Medical Oncology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University of Brescia, ASST-Spedali Civili, Brescia, Italy.
Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, IEO European Institute of Oncology, IRCCS, Milan, Italy.
Front Endocrinol (Lausanne). 2021 Apr 27;12:669484. doi: 10.3389/fendo.2021.669484. eCollection 2021.
Antiproliferative activity of somatostatin analogs (SSAs) has been demonstrated in digestive neuroendocrine tumors (NETs), but few data have been published in patients with pulmonary NETs. We therefore conducted a retrospective study to provide additional data on the outcome of patients with metastatic lung NETs submitted to front line SSAs.
Patients with metastatic lung NET treated with first line SSA-monotherapy (octreotide or lanreotide) in two different reference Institutions were reviewed. Outcome measures were progression-free survival (PFS) overall survival (OS), overall response rate and safety. We also explored prognostic factors associated with PFS.
The outcome of consecutive patients (pts) with metastatic lung NETs, who underwent first-line treatment with SSAs, recruited from 2014 on 2019 in two Italian reference Institutions, was retrospectively evaluated.
Thirty-one patients entered the study: 14 (45.2%) with typical and 17 (54.8%) atypical carcinoid. Six patients (19.4%) had a carcinoid syndrome. 60.0% of patients had Ki-67 ≤ 10%. Two (6.5%) patients obtained a partial response, 24 (77.4%) disease stabilization while 5 (16.1%) had progressive disease. Median progression free survival (PFS) was 28.6 months, median overall survival (OS) was not attained. Ki-67 ≤ 10%, typical carcinoid histotype and non-functioning disease, were associated with a non-significant PFS prolongation. PFS in patients with atypical carcinoids and in those with Ki-67 >10% was greater than 19 months.
The long PFS and OS obtained in this case series suggest that SSAs could be effective as first line approach in the management of patients with progressive, metastatic pulmonary NET.
生长抑素类似物（SSAs）的抗增殖活性已在消化道神经内分泌肿瘤（NETs）中得到证实，但很少有数据发表在肺 NET 患者中。因此，我们进行了一项回顾性研究，为接受一线 SSAs 治疗的转移性肺 NET 患者的预后提供更多数据。
回顾性分析了在两个不同参考机构接受一线 SSA 单药治疗（奥曲肽或兰瑞肽）的转移性肺 NET 患者。主要终点为无进展生存期（PFS）、总生存期（OS）、总缓解率和安全性。我们还探讨了与 PFS 相关的预后因素。
回顾性分析了 2014 年至 2019 年期间在意大利两个参考机构接受一线 SSAs 治疗的转移性肺 NET 患者的连续患者（pts）的结局。
31 例患者进入研究：14 例（45.2%）为典型类癌，17 例（54.8%）为非典型类癌。6 例（19.4%）存在类癌综合征。60.0%的患者 Ki-67≤10%。2 例（6.5%）患者获得部分缓解，24 例（77.4%）疾病稳定，5 例（16.1%）疾病进展。中位无进展生存期（PFS）为 28.6 个月，中位总生存期（OS）未达到。Ki-67≤10%、典型类癌组织学类型和无功能性疾病与无显著 PFS 延长相关。非典型类癌和 Ki-67>10%的患者的 PFS 超过 19 个月。
本病例系列研究中获得的较长 PFS 和 OS 表明，SSAs 可能是治疗进展性、转移性肺 NET 患者的一线有效方法。
