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使用链毒素的化学栓塞与转移性NET中的栓塞相比.

Anne-Laure Védie1, Francesco Matteini2,3, Jérôme Cros4

  • 1Université Paris-Cité, Department of Pancreatology and Digestive Oncology, Beaujon Hospital (APHP.Nord), Clichy, France.

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在肝转移的神经内分泌瘤中,用条毒素 (STZ) 进行的跨动脉化学栓塞 (TACE) 显示出比跨动脉栓塞 (TAE) 更高的响应率. 低基氨酸-DNA-N-葡萄糖酶 (APNG) 表达可能预测TACE的疗效.

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科学领域:

  • 在瘤学瘤学.
  • 干预性放射学 干预性放射学

背景情况:

  • 地方区域疗法是肝转移的神经内分泌瘤 (NET) 的标准.
  • 通过动脉化学栓塞 (TACE) 与链毒素 (STZ) 与通过动脉栓塞 (TAE) 和预测生物标志物的疗效尚未得到充分研究.

研究的目的:

  • 为了比较TACE-STZ与TAE在患有胰腺 (panNET) 或小肠 (siNET) NET和肝脏转移的患者中的疗效.
  • 为了探索TACE-STZ疗效的预测生物标志物.

主要方法:

  • 在2006-2022年间接受TACE-STZ或TAE治疗的116名患者的回顾性研究.
  • 每个RECIST 1.1的目标响应率 (ORR) 是主要的终点.
  • 评估了倾向性评分分析和瘤生物标志物表达 (MGMT,APNG,CAIX).

主要成果:

  • TACE-STZ的ORR (43%与22%相比,P=0.045) 显著高于TAE.
  • 在panNET (12.9 vs 6.4个月,P=0.026) 中,TACE-STZ改善了无进展生存期 (PFS),但不是siNET患者.
  • 较低的APNG表达预测TACE-STZ的ORR更高 (70%与16%,P<0.001).

结论:

  • 在对具有肝转移的NET的响应率方面,TACE-STZ比TAE更有效.
  • TACE-STZ主要在泛网患者中提供PFS的好处.
  • 低APNG表达可能会识别出可能从TACE-STZ治疗中受益的患者.