The North American Neuroendocrine Tumor Society (NANETS) conference, held in Chicago this October, featured groundbreaking research, best practices in collaboration, and discussion in the field of neuroendocrine tumors (NETs). Several key presentations from University of Iowa Health Care showcased the depth and diversity of NET research collaborations across the hospital’s subspecialties.

One significant discussion was led by hematology-oncology fellow Udhayvir Singh Grewal, MD, via his poster presentation regarding Racial Inequities in NET Clinical Trial Enrollment in the United States.

Grewal and his team based their project off preliminary work by Brendon Herring, PhD, and J. Bart Rose, MD, MAS, both from University of Alabama at Birmingham’s Neuroendocrine Cancer Research Lab. Herring and Rose had found distinct molecular alterations associated with more aggressive disease biology in Black people with pancreatic neuroendocrine tumors.

“There is obviously a strong signal that suggests underlying biological differences between African American and Caucasians with pancreatic NETs. So, I was intrigued to look at if our African American population is adequately represented on NET clinical trials,” Grewal said. “This is important because we want to bring to the clinic therapies that work for all the patients that we treat and promote an equitable delivery of care.”

Along with Grewal, the presenting team included Matthew Gao, MS2 and Rishi Patel, MS4. The team was mentored by Joseph Dillon, MB, BCh, BAO, professor in Endocrinology and Metabolism, and Chandrikha Chandrasekharan, MBBS, medical oncologist. The team’s gathered data revealed troubling disparities:

• NET diagnoses have been rising, with disproportionate increases seen in Black populations.
• Black patients appear to have higher incidences of NETs and experience poorer outcomes compared to white patients.
• The question of whether Black patients are adequately represented in clinical trials was raised, highlighting a critical area for improvement.

This was the first focused attempt to explore this disparity, and the findings underscore the need for diverse and representative clinical trials. The presentation was well-received at NANETS, earning Grewal and his team Best Scientific Poster in the Clinical Research category.

“This is the first time any group has published these data and brought to light a significant concern that needs to be addressed by our field moving forward,” Grewal said. “We are currently working on a full manuscript related to this project. I would also like to thank Brad Loeffler, a biostatistics expert at Holden Comprehensive Cancer Center, for his tremendous help with this project.”

NANETS served as a reminder of the progress made in NET research and the challenges that remain. From addressing racial disparities to exploring early-onset NETs and advancing targeted therapies, the research presented underscored the importance of collaboration, advocacy, and representation.

“I would like to add that none of this would be possible without the invaluable guidance and support of Dr. Chandrasekharan, my mentor,” Grewal said of his win. “I am indebted to Dr. Dillon, a luminary and renowned expert in the research and practice of NETs for his guidance and collaboration on the work that we presented at NANETS.”

“One of the best aspects of being a medical student at the University of Iowa is the opportunity to participate in impactful research projects like this one, in addition to the fantastic clinical education,” Patel said. “I am deeply grateful to Dr. Grewal, Dr. Chandrasekharan, and Dr. Dillon for their invaluable mentorship. Their guidance has fueled my passion for clinical research, and I hope to follow in their footsteps one day and pursue a career involving both patient care and clinical research. I look forward to collaborating with them on future neuroendocrine tumor projects.”