These researchers dedicate their careers to finding new treatments and cures for people with cancer.
Though NETs can grow more slowly than other cancers, they can still be deadly. Moreover, their rarity and inconsistent behavior make them hard to predict. As a result, it's often hard to gauge a patient’s prognosis and optimize their treatment plans. With so many barriers, there’s a growing focus on addressing tumor resistance to prolong patients’ lives.
“This disease often comes with questions about how much time a patient has and what their prognosis is,” says Dr. Raj, a gastrointestinal oncologist at Memorial Sloan Kettering Cancer Center. “To answer these questions, we need to better understand how NETs change over time and find the most effective sequence of therapies.”
To Start, Researching Genetic Makeup and Drug Resistance
Supported by a 2015 Conquer Cancer Young Investigator Award (YIA), Dr. Raj launched a study1 looking at treatment resistance to a specific drug that’s commonly used to treat advanced NETs. Partnering with a network of mentors and collaborators, Dr. Raj learned about how these treatments alter the tumors’ genetic makeup, sometimes causing stubborn behavior. This research is especially important for advanced-stage pancreatic NETs, which can have short treatment responses to the available therapies.2
“My YIA project strengthened our understanding of how NETs change genetically over time and how treatments influence tumor growth,” Dr. Raj says. “This laid the foundation for my subsequent research into mutational changes in NETs over time and various therapies.”
Then, Studying How Rare Tumors Change Over Time
Using a 2018 Career Development Award (CDA) from Conquer Cancer, Dr. Raj expanded her project to further explore how NETs mutate. This research could provide a better understanding about the tumors’ genetic evolution during treatment. It can also help doctors tailor care to individual patients based on the unique makeup of their disease.
“Learning about these different tumor subtypes and how they change over time may allow us to personalize therapy for patients,” Dr. Raj explains, “especially when drug resistance develops.”
In clinical settings, these findings could help improve how providers talk to patients about cancer prognosis and prolonging survival.
“Now, when we talk to patients and review their genetic results, we can offer deeper insights into their disease evolution,” Dr. Raj says. “The CDA research has allowed me to more effectively address patients’ questions about their prognosis and disease biology. We’re beginning to offer patients a better understanding of promising advancements in the field.”
More Research, More Answers, and Better Patient Care
Dr. Raj’s findings hold promise beyond studying NETs. When physician-scientists improve their understanding of rare diseases, they can often apply the insights they gain to other types of cancer.
“What’s so interesting about NETs is that we often provide ongoing care for patients with these diseases for many years,” Dr. Raj says. “This can enable us to learn a lot about cancer biology and genetic evolution more generally. It also helps oncologists study other types of solid tumors through the lens of these rare cancers.”
As Dr. Raj pursues the next steps in her research, she remains vigilant of persistent challenges in treating NETs. That includes the difficulty of recruiting patients for clinical trials. Researchers are also continually working to find the most optimal treatment sequence for patients with NETs.
“In recent years, there’s been a wealth of therapies developed for GI cancers, especially NETs, but sequencing treatment remains a challenge,” Dr. Raj explains. “My hope is that 10 years from now we’ll have a better understanding of which therapies to give first, second, and third to our patients.”
Despite limited funding for rare cancers, Dr. Raj is determined to continue pursuing NET research so that every patient—no matter their diagnosis—can enjoy longer, healthier lives.
“Conquer Cancer’s commitment to funding rare cancer research allows us to answer critical questions about NETs,” Dr. Raj says. “I feel very fortunate to work closely with a wonderful community that’s invested in pursuing important studies to answer these questions more effectively. And I anticipate that in 10 years, we’ll have many of those answers.”
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