NETs Expert Looking Forward to New Research Updates, Networking at Upcoming NANETS Symposium

Pamela Kunz, MD

As an experienced medical oncologist and clinical researcher specializing in the treatment of gastrointestinal tumors, Pamela Kunz, MD, says the upcoming 2017 North American Neuroendocrine Tumor Society (NANETS) Annual Symposium offers her a chance to not only expand her own knowledge of neuroendocrine tumor (NET) research, but also allows her to share her past experience with professionals just starting out in the field.

Kunz, an assistant professor of Medicine at the Stanford University Medical Center, will be co-moderating an In Training/Early Career Program session during the symposium, which will be held tomorrow, October 19, through Saturday, October 21. The session will feature presentations geared toward professionals just starting out in the field of NETs, with topics like building an independent basic science research program and being a good mentee. Kunz will be giving a presentation herself during the session on work-life balance.

“This is a field that draws from multiple disciplines, such as medical oncology, surgical oncology, nuclear medicine, or interventional radiology, and so these in-training/early career programs invite trainees and junior faculty to sessions that are geared for them,” Kunz said.

Kunz, a member of the NANETS Board of Directors, research committee, finance committee, and conference organizing committee, recently shared some background on her presentation and the In Training/Early Career Program, and discussed what she is looking forward to most at this year’s NANETS Symposium, during an interview withTargeted Oncology.

TARGETED ONCOLOGY:You will be co-moderating the In Training/Early Career Program session. Can you give some background on that program?

Kunz:As an organization, we are really trying to help draw, retain, and train junior faculty and trainees in best practices in neuroendocrine tumors, no matter what specialty they are from. This is a field that draws from multiple disciplines, so it could be medical oncology, surgical oncology, nuclear medicine, or interventional radiology, and so these in-training early career programs invite trainees and junior faculty to sessions that are geared for them. Most of the sessions include topics like building a program, clinical cases, building a research program, and building a basic science program. My talk is on work-life balance, which I think applies to all of us, not just trainees, but we're going to try to talk to them a little bit about how to try to maintain work-life balance as they are making their way up the ladder.

TARGETED ONCOLOGY:What are you going to discuss in your talk?

Kunz:There's been a lot of research recently on burnout. We're going to talk about ways to try to mitigate that, such as making certain choices, and saying no. It's a lot of common sense things, but I will talk a little bit about my own personal experiences and how there really is no perfect balance. We have to make different choices at different times. Those are the main take-home messages.

I think medicine is a field where there are a lot of bright, motivated people. It's hard to admit that you can't do everything, so I think it's good for those of us who have been there longer to role model that it is OK to say no, and in fact, you're not going to be able to do everything. You really have to make strategic choices in order to be successful in both work and life.

TARGETED ONCOLOGY:What else will be covered in the session?

Kunz:In that particular session that I'm moderating with Dr Jonathan Strosberg, Dr James Bibb will talk about building an independent basic science research program. That is a partner to the talk Dr Emily Bergsland will be giving earlier in the morning, which is on building an independent clinical research program. With those talks, we're trying to address both the laboratory researchers, and then those who have a goal to do clinical research, which is mostly around clinical trials or population health. Dr Bibb's talk is around how you would envision getting from a trainee to being a head of a lab, and how you would do that successfully. There are a lot of common denominators, like being super focused, making sure you have the right mentors, and being good at time management.

Dr Michael Soulen is going to talk about how to be a good mentee, which is a subject he and I have both spoke on in the past. It's a fun talk, and it's about the concept that you have to mentor up. As the mentee, you really need to manage your mentor to have a successful relationship. There is no single mentor who is going to meet your needs, it's about building a mentor network. Particularly in a field that studies a rare disease, many of us over the years have had mentors both inside and outside of our institutions, and through professional organizations like NANETS.

NANETS is set up to be a really great network resource for trainees and junior faculty. I think part of the reason we are focusing on these in-training and early career programs is that we want to try to train future leaders and create a forum at the meeting where they have access to a lot of the experts in the field.

TARGETED ONCOLOGY:Are there any themes you see throughout the presentations of this year's meeting? Are there any emerging areas of research that you are particularly excited to see discussed?

Kunz:There are a couple of talks on PRRT, which is still a hot topic, and it's still not quite FDA approved. We are hoping for that in January. You'll see a few talks scattered throughout on the NETTER-1 trial, quality of life, and updates. I come from a medical oncology and clinical trial background, and I think the things I'm looking at for the future are how we can build on some of our current successes. One of the most recent successes is PRRT, so I think there will be a fair amount of talk on the latest studies that may suggest ways to improve it. That's what I'm hoping to hear more about.

TARGETED ONCOLOGY:NANETS has evolved over the past 10 years to include presentations geared toward many different specialists who treat patients with NETs. Why is this multidisciplinary approach important?

Kunz:In their lifetime, a patient with a neuroendocrine tumor will connect with multiple disciplines at various timepoints. It requires them having a quarterback for that team, which usually is a medical oncologist, but then that medical oncologist very often needs to collaborate and consult with any number of other specialties. I think particularly as PRRT will likely be used more often, that includes nuclear medicine. Dr Soulen's specialty is interventional radiology. That is still used to do liver-direct therapies. We often will need endocrinologists to help manage symptoms of hormone excess. If they need to have surgery, it's surgeons. Moreso than any other cancers, it requires careful coordination between all these teams.

Also, the majority of patients who have the grade 1 and 2 tumors, the slower-growing variety of NET, those patients even with metastatic disease often live for years, so they are in the healthcare system for a long time. This often means they have many more of these touch points with other disciplines. Most of us advocate for multidisciplinary discussions with these patients; many of our institutions have formal tumors boards where these patients are discussed in a multidisciplinary format. Many of our discussions at NANETs will elude to that. That is why this meeting has become very multidisciplinary itself. It's a great meeting, because we get everybody together.

TARGETED ONCOLOGY:Why are you looking forward to this year's meeting and what do you think attendees will take away from it?

Kunz: