The only Neuroendocrine Tumor Center of Excellence in the United States, and just one of 50 in the world, is right here at the Roy J. and Lucille A. Carver College of Medicine (CCOM). The neuroendocrine tumor (NET) team at University of Iowa Health Care is multidisciplinary, composed of Department of Internal Medicine physicians including medical oncologist Daniel Berg, MD; medical oncologist Chandrikha Chandrasekharan, MBBS; endocrinologist Joseph Dillon, MD; gastroenterologist Henning Gerke, MD; and many other providers throughout the hospital.

Medicine resident Alexander Paschke, MD, and oncology fellow Udhayvir Singh Grewal, MD, are mentored by Chandrasekharan and also contribute to the research and clinical activity of the NET team at UI Health Care. One of the projects the pair worked on was the application of repeat Peptide Receptor Radionuclide Therapy, or PRRT, in cases with patients who have progressive NETs. PRRT was just approved for use by the US Food and Drug Administration (FDA) in 2018, so the NET team’s study of using repeat treatment is relatively novel. What the team found was that a second administration of the therapy was safe and effective for patients who had previously tolerated PRRT, offering symptomatic improvement, or, in some cases, alleviation.

Grewal presented the findings of the NET team’s study at the North American Neuroendocrine Tumor Society (NANETS) annual meeting this October. NANETS aims to consolidate all the research efforts and advocacy for patients with NETs through multidisciplinary medical education. Sharing NET innovations across North America is at the core of their mission, and Grewal did just that on behalf of UIHC’s NET team, earning the distinction of Best Oral Presentation in the conference’s clinical category.

“We identified all the patients in our registry who had undergone repeat PRRT, and we found that it is helpful, if you are able to select these patients appropriately, to give them PRRT again,” Grewal said. “This is another option that you can consider for these patients who may have exhausted other treatment lines or therapies. And this is a first study from the US looking at the use of repeat PRRT in patients with neuroendocrine tumors.”

Grewal notes that the diversity and expertise of specialists on the NET team as beneficial elements. “We have a medical oncologist, we have an endocrinologist, we have a surgical oncologist, then we have nurses and physician assistants who are experienced and who are specifically or specially trained to take care of patients with neuroendocrine tumors. We have case managers, and we have expert pathologists and who are actually, I would say, well-renowned and acclaimed in the field. And we have nuclear medicine specialists as well, who actually perform these therapies,” Grewal said.

On his win at NANETS, Grewal said, “For me, more than the recognition or the opportunity, it is the learning experience that I had with my mentor and my team. And this was more than just learning about research, it was learning about how mentorship should look, because in a few years I will be somebody’s mentor and definitely, Drs. Chandrasekharan and Dillon have set the benchmark very high. This is a great story for me to tell my trainees in the future – definitely very satisfying to experience.”