 16(12): 4532-4536 Published online Dec 15, 2024. doi: 10.4251/wjgo.v16.i12.4532
Mixed neuroendocrine non-neuroendocrine tumors: The quest for evidence
Mauro Cives, Camillo Porta, Raffaele Palmirotta
Mauro Cives, Camillo Porta, Raffaele Palmirotta, Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, Bari 70124, Italy
Mauro Cives, Camillo Porta, Department of Medical Oncology, AOU Consorziale Policlinico di Bari, Bari 70124, Italy
Author contributions: Cives M, Porta C and Palmirotta R contributed to this paper; Palmirotta R designed the overall concept and outline of the manuscript; Cives M and Palmirotta R contributed to the discussion and design of the manuscript; Cives M, Porta C and Palmirotta R contributed to the writing and editing of the manuscript, and review of literature.
Supported byThe Associazione Italiana per la Ricerca sul Cancro, No. 23583; and The Apulia Region (“Il Team Oncogenomico: Modello operativo per la riduzione dei costi dell’assistenza sanitaria in Oncologia” Project).
Conflict-of-interest statement: Authors declare no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Raffaele Palmirotta, MD, PhD, Associate Professor, Senior Researcher, Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, Piazza G. Cesare 11, Bari 70124, Italy. raffaelepalmirotta@gmail.com
Received: April 8, 2024 Revised: July 16, 2024 Accepted: July 22, 2024 Published online: December 15, 2024 Processing time: 218 Days and 0.8 Hours
Abstract
Mixed neuroendocrine non-neuroendocrine neoplasms (MiNENs) are rare mixed tumors containing both neuroendocrine and non-neuroendocrine components that occupy at least 30% of the whole tumor. Biologically, both components appear to derive from an identical cellular precursor undergoing early dual differentiation or late transdifferentiation. While our understanding of MiNENs has improved in recent years, many areas of uncertainty remain. In this context, setting diagnostic criteria capable of capturing the continuum of disease biology while providing clinically meaningful information in terms of prognosis and response to treatments appears vital to advance the field and improve patients’ outcomes. Evidence is needed to generate robust classification schemes, and multi-institutional cooperation will likely play a crucial role in building adequately powered cohorts to address some of the most pressing questions discussed in this Editorial. What is the minimum representation for each component needed to define MiNENs? How can the epidemiology of MiNENs change according to different diagnostic definitions? How can we generate the clinical evidence needed to optimize the management of MiNENs?
Core Tip: In this Editorial, we highlight potential pitfalls in the current classification of mixed neuroendocrine non-neuroendocrine neoplasms and comment on challenges in the management of this heterogeneous group of malignancies in light of the paucity of evidence in the field. Improved biological and clinical knowledge is needed to generate robust classification schemes that will in turn provide clarity on the epidemiology of the disease, prognosis of affected patients and guidance for treatment tailoring.
