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Published on: August 14, 2012
Tumor Growth Rate in Neuroendocrine Neoplasms: An Additional Tool for Treatment Strategies?
Roberta Modica1, Alessia Liccardi1, Elio Benevento1
1Endocrinology, Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, Federico II University of Naples, 80131 Naples, Italy.
Abstract:
Background and Objectives: Neuroendocrine neoplasms (NENs) are rare, mainly gastro-entero-pancreatic tumors with heterogeneous biology and multiple therapeutic options. Assessing treatment response remains challenging. Standard evaluation relies on RECIST 1.1, although its limitations are well recognized. Tumor growth rate (TGR), defined as the monthly percentage change in tumor size between two imaging assessments, has been proposed as a dynamic parameter to complement conventional criteria. This review explores the role of TGR in NEN. Results: Two different evaluations of TGR, once conducted between baseline diagnostic scan and a radiological assessment 12-24 weeks after (TGR0), and another conducted between baseline scan and a diagnostic evaluation three months after (TGR3m), proved to be well correlated to progression free survival (PFS) in G1 and low-G2 NEN, with cut off of 4%/month and 0.8%/month, respectively. Conclusions: TGR offers additional insights into tumor kinetics and may help refine treatment monitoring in NEN. While retrospective evidence supports its prognostic utility, prospective studies are required to validate TGR as a standard clinical tool.
Insights
Tumor growth rate (TGR) shows promise for monitoring neuroendocrine neoplasms (NENs). This dynamic parameter may improve treatment assessment beyond standard RECIST 1.1 criteria in NEN patients.
Area of Science:
- Oncology
- Radiology
- Medical Imaging
Background:
- Neuroendocrine neoplasms (NENs) are rare tumors with complex biology and varied treatments.
- Accurate assessment of treatment response in NENs is challenging.
- Current RECIST 1.1 criteria have recognized limitations for NEN evaluation.
Purpose of the Study:
- To review the role and utility of Tumor Growth Rate (TGR) in assessing neuroendocrine neoplasms.
- To explore TGR as a dynamic parameter complementing conventional imaging criteria for NENs.
Main Methods:
- Review of studies evaluating Tumor Growth Rate (TGR) in neuroendocrine neoplasms.
- Analysis of TGR calculations, including TGR0 (12-24 weeks) and TGR3m (3 months).
- Correlation of TGR with progression-free survival (PFS) in different NEN grades.
Main Results:
- TGR assessments (TGR0 and TGR3m) correlated well with progression-free survival (PFS) in G1 and low-G2 NEN.
- Specific TGR cut-offs identified: 4%/month for TGR0 and 0.8%/month for TGR3m in relevant NEN subtypes.
- TGR provides insights into tumor kinetics beyond static RECIST measurements.
Conclusions:
- Tumor Growth Rate (TGR) offers valuable prognostic information in neuroendocrine neoplasms.
- TGR may refine treatment monitoring strategies for NEN patients.
- Further prospective studies are needed to establish TGR as a standard clinical tool for NEN management.
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