Treatment for gastrointestinal and pancreatic neuroendocrine tumours: a network meta-analysis

Walter, Martín; Nesti, Cédric; Spanjol, Marko; Kollár, Attila; Bütikofer, Lukas; Gloy, Viktoria; Dumont, Rebecca A.; Seiler, Christian; Christ, Emanuel; Radojewski, Piotr; Briel, Matthias; Kaderli, Reto

doi:10.1002/14651858.cd013700.pub2

Cited by 7 publications

(2 citation statements)

References 112 publications

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“…High-risk features include, in particular, deep mid-appendiceal invasion >3 mm, positive lymphovascular/vascular invasion, positive or indistinct cut margins, and high proliferation rates [ 19 ]. Over the last 10 years, many treatment options have been developed for metastatic aNETs, including pharmacological treatment with targeted drugs, cytotoxic chemotherapy or somatostatin, and external beam radiotherapy [ 5 , 20 , 21 ]. Long-acting somatostatin analogues were effective in inhibiting tumor growth in randomized phase III trials (CLAIRNET and PROMID) and are used to treat metastatic, well-differentiated aNETs [ 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

Incidence trends and survival analysis of appendiceal tumors in the United States: Primarily changes in appendiceal neuroendocrine tumors

Wang,

Ge,

et al. 2023

PLoS ONE

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Background Appendiceal tumors are considered to be a relatively rare tumor of the gastrointestinal tract and the prognosis is unclear. This study comprehensively investigated trends in the epidemiology and survival of appendiceal tumors in the United States over the past approximately 20 years. Methods Patients with pathologically confirmed appendiceal tumors from 2000 to 2017 were selected from the Surveillance, Epidemiology and End Results (SEER) database. Age-adjusted incidence rates were calculated by SEER*Stat 8.4.0. The Kaplan-Meier method was used to analyze survival and prognostic factors were investigated by a multivariate Cox proportional risk model. Results Ultimately, 13,546 patients with appendiceal tumors between 2000 and 2017 were included. The annual incidence of colonic adenocarcinoma and mucinous adenocarcinoma remained relatively stable. Interestingly, the annual incidence of appendiceal neuroendocrine tumors (aNETs) increased significantly, from 0.03 to 0.90 per 100,000 person-years, with the most dramatic increase in the number of patients with localized disease. Patients with aNETs showed a significant improvement in survival between 2009–2017, compared to the period 2000–2008. Moreover, this improvement in survival over time was seen at all stages (localized, regional, distant) of aNETs. However, this improved survival over time was not seen in colonic and mucinous adenocarcinoma. Conclusions The incidence of appendiceal neoplasms has increased significantly over the past nearly two decades, which is mainly due to the increased incidence and significant migration to earlier stages in aNETs. We must note that despite the increased incidence of aNETs, survival rates have improved at different disease stages.

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Section: Discussionmentioning

confidence: 99%

Incidence trends and survival analysis of appendiceal tumors in the United States: Primarily changes in appendiceal neuroendocrine tumors

Wang,

Ge,

et al. 2023

PLoS ONE

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“…Three small randomized trials comparing SSA vs SSA plus interferon-alpha (IFNα) showed some advantage for the combination but could not detect a statistically significant OS benefit ( Fazio et al 2007 ), while two recent network meta-analyses confirmed the efficacy of SSA plus IFNα in non-pancreatic NET ( Kaderli et al 2019 , Walter et al 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Treatment efficacy in a metastatic small intestinal neuroendocrine tumour grade 2 cohort

Papantoniou

Grönberg

Thiis‐Evensen

et al. 2023

Endocrine-Related Cancer

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Small intestinal neuroendocrine tumours (Si-NET) are often studied as a uniform group. Proliferation index Ki-67 influences prognosis and determines tumour grade. We hypothesized that Si-NET grade 2 (G2), which have a higher Ki-67 than G1 tumours, might benefit less from established treatments for metastatic disease. We conducted a retrospective cohort study of 212 patients with metastatic Si-NET G2 treated in two Swedish hospitals during 20 years (2000-2019). Median cancer-specific survival (CSS) on first-line somatostatin analogues (SSA) was 77 months. Median progression-free survival (PFS) was 12.4 months when SSA was given as monotherapy, and 19 months for all patients receiving first-line SSA. PFS after SSA dose escalation was 6 months in patients with radiological progression. Treatment efficacies of SSA and peptide-receptor radionuclide treatment (PRRT) were studied separately in patients with Ki-67 of 3-5%, 5-10% and 10-20%. For SSA, PFS was significantly shorter at higher Ki-67 levels (31, 18 and 10 months, respectively) while there was only a minor difference in PFS for PRRT (29, 25 and 25 months). Median PFS for sequential treatment with interferon-alpha (IFNa), everolimus and chemotherapy was 6, 5 and 9 months. IFNa seemed to be effective in tumours with low somatostatin-receptor expression. In conclusion, established treatments appeared effective in Si-NET G2, despite their higher proliferation index compared to G1 tumours. However, efficacy of SSA but not PRRT was reduced at higher Ki-67 levels. SSA dose escalation provided limited disease stabilization.

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How do different therapies compare with placebo and with each other in people with pancreatic neuroendocrine tumors (pNETs)?

Tort¹,

Sharifan²

2022

Cochrane Clinical Answers

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Treatment for gastrointestinal and pancreatic neuroendocrine tumours: a network meta-analysis

Abstract: Treatment for gastrointestinal and pancreatic neuroendocrine tumours: a network meta-analysis (Review)

Cited by 7 publications

References 112 publications

Incidence trends and survival analysis of appendiceal tumors in the United States: Primarily changes in appendiceal neuroendocrine tumors

Incidence trends and survival analysis of appendiceal tumors in the United States: Primarily changes in appendiceal neuroendocrine tumors

Treatment efficacy in a metastatic small intestinal neuroendocrine tumour grade 2 cohort

How do different therapies compare with placebo and with each other in people with pancreatic neuroendocrine tumors (pNETs)?

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