Healthcare cost by primary tumour, functioning status and treatment among patients with metastatic neuroendocrine tumours: The LyREMeNET study

Perrier, Marine; Polazzi, Stéphanie; Lemelin, Annie; Fernandez, V.; Labonne, Stéphanie; Maucort‐Boulch, Delphine; Lombard‐Bohas, Catherine; Duclos, Antoine; Walter, Thomas

doi:10.1111/jne.13092

Cited by 3 publications

(12 citation statements)

References 18 publications

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“…The available therapies as well as their actions, their results, and their use against mNET are detailed in several recent published studies. 2 , 5 , 6 There are a rather large number of weapons currently available, and these can be categorized as either systemic or locoregional treatments. The latter include the surgical resection of the primary tumour and/or metastases (curative or palliative), the ablative therapies (including radiofrequency ablation), the liver embolization (either alone or associated with chemotherapy), and the selective internal radiation therapy of the liver (not reimbursed in some countries).…”

Section: Treatment Optionsmentioning

confidence: 99%

“…The two main cost drivers during the management of patients with mNET are drugs and hospital stays (75% of the overall cost 6 ), the latter depending on the type of administration [pills can be administered to outpatients, whereas chemotherapy or PRRT have to be administered intravenously (IV) to hospitalized patients]. The treatment cost estimated from the societal perspective (per patient per month) is highest for PRRT, followed by targeted therapies, chemotherapy, and then SSA.…”

Section: Treatment Optionsmentioning

confidence: 99%

“…However, some available treatment options such as sunitinib (26%) and PRRT (28%) were less often used in second-line and further treatments. In the LyREMeNET study 6 including 102 consecutive patients with metastatic pNET, patients were often treated with cytotoxic chemotherapy (72%), followed by SSA (56%), targeted therapies (33%), PRRT (11%), and liver embolization (9%). If the same type of study was to be performed after 2020, that is a period with a greater availability of PRRT, it would probably find a higher use of PRRT earlier within the sequence.…”

Section: The Sequence Optionsmentioning

confidence: 99%

“…Although 86% of siNET patients had synchronous metastases, 72.5% of patients underwent a resection of their primary tumour. 6 …”

Section: The Sequence Optionsmentioning

confidence: 99%

“…Healthcare system characteristics. The two main cost drivers during the management of patients with mNET are drugs and hospital stays (75% of the overall cost 6 ), the latter depending on the type…”

Section: The Four Types Of Features That Should Be Taken Into Account...mentioning

confidence: 99%

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A practical proposal on treatment sequencing of metastatic well-differentiated neuroendocrine tumours

2023

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According to the neuroendocrine tumour (NET) characteristics, 3 to 7 different treatment options are available, corresponding to 6 to 5,040 theoretical different sequences. Even though each patient is unique and despite a large heterogeneity in NET characteristics, the present review aims to discuss the main sequences and addresses how one can propose the best sequence to treat metastatic NET (mNET) on a case-by-case basis. Each treatment must be discussed during dedicated multi-disciplinary meetings, and inclusions in clinical trials should be favoured. After a thorough characterization of patients and their mNET, and taking into account the availability of drugs, the first-line treatment should be chosen according to the treatment aim. The latter is determined based on three main topics (efficacy, safety, and patient preferences) that do not necessarily converge and must be defined a priori. At baseline, physicians should design an a priori full therapeutic sequence, which may evolve at each step depending on the response to previous treatment, the occurrence of chronic toxicities, and the patients’ perception of the prior treatment. To improve knowledge in terms of effectiveness and risk of cumulative toxicities regarding the different sequences, real-world data using long follow-up durations are necessary; such issues will not be resolved by randomized clinical trials.

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Section: Treatment Optionsmentioning

confidence: 99%

Section: Treatment Optionsmentioning

confidence: 99%

Section: The Sequence Optionsmentioning

confidence: 99%

“…Although 86% of siNET patients had synchronous metastases, 72.5% of patients underwent a resection of their primary tumour. 6 …”

Section: The Sequence Optionsmentioning

confidence: 99%

Section: The Four Types Of Features That Should Be Taken Into Account...mentioning

confidence: 99%

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A practical proposal on treatment sequencing of metastatic well-differentiated neuroendocrine tumours

2023

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Computing the Cost of Care per Patient per Day for Patients With Metastatic Neuroendocrine Neoplasms

Gupta,

Barnes,

Qin

et al. 2024

JCO Oncol Pract

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PURPOSE Patients with well-differentiated, low-grade metastatic neuroendocrine neoplasms (NENs) usually have a long median survival and require complex, expensive care over many years at multidisciplinary centers. The cost burden for patients and institutions serves as a barrier to care. Understanding the drivers of these costs and whether intense monitoring adds value will help to optimize value-based care. METHODS We adapted the cost of care per patient per day (CCPD) validated methodology to measure cost while accounting for varying follow-up duration. We queried the Stanford NEN Database, which aggregates data from the electronic health record and other electronic sources, to study patients with metastatic NENs receiving regular care at Stanford. Current Procedural Terminology codes for services incurred during the monitoring period for each patient were mapped to the corresponding cost conversion factor and date in the Medicare fee schedule. RESULTS Two hundred two patients between 2010 and 2017 were studied with a mean CCPD of $119.11 in US dollars (USD); NEN-specific systemic therapy made up 55% of this cost. Somatostatin analogs were the costliest systemic therapy. Systemic therapy was the driver of cost differences among patients with various primary tumor types, stage of disease, tumor differentiation and grade, and functional hormone status. Patients in the most expensive CCPD group did not have a significant survival benefit ( P = .66). CONCLUSION The CCPD methodology was effective in studying cancer care value in NENs. Systemic therapy, specifically somatostatin analogs, was the primary driver of cost, and intense monitoring and higher-cost care did not improve survival outcomes.

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Assessment of the Role of Leptin and Adiponectinas Biomarkers in Pancreatic Neuroendocrine Neoplasms

Bocian-Jastrzębska,

Malczewska-Herman,

Rosiek

et al. 2023

Cancers

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Data on the possible connection between circulating adipokines and PanNENs are limited. This novel study aimed to assess the serum levels of leptin and adiponectin and their ratio in patients with PanNENs and to evaluate the possible relationship between them and PanNEN’s grade or stage, including the presence of metastases. The study group consisted of PanNENs (n = 83), and healthy controls (n = 39). Leptin and adiponectin measurement by an ELISA assay was undertaken in the entire cohort. The serum concentration of adiponectin was significantly higher in the control group compared to the study group (p < 0.001). The concentration of leptin and adiponectin was significantly higher in females than in males (p < 0.01). Anincreased leptin–adiponectin ratio was observed in well-differentiated PanNENs (G1) vs. moderatelydifferentiated PanNENs (G2) (p < 0.05). An increased leptin–adiponectin ratio was found in PanNENs with Ki-67 < 3% vs. Ki-67 ≥ 3% (p < 0.05). PanNENs with distal disease presented lower leptin levels (p < 0.001) and a decreased leptin–adiponectin ratio (p < 0.01) compared with the localized disease group. Leptin, adiponectin, and the leptin–adiponectin ratio may serve as potential diagnostic, prognostic, and predictive biomarkers for PanNENs. Leptin levels and the leptin–adiponectin ratio may play an important role as predictors of malignancy and metastasis in PanNENs.

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Healthcare cost by primary tumour, functioning status and treatment among patients with metastatic neuroendocrine tumours: The LyREMeNET study

Cited by 3 publications

References 18 publications

A practical proposal on treatment sequencing of metastatic well-differentiated neuroendocrine tumours

A practical proposal on treatment sequencing of metastatic well-differentiated neuroendocrine tumours

Computing the Cost of Care per Patient per Day for Patients With Metastatic Neuroendocrine Neoplasms

Assessment of the Role of Leptin and Adiponectinas Biomarkers in Pancreatic Neuroendocrine Neoplasms

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