LAUSR

Gastroenteropancreatic (GEP) neuroendocrine tumors (NETs) comprise a heterogenous and diverse group of neoplasms arising from a common neuroendocrine cell origin. The majority of these tumors occur sporadically while ~20% manifest within the context of hereditary syndromes. Germline MEN1 mutations cause a syndrome with an increased susceptibility to multifocal primary GEP NETs. In addition, MEN1 mutations also occur in sporadic GEP NETs. MEN1 alternations are the most frequent sporadic mutation found in pancreatic neuroendocrine tumors (PNETs). We explore the implication of the loss of the MEN1 encoded protein menin as a key pathogenic driver in subsets of GEP NETs with downstream consequences including upregulation of the oncogenic receptor c-MET (hepatocyte growth factor receptor). This review will summarize the data related to the clinical presentation, therapeutic standards, and outcomes of sporadic and MEN1 associated GEP NETs. We present the data on c-MET expression in GEP NETs, clinical trials using c-MET inhibtors, and provide an overview of the molecular mechanisms by which c-MET inhibition in GEP NETs represents a potential precision-medicine targeted approach.