United States-based practice patterns and resource utilization in advanced neuroendocrine tumor treatment

Strosberg, Jonathan R.; Casciano, Roman; Stern, Lee; Parikh, Rohan; Chulikavit, Maruit; Willet, Jacob; Liu, Zhimei; Wang, Xufang; Grzegorzewski, Krzysztof

doi:10.3748/wjg.v19.i15.2348

Cited by 21 publications

(28 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Hospitalization (∼60%), imaging (∼72%), and laboratory testing (∼65%) were common. Progression of disease was strongly associated with increased use of imaging and physician visits . In our study, a low NETest score was associated with a decreased imaging frequency in ∼40% of patients, irrespective of whether they were in the watch‐and‐wait or treatment group.…”

Section: Discussionmentioning

confidence: 46%

Assessment of NETest Clinical Utility in a U.S. Registry-Based Study

et al. 2018

View full text Add to dashboard Cite

A circulating multigene molecular biomarker to guide neuroendocrine tumor (NET) management has been developed because current biomarkers have limited clinical utility. NETest is diagnostic (96%) and in real time defines the disease status (>95%) as stable or progressive. It is >90% effective in guiding treatment decisions in conjunction with diagnostic imaging. Monitoring was effective in watch-and-wait or treatment groups. Low levels supported no management change and reduced the need for imaging. High levels indicated the need for management intervention. Real-time liquid biopsy assessment of NETs has clinical utility and can contribute additional value to patient management strategies and outcomes.

show abstract

Section: Discussionmentioning

confidence: 46%

Assessment of NETest Clinical Utility in a U.S. Registry-Based Study

et al. 2018

View full text Add to dashboard Cite

show abstract

“…In addition to characterizing the various treatments, dose data for octreotide, the most common SSA treatment in this study, were analyzed, and the analysis showed most octreotide administrations were given at the standard dose of 30 mg/4 weeks for CS treatment. Furthermore, whereas prior studies on resource use for patients with NET have focused on all‐cause use , this study adds to the literature by showing lung NET‐related resource use following advanced lung NET diagnosis.…”

Section: Discussionmentioning

confidence: 83%

“…Study time periods in relation to the time of availability of particular SSAs may also impact the reported use of particular SSAs by patients. Strosberg et al reported 77% of patients with lung/gastrointestinal (GI) NET in an analysis of physician‐reported data from academic and community settings were ever treated with SSAs; however, this study population included patients who may have had surgery as their only treatment, whereas the current study required patients to have some nonsurgical treatment. In a claims data analysis of a commercially insured population in 2007–2010, Chuang et al reported that among those treated with SSAs or chemotherapy following carcinoid or pancreatic islet‐cell tumor diagnosis, 92% were treated with long‐acting octreotide, 27% were treated with short‐acting octreotide, and 1.4% were treated with lanreotide depot during the 12 months immediately following diagnosis.…”

Section: Discussionmentioning

confidence: 92%

Treatment Patterns and Clinical Outcomes in Advanced Lung Neuroendocrine Tumors in Real-World Settings: A Multicenter Retrospective Chart Review Study

et al. 2019

View full text Add to dashboard Cite

Background Using data from four tertiary referral centers in the U.S., we assessed real‐world treatment patterns and clinical outcomes of patients with advanced lung neuroendocrine tumors (NETs). Subjects, Materials, and Methods We performed a retrospective chart review of adult patients with locally advanced/metastatic (typical/atypical) lung NETs treated between July 2011 and December 2014. Index date was histologically confirmed typical/atypical carcinoid tumor diagnosis date. Data included baseline characteristics, treatment patterns, progression, death, and lung NET‐related health care resource use from index date through last contact/death. Time to treatment discontinuation and first progression, time from first to second progression, and overall survival (OS) were estimated using Kaplan‐Meier analysis. Results We identified 83 patients; 19 (23%) had functional NET. First‐line treatments included somatostatin analogs (SSAs) alone (56%) or in combination with other therapies (6%), cytotoxic chemotherapy (20%), external beam radiation therapy (EBRT) (9%), liver‐directed therapy (LDT) (4%), and everolimus/other (5%). Sixty patients had second‐line therapy including SSA alone (18%) or in combination (40%), cytotoxic chemotherapy (17%), everolimus (12%), LDT (7%), EBRT (3%), and other treatments (3%). Median time (months) to first‐line discontinuation were as follows: SSAs, 43.3; cytotoxic chemotherapy, 3.6. Overall median time (months) to investigator‐assessed progression following treatment initiation was 12.4. Median OS (months) following treatment initiation was 66.4 for all patients and 81.5 for patients receiving SSAs. Conclusion SSAs, alone and in combination, are common treatments for advanced lung NETs. Patients have additional treatment options and relatively long survival compared with patients with other advanced cancers. Treatment pattern assessment following approval of newer treatments is needed. Implications for Practice Somatostatin analogs (SSAs), cytotoxic chemotherapy, EBRT, liver‐directed therapy, and targeted therapies are common treatments for locally advanced/metastatic (typical/atypical) lung neuroendocrine tumors (NETs). SSAs alone or in combination with other treatment modalities were the most common first‐ and second‐line therapy, followed by cytotoxic chemotherapy. Patients continued treatment with SSAs long‐term with median treatment duration of 43 months. Median overall survival was 66 months following initiation of first‐line therapy for all patients. Treatment pattern assessment beyond the time period of this study is needed given recent U.S. Food and Drug Administration approvals for additional treatments for lung NETs that will likely be incorporated in the treatment landscape.

show abstract

“…A study by Ezziddin and colleagues [112] showed that PRRT may be useful not only for tumors with Ki-67 tumor proliferation index of < 20% (G1 and G2) but also in patients with poorly differentiated tumors with a Ki-67 proliferation index of > 20% (G3). Given the NETTER-1 results, use of PRRT may increase [113]. …”

Section: Peptide Receptor Radionuclide Therapy In Neuroendocrine Tumorsmentioning

confidence: 99%

Targeted Radionuclide Therapy: An Evolution Toward Precision Cancer Treatment

Jadvar

2017

American Journal of Roentgenology

View full text Add to dashboard Cite

Objective This article reviews recent developments in targeted radionuclide therapy (TRT) approaches directed to malignant liver lesions, bone metastases, neuroendocrine tumors, and castrate-resistant metastatic prostate cancer and discusses challenges and opportunities in this field. Conclusion TRT has been employed since the first radioiodine thyroid treatment almost 75 years ago. Progress in the understanding of the complex underlying biology of cancer and advances in radiochemistry science, multimodal imaging techniques including the concept of “see and treat” within the framework of theranostics, and universal traction with the notion of precision medicine have all contributed to a resurgence of TRT.

show abstract

United States-based practice patterns and resource utilization in advanced neuroendocrine tumor treatment

Abstract: Resource utilization in advanced NET in the United States is significant overall and data suggests progression has an impact on resource utilization regardless of NET tumor site.

Cited by 21 publications

References 8 publications

Assessment of NETest Clinical Utility in a U.S. Registry-Based Study

Assessment of NETest Clinical Utility in a U.S. Registry-Based Study

Treatment Patterns and Clinical Outcomes in Advanced Lung Neuroendocrine Tumors in Real-World Settings: A Multicenter Retrospective Chart Review Study

Targeted Radionuclide Therapy: An Evolution Toward Precision Cancer Treatment

Contact Info

Product

Resources

About