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Sonia M Abuzakhm OhioHealth, Columbus, Ohio, USA

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Vineeth Sukrithan The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA

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Briant Fruth Mayo Clinic, Rochester, Minnesota, USA

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Rui Qin Janssen Pharmaceuticals, Raritan, New Jersey, USA

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Jonathan Strosberg H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA

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Timothy J Hobday Mayo Clinic, Rochester, Minnesota, USA

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Thomas Semrad Tahoe Forest Cancer Center, Truckee, California, USA

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Diane Reidy-Lagunes Memorial Sloan Kettering Cancer Center, New York, New York, USA

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Hedy Lee Kindler University of Chicago Medical Center, Chicago, Illinois, USA

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George P Kim George Washington University Cancer Center, Washington, DC, USA

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Jennifer J Knox Princess Margaret Cancer Centre, Toronto, ON, Canada

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Andreas Kaubisch Montefiore Medical Center, Bronx, New York, USA

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Miguel Villalona-Calero City of Hope, Duarte, California, USA

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Helen Chen CTEP National Cancer Institute, Bethesda, Maryland, USA

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Charles Erlichman Mayo Clinic, Rochester, Minnesota, USA

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Manisha H Shah The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA

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tract (also referred to as carcinoid tumors) typically behave in an indolent fashion, while high-grade neuroendocrine tumors are aggressive. In patients with unresectable or metastatic extra-pancreatic NETs, options for treatment are limited. Lanreotide

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Marc Diedisheim Université de Paris, Institut Cochin, Inserm U1016, CNRS UMR8104, F-75014, Paris, France
Department of Diabetology, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France

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Solène Dermine Université de Paris, Institut Cochin, Inserm U1016, CNRS UMR8104, F-75014, Paris, France
Department of Gastroenterology and Digestive Oncology, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France

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Anne Jouinot Université de Paris, Institut Cochin, Inserm U1016, CNRS UMR8104, F-75014, Paris, France
Department of Endocrinology, Center for Rare Adrenal Diseases, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France

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Amandine Septier Université de Paris, Institut Cochin, Inserm U1016, CNRS UMR8104, F-75014, Paris, France

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Sébastien Gaujoux Université de Paris, Institut Cochin, Inserm U1016, CNRS UMR8104, F-75014, Paris, France
Department of Digestive Surgery, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France

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Bertrand Dousset Université de Paris, Institut Cochin, Inserm U1016, CNRS UMR8104, F-75014, Paris, France
Department of Digestive Surgery, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France

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Guillaume Cadiot Department of Gastroenterology, Robert-Debré Hospital, Reims, France

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Etienne Larger Université de Paris, Institut Cochin, Inserm U1016, CNRS UMR8104, F-75014, Paris, France
Department of Diabetology, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France

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Jérôme Bertherat Université de Paris, Institut Cochin, Inserm U1016, CNRS UMR8104, F-75014, Paris, France
Department of Endocrinology, Center for Rare Adrenal Diseases, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France

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Raphael Scharfmann Université de Paris, Institut Cochin, Inserm U1016, CNRS UMR8104, F-75014, Paris, France

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Benoit Terris Université de Paris, Institut Cochin, Inserm U1016, CNRS UMR8104, F-75014, Paris, France
Department of Pathology, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France

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Romain Coriat Université de Paris, Institut Cochin, Inserm U1016, CNRS UMR8104, F-75014, Paris, France
Department of Gastroenterology and Digestive Oncology, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France

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Guillaume Assié Université de Paris, Institut Cochin, Inserm U1016, CNRS UMR8104, F-75014, Paris, France
Department of Endocrinology, Center for Rare Adrenal Diseases, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France

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represent this family of fibrinogen genes with highly correlated expression. In univariate analysis, high grade tumors (grade 2, grade 3 and neuroendocrine carcinomas) (HR = 11.83, P  = 0.001) and FGA expression (HR = 1.13, P  = 0.005) were associated

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Zane Hammoud Department of Obstetrics and Gynecology, Thoracic Surgery, Pathology, Indiana University School of Medicine, 975 West Walnut Street (IB360), Indianapolis, Indiana 46202-5121, USA Departments of

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Bailin Tan
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Sunil Badve Department of Obstetrics and Gynecology, Thoracic Surgery, Pathology, Indiana University School of Medicine, 975 West Walnut Street (IB360), Indianapolis, Indiana 46202-5121, USA Departments of

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Robert M Bigsby
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, activating mutations in each of these signaling molecules have been shown to be more prevalent in lung adenocarcinomas found in women than in men ( Graziano et al . 1999 , Nelson et al . 1999 , Shigematsu & Gazdar 2006 ). A high percentage of human lung

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J Hadoux Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France

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D Malka Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France

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D Planchard Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France

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J Y Scoazec Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France

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C Caramella Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France

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J Guigay Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France

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V Boige Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France

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S Leboulleux Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France

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P Burtin Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France

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A Berdelou Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France

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Y Loriot Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France

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P Duvillard Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France

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C N Chougnet Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France

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D Déandréis Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France

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M Schlumberger Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France

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I Borget Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France
Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France

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M Ducreux Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France
Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France

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E Baudin Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France

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. 2010 , Panzuto et al . 2011 , Strosberg et al . 2011 ). These tumors, when located in the digestive system, are classified as WHO grade 3 NEC (G3-NEC), characterized by a poorly differentiated morphology, a mitotic count above 20/10 high-power field

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Mieke E R Henfling Department of Molecular Cell Biology, GROW-School for Oncology & Developmental Biology, Maastricht University, Maastricht, The Netherlands

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Aurel A Perren Institute of Pathology, University of Bern, Bern, Switzerland

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Anja M Schmitt Institute of Pathology, University of Bern, Bern, Switzerland

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Christiane M Saddig Insulinoma and GEP-Tumor Center Neuss-Düsseldorf, Klinik für Endokrine Chirurgie, Lukaskrankenhaus Neuss, Germany

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Achim A Starke Insulinoma and GEP-Tumor Center Neuss-Düsseldorf, Klinik für Endokrine Chirurgie, Lukaskrankenhaus Neuss, Germany

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Robert G Riedl Department of Pathology, GROW-School for Oncology & Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands

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Yvonne M H Versleijen-Jonkers Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands

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Diana M Sprij-Mooij Division of Endocrinology, Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands

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Frans C S Ramaekers Department of Molecular Cell Biology, GROW-School for Oncology & Developmental Biology, Maastricht University, Maastricht, The Netherlands

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Leo J Hofland Division of Endocrinology, Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands

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Ernst-Jan M Speel Department of Pathology, GROW-School for Oncology & Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands

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, (A) IGF2 (moderate (2) vs high (3) expression), (B) cytoplasmic IGF1R (low vs high expression), (C) cytoplasmic INSR (low vs high expression), (D) Grade (Grade1 vs Grade 2 + 3), (E) Disease (non-metastatic vs metastatic), (F) Tumor size (<2 cm vs ≥2

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Jennifer A Chan
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David P Ryan Department of Medical Oncology, Department of Hematology/Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, Massachusetts 02215, USA

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Andrew X Zhu Department of Medical Oncology, Department of Hematology/Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, Massachusetts 02215, USA

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Thomas A Abrams
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Brian M Wolpin
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Paige Malinowski
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Eileen M Regan
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Charles S Fuchs
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Matthew H Kulke
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histologically documented, locally unresectable or metastatic carcinoid or pancreatic neuroendocrine tumors of low grade or intermediate histological grade. Patients with poorly differentiated or high-grade neuroendocrine carcinomas were not eligible. Treatment

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Mintallah Haider Moffitt Cancer Center, Department of GI Oncology, Tampa, Florida, USA

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Satya Das Department of GI Oncology, Vanderbilt University, Nashville, Tennessee, USA

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Taymeyah Al-Toubah Moffitt Cancer Center, Department of GI Oncology, Tampa, Florida, USA

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Eleonora Pelle Department of Oncology, University of Bari, Bari, Puglia, Italy

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Ghassan El-Haddad Moffitt Cancer Center, Department of Diagnostic Imaging and Interventional Radiology, Tampa, Florida, USA

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Jonathan Strosberg Moffitt Cancer Center, Department of GI Oncology, Tampa, Florida, USA

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not reached in the PRRT arm (hazard ratio (HR) for disease progression or death 0.21, 95% CI, 0.13–0.33; P   < 0.001). Response rates were 3% in the high-dose octreotide arm and 18% in the PRRT arm ( P   < 0.001). In this analysis, grade 3

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Claudio Festuccia
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Giovanni Luca Gravina
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Paola Muzi
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Roberto Pomante
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Luca Ventura
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Robert L Vessella
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Carlo Vicentini
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Mauro Bologna
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moderate disorganization and a modest degree of stromal invasion (Gleason scores of 7); and group III consisted of poorly differentiated tumors showing high levels of disorganization and stromal invasion (Gleason of 8–10). Considering that the Gleason grade

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Anna Koumarianou Medical Oncology Unit, Endocrine Unit, MRI Unit, Pathology Department, Fourth Department of Surgery, Medical Oncology Unit, Second Department of Internal Medicine Propaedeutic, Attikon University General Hospital, Rimini 1, 12462 Athens, Greece

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Stavroula Antoniou Medical Oncology Unit, Endocrine Unit, MRI Unit, Pathology Department, Fourth Department of Surgery, Medical Oncology Unit, Second Department of Internal Medicine Propaedeutic, Attikon University General Hospital, Rimini 1, 12462 Athens, Greece

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George Kanakis Medical Oncology Unit, Endocrine Unit, MRI Unit, Pathology Department, Fourth Department of Surgery, Medical Oncology Unit, Second Department of Internal Medicine Propaedeutic, Attikon University General Hospital, Rimini 1, 12462 Athens, Greece

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Nikolaos Economopoulos Medical Oncology Unit, Endocrine Unit, MRI Unit, Pathology Department, Fourth Department of Surgery, Medical Oncology Unit, Second Department of Internal Medicine Propaedeutic, Attikon University General Hospital, Rimini 1, 12462 Athens, Greece

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Dimitra Rontogianni Medical Oncology Unit, Endocrine Unit, MRI Unit, Pathology Department, Fourth Department of Surgery, Medical Oncology Unit, Second Department of Internal Medicine Propaedeutic, Attikon University General Hospital, Rimini 1, 12462 Athens, Greece

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Anastasios Ntavatzikos Medical Oncology Unit, Endocrine Unit, MRI Unit, Pathology Department, Fourth Department of Surgery, Medical Oncology Unit, Second Department of Internal Medicine Propaedeutic, Attikon University General Hospital, Rimini 1, 12462 Athens, Greece

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Nikolaos Tsavaris Medical Oncology Unit, Endocrine Unit, MRI Unit, Pathology Department, Fourth Department of Surgery, Medical Oncology Unit, Second Department of Internal Medicine Propaedeutic, Attikon University General Hospital, Rimini 1, 12462 Athens, Greece

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Dimitrios Pectasides Medical Oncology Unit, Endocrine Unit, MRI Unit, Pathology Department, Fourth Department of Surgery, Medical Oncology Unit, Second Department of Internal Medicine Propaedeutic, Attikon University General Hospital, Rimini 1, 12462 Athens, Greece

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George Dimitriadis Medical Oncology Unit, Endocrine Unit, MRI Unit, Pathology Department, Fourth Department of Surgery, Medical Oncology Unit, Second Department of Internal Medicine Propaedeutic, Attikon University General Hospital, Rimini 1, 12462 Athens, Greece

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Gregory Kaltsas Medical Oncology Unit, Endocrine Unit, MRI Unit, Pathology Department, Fourth Department of Surgery, Medical Oncology Unit, Second Department of Internal Medicine Propaedeutic, Attikon University General Hospital, Rimini 1, 12462 Athens, Greece

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Dear Editor Neuroendocrine tumours (NETs) are highly vascularised tumours that express high levels of the vascular endothelial growth factor (VEGF) ligand together with its receptor VEGFR ( Modlin et al . 2008 ). Although advanced NETs may exhibit

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Kimberly Kamp Sector of Endocrinology, Department of Nuclear Medicine, Centro de Oncologia, Department of Pathophysiology, Department of Internal Medicine

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Brenda Gumz Sector of Endocrinology, Department of Nuclear Medicine, Centro de Oncologia, Department of Pathophysiology, Department of Internal Medicine

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Richard A Feelders Sector of Endocrinology, Department of Nuclear Medicine, Centro de Oncologia, Department of Pathophysiology, Department of Internal Medicine

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Dik J Kwekkeboom Sector of Endocrinology, Department of Nuclear Medicine, Centro de Oncologia, Department of Pathophysiology, Department of Internal Medicine

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Gregory Kaltsas Sector of Endocrinology, Department of Nuclear Medicine, Centro de Oncologia, Department of Pathophysiology, Department of Internal Medicine

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Frederico P Costa Sector of Endocrinology, Department of Nuclear Medicine, Centro de Oncologia, Department of Pathophysiology, Department of Internal Medicine

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Wouter W de Herder Sector of Endocrinology, Department of Nuclear Medicine, Centro de Oncologia, Department of Pathophysiology, Department of Internal Medicine

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-differentiated (WHO grades 1 and 2) GEP-NETs with progressive disease (PD), with a well-established safety profile ( Yao et al . 2008 , 2010 , 2011 , Pavel et al . 2011 ). In the randomized phase III RADIANT-3 study, everolimus therapy was associated with a 2

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