Caring for Carcinoid Foundation Multi-Institutional Bioconsortium

James C. Yao, MD
Associate Professor and Deputy Chairman
Gastrointestinal Medical Oncology
University of Texas M. D. Anderson Cancer Center

The Caring for Carcinoid Foundation Multi-Institutional Bioconsortium represents an important effort in advancing our understanding of neuroendocrine tumors. Our efforts in recent years have shown that there are significant heterogeneity in neuroendocrine tumors of various sites in terms of epidemiology, genetics, and biologic behavior.1,2 It is likely that the development of neuroendocrine tumors is a result of complex interactions between genetics and environmental factors. While the tools available to scientists have advanced over the past decade, they actually present increasingly complex computational problems in order to understand the data.

There are more then 1.8 million known subtle variations (Single Nucleotide Polymorphisms) in the human genome that makes each of us different but may also predispose some of us to certain diseases. There are often complex interactions between these genetic variations and environmental factors which ultimately determine who will get the disease. For example, not everyone who is exposed to a given carcinogen will develop cancer. Similarly, individuals with similar genetic makeup may not get the same disease if they have different environmental exposures. Today’s high throughput techniques allow us to ask over 1 million questions from a single sample about these genetic variations. Thus, if we looked at these variations in a small number of patients, we would have very little power to detect subtle differences that may predispose patients to develop neuroendocrine tumors.

This means we must work together to have the best chance for success. Member institutions of the bioconsortium will join forces to collect the much needed data and biospecimens to make this meaningful research possible. Our goal would be to work together to collect clinical, epidemiological, and risk factor data that will enable large scale collaborative research.

1. Yao JC, Hassan M, Phan A, et al: One hundred years after "carcinoid": epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States. J Clin Oncol 26:3063-72, 2008
2. Kim do H, Nagano Y, Choi IS, et al: Allelic alterations in well-differentiated neuroendocrine tumors (carcinoid tumors) identified by genome-wide single nucleotide polymorphism analysis and comparison with pancreatic endocrine tumors. Genes Chromosomes Cancer 47:84-92, 2008