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    Prediction of progression-free survival in patients with advanced, well-differentiated, neuroendocrine tumors being treated with a somatostatin analog: the GETNE-TRASGU study

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    Authors
    Carmona-Bayonas, A
    Jimenez-Fonseca, P
    Lamarca, Angela
    Barriuso, Jorge
    Castano, A
    Benavent, M
    Alonso, V
    Riesco-Martinez, MDC
    Alonso-Gordoa, T
    Custodio, A
    Sanchez, CM
    Hernando, CJ
    Lopez, C
    Lacasta, A
    Fernandez, MA
    Marazuela, M
    Crespo, G
    Escudero, P
    Diaz, JA
    Feliciangeli, E
    Gallego, J
    Llanos, M
    Segura, A
    Vilardell, F
    Percovich, JC
    Grande, E
    Capdevila, J
    Valle, Juan W
    Garcia-Carbonero, R
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    Affiliation
    Hospital Universitario Morales Meseguer, Universidad de Murcia, Instituto Murciano de Investigacion Biosanitaria, Murcia, Spain
    Issue Date
    2019
    
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    Abstract
    PURPOSE: Somatostatin analogs (SSAs) are recommended for the first-line treatment of most patients with well-differentiated, gastroenteropancreatic (GEP) neuroendocrine tumors; however, benefit from treatment is heterogeneous. The aim of the current study was to develop and validate a progression-free survival (PFS) prediction model in SSA-treated patients. PATIENTS AND METHODS: We extracted data from the Spanish Group of Neuroendocrine and Endocrine Tumors Registry (R-GETNE). Patient eligibility criteria included GEP primary, Ki-67 of 20% or less, and first-line SSA monotherapy for advanced disease. An accelerated failure time model was developed to predict PFS, which was represented as a nomogram and an online calculator. The nomogram was externally validated in an independent series of consecutive eligible patients (The Christie NHS Foundation Trust, Manchester, United Kingdom). RESULTS: We recruited 535 patients (R-GETNE, n = 438; Manchester, n = 97). Median PFS and overall survival in the derivation cohort were 28.7 (95% CI, 23.8 to 31.1) and 85.9 months (95% CI, 71.5 to 96.7 months), respectively. Nine covariates significantly associated with PFS were primary tumor location, Ki-67 percentage, neutrophil-to-lymphocyte ratio, alkaline phosphatase, extent of liver involvement, presence of bone and peritoneal metastases, documented progression status, and the presence of symptoms when initiating SSA. The GETNE-TRASGU (Treated With Analog of Somatostatin in Gastroenteropancreatic and Unknown Primary NETs) model demonstrated suitable calibration, as well as fair discrimination ability with a C-index value of 0.714 (95% CI, 0.680 to 0.747) and 0.732 (95% CI, 0.658 to 0.806) in the derivation and validation series, respectively. CONCLUSION: The GETNE-TRASGU evidence-based prognostic tool stratifies patients with GEP neuroendocrine tumors receiving SSA treatment according to their estimated PFS. This nomogram may be useful when stratifying patients with neuroendocrine tumors in future trials. Furthermore, it could be a valuable tool for making treatment decisions in daily clinical practice.
    Citation
    Carmona-Bayonas A, Jimenez-Fonseca P, Lamarca A, Barriuso J, Castano A, Benavent M, et al. Prediction of progression-free survival in patients with advanced, well-differentiated, neuroendocrine tumors being treated with a somatostatin analog: the GETNE-TRASGU study. J Clin Oncol. 2019 Aug 7:JCO1900980.
    Journal
    Journal of Clinical Oncology
    URI
    http://hdl.handle.net/10541/622126
    DOI
    10.1200/JCO.19.00980
    PubMed ID
    31390276
    Additional Links
    https://dx.doi.org/10.1200/JCO.19.00980
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1200/JCO.19.00980
    Scopus Count
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