Long-term results of PRRT in advanced bronchopulmonary carcinoid

Mariniello, Annapaola; Bodei, Lisa; Tinelli, Carmine; Baio, Silvia M.; Gilardi, Laura; Colandrea, Marzia; Papi, Stefano; Valmadre, Giuseppe; Fazio, Nicola; Galetta, Domenico; Paganelli, Giovanni; Grana, Chiara Maria

doi:10.1007/s00259-015-3190-7

Cited by 105 publications

(85 citation statements)

References 23 publications

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“…Our data showed a reduction in PFS and OS in both univariate and multivariate analysis in patients pretreated with chemotherapy, as was also demonstrated in other studies (23,25). Additional analysis in our dataset revealed that of the 43 patients with a G3 tumor, 19 (44%) were treated with chemotherapy, whereas among patients with G1 and G2 tumors, only 12% and 23%, respectively, were treated with chemotherapy.…”

Section: Discussionsupporting

confidence: 89%

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Parameters to Predict Progression-Free and Overall Survival After Peptide Receptor Radionuclide Therapy: A Multivariate Analysis in 782 Patients

et al. 2019

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Peptide receptor radionuclide therapy (PRRT) is an effective treatment for patients with neuroendocrine neoplasms. The aim of this study was to identify clinical and treatment parameters associated with progression-free survival (PFS) and overall survival (OS). Methods: All patients treated from October 2002 until March 2016 at the Zentralklinik Bad Berka with at least 3 administrations of PRRT (maximal interval of 6 mo between consecutive administrations) were included. Data were collected in 5 categories: general patient characteristics, tumor characteristics, prior treatments, radioisotope used for PRRT, and blood chemistry. Survival was analyzed using Kaplan-Meier curves. Univariate and multivariate Cox regression analyses were performed to identify parameters associated with PFS and OS. Results: In total, 782 patients were included, with a median follow-up of 36 mo. The median PFS and OS were 22 and 53 mo, respectively. Parameters associated with lower PFS in the multivariate analysis were a Ki-67 of more than 5%, previous treatment with interferon-α and chemotherapy, presence of diabetes, and chromogranin-A (CgA) levels higher than 336 μg/L. Parameters associated with lower OS were a Ki-67 of more than 10%, performance status of at least 1, previous chemotherapy and ablation, and CgA levels higher than 112 μg/L. Conclusion: Higher Ki-67 values, as well as higher CgA levels and previous chemotherapy, had a negative outcome on both PFS and OS. Furthermore, PFS was negatively associated with previous interferon-α treatment and diabetes, whereas lower OS was related to prior ablation and higher performance status. http://jnm.snmjournals.org/content/60/9/1259 This article and updated information are available at: http://jnm.snmjournals.org/site/subscriptions/online.xhtml Information about subscriptions to JNM can be found at: http://jnm.snmjournals.org/site/misc/permission.xhtml

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Section: Discussionsupporting

confidence: 89%

“…The reported PFS in other studies (32-41 mo) is higher than in the current study (22 mo). Meanwhile, the OS (43 mo) of the current patient cohort was within the reported range in the literature (38-82 mo) (21)(22)(23)(24)(25)(26). However, differences between the current study and the literature exist.…”

Section: Discussionsupporting

confidence: 61%

Parameters to Predict Progression-Free and Overall Survival After Peptide Receptor Radionuclide Therapy: A Multivariate Analysis in 782 Patients

et al. 2019

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“…Studies of therapies in the advanced or metastatic lung carcinoid setting have been limited to retrospective analyses and some small prospective studies (6,(38)(39)(40). Recent articles reviewed the current standard of care and recent advances in therapy for bpNETs (41)(42)(43)(44).…”

Section: Discussionmentioning

confidence: 99%

A single-institution retrospective analysis of metachronous and synchronous metastatic bronchial neuroendocrine tumors

et al. 2018

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“…Non-controlled studies in PanNEN and SBNEN have demonstrated its effectiveness: objective responses ( Fig. 6, 7) occur in 28-39% [227,228], symptomatic improvements have been noted and a positive impact on survival parameters is documented [152,228,229]. A recent phase III, randomised, controlled trial of midgut NEN, progressive on standard-dose octreotide LAR (NETTER-1), demonstrated 177 Lu-DOTATATE to be more effective than high-dose octreotide LAR (median PFS 28.4 vs. 8.4 months), resulting in a 79% reduction of the risk of progression and a significant symptomatic improvement (e.g., fatigue, diarrhoea, pain) [9,230].…”

Section: Peptide Receptor Radionuclide Therapymentioning

confidence: 99%

Neuroendocrine Neoplasms of the Small Bowel and Pancreas

et al. 2019

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The traditionally promulgated perspectives of neuroendocrine neoplasms (NEN) as rare, indolent tumours are blunt and have been outdated for the last 2 decades. Clear increments in their incidence over the past decades render them increasingly clinically relevant, and at initial diagnosis many present with nodal and/or distant metastases (notably hepatic). The molecular pathogenesis of these tumours is increasingly yet incompletely understood. Those arising from the small bowel (SB) or pancreas typically occur sporadically; the latter may occur within the context of hereditary tumour predisposition syndromes. NENs can also be associated with endocrinopathy of hormonal hypersecretion. Tangible advances in the development of novel biomarkers, functional imaging modalities and therapy are especially applicable to this sub-set of tumours. The management of SB and pancreatic neuroendocrine tumours (NET) may be challenging, and often comprises a multidisciplinary approach wherein surgical, medical, interventional radiological and radiotherapeu-tic modalities are implemented. This review provides a comprehensive overview of the epidemiology, pathophysiology, diagnosis and treatment of SB and pancreatic NETs. Moreover, we provide an outlook of the future in these tumour types which will include the development of precision oncology frameworks for individualised therapy, multi-analyte predictive biomarkers, artificial intelligence-derived clinical decision support tools and elucidation of the role of the microbiome in NEN development and clinical behaviour.According to SEER version 18, SBNEN and PanNEN incidences are currently estimated at 1.2 and 0.7 per 100,000, respectively [5]. The overall 20-year duration prevalence of all NEN is estimated at 171,321; SBNEN constituting 32,122 patients with 3-fold fewer PanNEN (10,707) [5]. Possible attributable factors for this increase evolving epidemiology include increased use of endoscopy and also improvements in the sensitivity of widely used imaging modalities, leading to increased detection of early-stage, asymptomatic disease [5].The median overall survival (OS) for NEN (irrespective of site and grade) is 9.3 years [5]. For SB (median OS: 14 years), this ranges from 70 months (advanced disease with distant metastases) to 170 months (localised disease) and from 30 months (Grade 3) to 160 months (Grade 1). For pancreas (median OS: 3.6 years): 21 months (advanced) to 235 months (localised disease) and from 15 months (Grade 3) to 140 months (Grade 1) [5].Multivariable analyses have identified that ethnicity, age, differentiation, stage and site all have statistically significant correlations with survival. In general, Caucasian ethnicity, age (< 50 years) and localised, well-differentiated NEN exhibit the best survival. SB tumour patients are approximately 1.5 times more likely to survive longer than those with PanNEN [19]. Many of these correlations are self-evident since they pertain to degree of malignancy, disease duration and patient performance status.OS (median 5-year) app...

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Long-term results of PRRT in advanced bronchopulmonary carcinoid

Cited by 105 publications

References 23 publications

Parameters to Predict Progression-Free and Overall Survival After Peptide Receptor Radionuclide Therapy: A Multivariate Analysis in 782 Patients

Parameters to Predict Progression-Free and Overall Survival After Peptide Receptor Radionuclide Therapy: A Multivariate Analysis in 782 Patients

A single-institution retrospective analysis of metachronous and synchronous metastatic bronchial neuroendocrine tumors

Neuroendocrine Neoplasms of the Small Bowel and Pancreas

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