Tamas Gonda, MD

Overview

Aim: Treatment and Therapy

Pancreatic neuroendocrine tumors, also called PanNETs or PNETs, are the second most common type of pancreatic cancer and have been increasing in incidence. PNETs arise from a specialized type of cell called a neuroendocrine cell that receives signals from the nervous system to release hormones. PNETs tend to be slow-growing with less metastatic potential that other types of pancreatic cancer and therefore have a higher chance of being diagnosed when disease is still localized and removal is possible. Until recently, the only curative treatment option for removal has been surgery that carries risks and the potential for long-term complications but minimally invasive alternatives to surgery have emerged. Techniques for localized ablation including endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) allow for the targeted destruction of tumors from within the gastrointestinal tract with the goal of reducing complications while preserving pancreatic function.

Tamas Gonda, MD, Professor of Medicine at NYU Grossman School of Medicine, Co-Director of the Pancreatic Cancer Program, and Director of Pancreatic Disease Program, recently completed the largest retrospective cohort study of EUS-RFA of PNETs demonstrating promising efficacy with a well-tolerated safety profile with no high-grade side effects. While the results support the use of EUS-RFA for localized PNETs, there is still a need for guidance on which patients should undergo EUS-RFA and a better understanding of what biomarkers are predictors of treatment response. Dr. Gonda’s 2026 PNET Pathway grant project, Optimizing patient selection and treatment approach for endoscopic therapy of localized pancreatic endocrine tumors will focus on these two key questions. He will develop a simulation model to define optimal treatment decisions between surveillance, endoscopic ablation, or surgery for PNET patients with different characteristics such as age, sex, and tumor size based on previous clinical trial data. His project will also profile tumor samples from patients undergoing EUS-RFA to correlate treatment response to biomarker expression to identify a biomarker or signature of biomarkers that may predict response to EUS-RFA and in the future have a role in clinical decision-making for PNET patients.

The Hirshberg Foundation is proud to continue to support Dr. Gonda’s work in developing minimally invasive techniques for PNET management with a 2026 PNET Pathway Grant. When awarded this grant he wrote, “Especially in the area of pancreatic neuroendocrine tumors, this grant is critically important to help define the best use of new treatment strategies. The proposal supported by the Hirshberg Foundation will allow us to understand how and when we should consider a novel, minimally invasive, endoscopic therapy (radiofrequency ablation) in the treatment of pancreatic NETS. It will also allow us to begin the work to define predictors of treatment response. Thank you for supporting this crucial work and I look forward to better treatment options for PNET patients.”

Overview

Focus: Pancreatic neuroendocrine tumors (PanNETs)

Pancreatic neuroendocrine tumors (PanNETs) are the second most common type of pancreatic malignancy and are being diagnosed with increasing frequency. Until recently, surgery was the only curative option for localized disease. Even when performed using minimally invasive techniques, surgery can carry significant risks and long-term complications. While some small PanNETs have a low risk of metastasis, long-term studies show that tumor progression and lymph node spread can still occur over time. Alternatives to surgery have emerged but none have been rigorously evaluated. These strategies may include long-term treatment with somatostatin receptor inhibitors (e.g. octreotide or its long-term analogue, lanreotide) or local ablation.

Our research has focused on defining the most effective currently available strategy for local ablation, endoscopic ultrasound guided radiofrequency ablation (EUS RFA). EUS RFA is a less invasive alternative to surgery and allows physicians to target and destroy tumors from within the gastrointestinal tract, potentially reducing complications while preserving pancreatic function.