Abstract Heat shock protein 90 (Hsp90), an emerging target in cancer, is a chaperone protein that contributes to tumorigenesis by maintaining the stability and activity of multiple oncogenic proteins. Infinity Pharmaceuticals is currently developing two Hsp90 inhibitors: IPI-504 (retaspimycin hydrochloride), an intravenous agent that has entered several phase II clinical trials, and IPI-493, an orally administered compound that is currently being tested in a phase I dose-escalation trial. In pre-clinical animal models, IPI-504 and IPI-493 have demonstrated anti-tumor activity against a wide variety of tumor types. Neuroendocrine tumors form a heterogeneous group of malignancies, which differ from each other in their biology, prognosis, and genetics. They mainly occur in the gastrointestinal tract and bronchopulmonary system. Conventional cytotoxic therapy has failed to demonstrate effective treatment of neuroendocrine/carcinoid cancers over the past 4 decades, resulting in an unmet need for improved pharmacological treatment of these tumors. To date, no data have been reported on the activity of Hsp90 inhibitors against carcinoid cancer cells. Herein we describe the activity of the Hsp90 inhibitors IPI-504 and IPI-493 against a panel of neuroendocrine tumors including: BON-1, a cell line derived from a metastasis of a primary pancreatic neuroendocrine tumor, NCI-H720, a lung carcinoid, QGP-1, a pancreatic carcinoma of islet cells and HC-45, an ileal carcinoid. In vitro, most of the carcinoid cell lines are sensitive to the Hsp90 inhibitors with EC50 values between 10 and 189 nM for IPI-493 and 49 and 930 nM for IPI-504. In vivo, IPI-504 dosed twice weekly inhibits the tumor growth of BON-1 cells in mice. To identify the potential mechanism of action of IPI-504 in BON-1 cells we have determined that IGF-1R, a tyrosine kinase receptor and an Hsp90 client protein, is constitutively activated in these cells suggesting that it could participate in the unregulated growth of these tumor cells. Upon treatment of BON-1 cells with IPI-504, phospho-IGF-1R is degraded in a dose-dependent manner. The EC50 of the protein degradation and the in vitro growth inhibitory activity of IPI-504 are similar (∼50 nM), suggesting that the anti-tumor activity of IPI-504 could be due, in part, to the inactivation of this growth factor receptor. In conclusion, we demonstrated that the Hsp90 inhibitors IPI-504 and IPI-493 potently inhibit the growth of neuroendocrine tumor cell lines both in vitro and in vivo and identified IGF-1R as a potential client protein. These data suggest further exploring IPI-504 for the possible treatment of neuroendocrine tumors in the clinic. Citation Information: Mol Cancer Ther 2009;8(12 Suppl):A215.