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Published on: April 17, 2019
Therapeutic Efficacy of Neoadjuvant Peptide Receptor Radionuclide Therapy in Neuroendocrine Tumors: A Meta-analysis
1Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Purpose:
Peptide receptor radionuclide therapy (PRRT) has an established role in the management of metastatic neuroendocrine tumors (NETs); however, the potential benefits of neoadjuvant PRRT remain insufficiently characterized. This study aimed to evaluate the therapeutic efficacy of neoadjuvant PRRT in patients with NETs through a meta-analysis.
Patients And Methods:
A systematic database search of PubMed, EMBASE, and the Cochrane Library was performed using the keywords "neuroendocrine tumor," "neoadjuvant therapy," and "peptide receptor radionuclide therapy." Pooled proportions of objective response rate (ORR), disease control rate (DCR), surgical resection rate (SRR), and R0 resection rate (RRR) were calculated to assess therapeutic efficacy. Subgroup analyses were conducted to explore the influence of primary NET resectability.
Results:
A total of 237 patients from 10 studies were included. Neoadjuvant PRRT achieved ORR of 39.1% (95% CI, 21.0%-59.0%), DCR of 89.0% (95% CI, 78.5%-96.3%), SRR of 51.7% (95% CI, 31.1%-72.1%), and RRR of 69.0% (95% CI, 59.9%-77.1%). Subgroup analysis indicated that therapeutic efficacy was comparable regardless of primary NET resectability (ORR, DCR, and RRR).
Conclusions:
Neoadjuvant PRRT appears to be an effective therapeutic strategy for patients with NETs, particularly by reducing tumor size and stage in borderline resectable or unresectable cases. These findings suggest that neoadjuvant PRRT represents a promising option to facilitate surgical resection and improve outcomes in NET patients.
Insights
Neoadjuvant peptide receptor radionuclide therapy (PRRT) shows significant efficacy in treating neuroendocrine tumors (NETs). This approach improves tumor response and facilitates surgical resection, offering a promising option for NET patients.
Area of Science:
- Oncology
- Nuclear Medicine
- Surgical Oncology
Background:
- Peptide receptor radionuclide therapy (PRRT) is established for metastatic neuroendocrine tumors (NETs).
- The efficacy of neoadjuvant PRRT for NETs requires further characterization.
- Neoadjuvant therapy aims to improve resectability and patient outcomes prior to definitive treatment.
Purpose of the Study:
- To evaluate the therapeutic efficacy of neoadjuvant PRRT in patients with neuroendocrine tumors (NETs).
- To assess response rates and surgical outcomes following neoadjuvant PRRT via meta-analysis.
Main Methods:
- Systematic literature search of PubMed, EMBASE, and Cochrane Library.
- Keywords: neuroendocrine tumor, neoadjuvant therapy, peptide receptor radionuclide therapy.
- Pooled analysis of objective response rate (ORR), disease control rate (DCR), surgical resection rate (SRR), and R0 resection rate (RRR).
Main Results:
- Included 237 patients from 10 studies.
- Achieved ORR: 39.1%, DCR: 89.0%, SRR: 51.7%, RRR: 69.0%.
- Efficacy was consistent regardless of primary NET resectability.
Conclusions:
- Neoadjuvant PRRT is an effective strategy for NET patients.
- It facilitates tumor downstaging and improves surgical resection rates.
- Represents a promising approach to enhance outcomes in NET management.
