Analytica LASER International, New York, New York, USA.
Analytica LASER International, Lörrach, Germany.
Oncologist. 2020 Apr;25(4):e644-e650. doi: 10.1634/theoncologist.2019-0691. Epub 2020 Jan 30.
Although an increasing number of treatments have become available for patients with advanced gastroenteropancreatic neuroendocrine tumors (GEP-NETs), there remains little consensus on treatment sequence and its impact on health care resource use (HRU). We sought to describe treatment patterns and HRU, in a cohort of patients with metastatic GEP-NETs treated at a tertiary referral center in the U.S.
We identified patients with a well-differentiated, metastatic GEP-NET evaluated at Dana-Farber Cancer Institute between July 2003 and May 2015. For these patients, we describe the sequence of treatment regimens received for their disease, together with associated HRU.
We identified 682 patients with advanced GEP-NETs. Of these patients, 597 (87.0%) initiated ≥1 treatment over the follow-up period. The mean age at diagnosis was 58.5 years, 50.2% were men, and 94.0% were white. A total of 83.1% initiated a somatostatin analog (SSA) as their first-line treatment, with 55% and 31% of patients continuing with second- and third-line therapies. A total of 31.2% of patients with SSAs underwent dose escalation to above standard dose. In this setting, patients with pancreatic neuroendocrine tumors were more commonly treated with cytotoxic regimens than other NET tumor types and also had higher HRU.
Our study suggests that, at a tertiary referral center, patients with advanced NETs commonly received multiple courses of treatments. Our data suggest a clear preference for use of SSAs as a first-line treatment for patients with advanced NETs, with SSAs commonly escalated and continued throughout the course of treatment in combination with other regimens.
The current study demonstrates the common use of somatostatin analog as a first-line therapy for patients with advanced gastroenteropancreatic neuroendocrine tumors as well as the incorporation of multiple different treatment regimens in the treatment course of patients with this disease.
尽管越来越多的治疗方法可用于治疗晚期胃肠胰神经内分泌肿瘤（GEP-NET）患者，但对于治疗顺序及其对医疗资源利用（HRU）的影响，仍缺乏共识。我们旨在描述在美国一家三级转诊中心治疗的转移性 GEP-NET 患者的治疗模式和 HRU。
我们确定了 2003 年 7 月至 2015 年 5 月在 Dana-Farber 癌症研究所接受评估的分化良好的转移性 GEP-NET 患者。对于这些患者，我们描述了他们疾病接受的治疗方案的顺序，以及相关的 HRU。
我们确定了 682 名晚期 GEP-NET 患者。其中，597 名（87.0%）在随访期间至少接受了 1 种治疗。诊断时的平均年龄为 58.5 岁，50.2%为男性，94.0%为白人。共有 83.1%的患者首先接受了生长抑素类似物（SSA）治疗，其中 55%和 31%的患者继续接受二线和三线治疗。共有 31.2%接受 SSA 治疗的患者将剂量上调至标准剂量以上。在这种情况下，胰腺神经内分泌肿瘤患者比其他 NET 肿瘤类型更常接受细胞毒性治疗方案，并且 HRU 也更高。
我们的研究表明，在三级转诊中心，晚期 NET 患者通常接受多次治疗。我们的数据表明，SSA 作为晚期 NET 患者的一线治疗药物具有明显的优势，SSA 通常在整个治疗过程中上调并与其他方案联合使用。
本研究表明，SSA 作为晚期胃肠胰神经内分泌肿瘤患者的一线治疗药物被广泛应用，并且在该疾病患者的治疗过程中加入了多种不同的治疗方案。
