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Multicenter Retrospective Study of Efficacy of Systemic Therapy in Patients with Neuroendocrine Tumor Grade 3
Hiroyuki Okuyama1, Taro Shibuki2, Naohiro Okano3
1Department of Medical Oncology, Kagawa University Hospital, Miki, Japan, okuyama.hiroyuki@kagawa-u.ac.jp.
Background:
Neuroendocrine tumor G3 (NET G3) is a new category introduced in the WHO 2017 classification. Accordingly, evidence regarding chemotherapy for NET G3 is limited. A multicenter, retrospective analysis was performed to evaluate the outcomes of systemic therapy for NET G3 and to identify the optimal regimens.
Methods:
Patient demographic and treatment outcome data were retrospectively collected for 73 patients with pathologically diagnosed NET G3 who started chemotherapy at participating institutions between January 2011 and December 2019, excluding those who were ineligible by central pathological review. The chemotherapy regimens used and their efficacies were evaluated.
Results:
Of the 73 patients, 47 had pancreatic NETs, 10 had gastrointestinal NETs, and 16 had NETs at other sites. Central pathological review was performed for 44 patients, with a concordance rate of 95%. Initial treatment regimens included NET-based treatment (somatostatin analog, molecular-targeted agent, cytotoxic chemotherapy such as streptozocin and temozolomide) for 37 patients, neuroendocrine carcinoma (NEC)-based treatment (platinum-containing chemotherapy) for 32 patients, and other regimens for 2 patients. There were no significant differences in progression-free survival (PFS) or overall survival (OS) between patients receiving NET-based and NEC-based treatment or among the individual treatment regimens. However, the response rate (RR) was higher for NET-based cytotoxic chemotherapy (50%) compared with NEC-based treatment (16%), suggesting greater efficacy of NET-based cytotoxic chemotherapy.
Conclusions:
Although no significant difference in PFS or OS was found among the chemotherapy regimens for NET G3, RR was notably higher for NET-based cytotoxic chemotherapy than for NEC-based treatment.
Insights
Chemotherapy for neuroendocrine tumor G3 (NET G3) shows similar survival outcomes. However, NET-based cytotoxic chemotherapy demonstrated a higher response rate compared to neuroendocrine carcinoma-based treatment.
Area of Science:
- Oncology
- Medical Research
Background:
- Neuroendocrine tumor G3 (NET G3) is a recently defined entity in the WHO 2017 classification.
- Limited evidence exists regarding optimal chemotherapy for NET G3.
- This study evaluates systemic therapy outcomes for NET G3.
Purpose of the Study:
- To assess the efficacy of different chemotherapy regimens for NET G3.
- To identify optimal treatment strategies for NET G3 patients.
Main Methods:
- Retrospective analysis of 73 NET G3 patients treated between 2011-2019.
- Evaluation of patient demographics, chemotherapy regimens, and treatment outcomes.
- Central pathological review for 44 patients.
Main Results:
- No significant difference in progression-free survival (PFS) or overall survival (OS) between NET-based and neuroendocrine carcinoma (NEC)-based treatments.
- Response rate (RR) was higher for NET-based cytotoxic chemotherapy (50%) versus NEC-based treatment (16%).
- Pancreatic NETs comprised the largest subgroup (47 patients).
Conclusions:
- While PFS and OS did not differ significantly across regimens, NET-based cytotoxic chemotherapy showed a superior response rate.
- Further research into optimal NET G3 chemotherapy is warranted.
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