Somatostatin analogs in association with peptide receptor radionucleotide therapy in advanced well-differentiated NETs

Future Oncol. 2019 Sep;15(26):3015-3024. doi: 10.2217/fon-2019-0138. Epub 2019 Aug 19.

Abstract

Aim: Data from 69 well-differentiated gastroenteropancreatic neuroendocrine tumors treated with peptide receptor radionucleotide therapy + somatostatin analogs (SSAs) after SSA treatment failure were evaluated. Methods: We identified two groups: S1 - patients who kept the same SSA treatment beyond progression; S2 - patients who switched the SSA with another SSA after progression. Results: Median progression-free survival was 53 and 127 months in S1 and S2, respectively (p = 0.001; hazard ratio: 0.31; 95% CI: 0.15-0.63). Median overall survival was 69 versus 150 months in S1 and S2, respectively (p = 0.004; hazard ratio: 0.32; 95% CI: 0.14-0.71). Conclusion: In patients with advanced well-differentiated gastroenteropancreatic neuroendocrine tumors treated with peptide receptor radionucleotide therapy plus SSA after SSA failure, the 'switch' strategy of SSA after progression improve progression-free survival and overall survival.

Keywords: combinational therapy; gasto-entero-pancreatic neuroendocrine tumors; peptide receptor radionucleotide therapy; somatostatin analogues; switching strategy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Intestinal Neoplasms / metabolism
  • Intestinal Neoplasms / mortality
  • Intestinal Neoplasms / pathology*
  • Intestinal Neoplasms / therapy*
  • Isotope Labeling*
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Neoplasm Metastasis
  • Neoplasm Staging
  • Neuroendocrine Tumors / metabolism
  • Neuroendocrine Tumors / mortality
  • Neuroendocrine Tumors / pathology*
  • Neuroendocrine Tumors / therapy*
  • Nucleotides* / chemistry
  • Pancreatic Neoplasms / metabolism
  • Pancreatic Neoplasms / mortality
  • Pancreatic Neoplasms / pathology*
  • Pancreatic Neoplasms / therapy*
  • Prognosis
  • Proportional Hazards Models
  • Receptors, Peptide / metabolism
  • Retrospective Studies
  • Somatostatin / analogs & derivatives
  • Somatostatin / chemistry
  • Somatostatin / therapeutic use*
  • Stomach Neoplasms / metabolism
  • Stomach Neoplasms / mortality
  • Stomach Neoplasms / pathology*
  • Stomach Neoplasms / therapy*
  • Treatment Outcome

Substances

  • Nucleotides
  • Receptors, Peptide
  • Somatostatin

Supplementary concepts

  • Gastro-enteropancreatic neuroendocrine tumor