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Somatostatin analogs for pancreatic neuroendocrine tumors: any benefit when KI-67 is ≥10%?
Merola, E. Alonso Gordoa, T. Zhang, P. Al-Toubah, T. Pelle, E. Kolasińska-Ćwikła, A. Zandee, W. T. Laskaratos, F. M. de Mestier, L. Lamarca, Angela
Merola, E.
Alonso Gordoa, T.
Zhang, P.
Al-Toubah, T.
Pelle, E.
Kolasińska-Ćwikła, A.
Zandee, W. T.
Laskaratos, F. M.
de Mestier, L.
Lamarca, Angela
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Abstract
Background: Long-acting somatostatin analogs (SSAs) are the primary first-line treatment of well-differentiated advanced gastroenteropancreatic neuroendocrine tumors (GEP-NETs), but data about their efficacy in pancreatic NETs (panNETs) with Ki-67 ≥10% are still limited.
Materials and methods: To assess the clinical outcomes of advanced, non-functioning, well-differentiated panNETs with Ki-67 ≥10% receiving first-line long-acting SSAs in a real-world setting, we carried out a retrospective, multi-center study including patients treated between 2014-2018 across ten centers of the NET CONNECT Network. The primary endpoints were time to next treatment (TNT) and progression-free survival (PFS), while overall survival (OS) and treatment safety were secondary endpoints.
Results: 73 patients were included (68 G2, 5 G3), with liver metastases in 61 cases (84%). After a median follow-up of 36.4 months (range, 6-173 months), the median TNT and PFS were 14.2 months (95% CI, 11.6-16.2 months) and 11.9 months (95% CI, 8.6-14.1 months) respectively. No statistically significant difference was observed according to the somatostatin analog used (octreotide vs lanreotide), while increased tumor grade (HR: 4.4, 95% CI, 1.2-16.6; p=0.04) and hepatic tumor load (HR: 2, 95% CI, 1-4; p=0.03) were independently associated with shortened PFS. The median OS recorded was 86 months (95% CI, 56.8-86 months), with poor outcomes observed when the hepatic tumor burden was >25% (HR: 3.4, 95% CI, 1.2-10; p=0.01). Treatment-related adverse events were reported in 14 patients, most frequently diarrhea.
Conclusions: SSAs exert antiproliferative activity in PanNETs with Ki-67 ≥10%, particularly in G2 tumors, as well as when hepatic tumor load is ≤25%.
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Date
2020
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Merola E, Alonso Gordoa T, Zhang P, Al-Toubah T, Pelle E, Kolasinska-Cwikla A, et al. Somatostatin Analogs for Pancreatic Neuroendocrine Tumors: Any Benefit When Ki-67 Is >/=10%? Oncologist. 2020.