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Treatment efficacy ...
Treatment efficacy in a metastatic small intestinal neuroendocrine tumour grade 2 cohort
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- Papantoniou, Dimitrios (author)
- Uppsala universitet,Onkologisk endokrinologi,Ryhov Cty Hosp, Dept Oncol, Jönköping, Sweden.,Uppsala Univ, Sweden; Ryhov Cty Hosp, Sweden
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- Grönberg, Malin, 1980- (author)
- Uppsala universitet,Onkologisk endokrinologi,Uppsala Univ, Sweden
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- Thiis-Evensen, Espen (author)
- Oslo Univ Hosp, Rikshosp, Dept Organ Transplant, Oslo, Norway.
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- Sorbye, Halfdan (author)
- Haukeland Hosp, Dept Oncol, Bergen, Norway.;Univ Bergen, Dept Clin Med, Bergen, Norway.
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- Landerholm, Kalle (author)
- Linköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Ryhov Cty Hosp, Sweden
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- Welin, Staffan (author)
- Uppsala universitet,Onkologisk endokrinologi,Uppsala Univ, Sweden
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- Tiensuu Janson, Eva (author)
- Uppsala universitet,Onkologisk endokrinologi,Uppsala Univ, Sweden
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(creator_code:org_t)
- Bioscientifica, 2023
- 2023
- English.
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In: Endocrine-Related Cancer. - : Bioscientifica. - 1351-0088 .- 1479-6821. ; 30:3
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Abstract
Subject headings
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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) tumours, 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 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 (IFN alpha), everolimus and chemotherapy was 6, 5 and 9 months. IFN alpha 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.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Gastroenterologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)
Keyword
- small intestinal neuroendocrine tumours
- Si-NET
- grade 2
- somatostatin analogues
- interferon
- PRRT
- peptide receptor radionuclide treatment
- Ki-67
- somatostatin receptor negative
Publication and Content Type
- ref (subject category)
- art (subject category)
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