Hematological Markers as Predictors of Treatment Outcomes with Lutetium 177 (Lu)-DOTATATE in Patients with Advanced Neuroendocrine Tumors.

Chronic inflammation has been linked to the development and prognosis of neuroendocrine tumors (NETs). The current study intended to evaluate the role of peripheral hematological inflammatory markers, viz. the platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio, and monocyte-lymphocyte ratio, as predictors of treatment outcomes in patients with advanced NETs after Lutetium-177(Lu)-DOTATATE therapy. Data of consecutive patients with advanced metastatic and/or inoperable NETs treated with Lu-DOTATATE from the year 2012 to 2019 at the authors' center were retrospectively analyzed. Forty-two NET patients (median age: 49.5 years) received a median cumulative activity of 29.6 GBq of Lu-DOTATATE over 2-5 cycles at 8-12-week intervals. The median progression-free survival (PFS) of the study cohort was 30 months (95% confidence interval, CI: 18.2-41.9 months). A baseline PLR ≥173.1 was found to be a significant predictor of poor PFS with a univariate hazard ratio of 3.82 (95% CI: 1.21-12.03); however, the association was not significant on multivariate analysis. The median overall survival was not reached and none of the parameters were significantly associated with it. A higher baseline PLR was shown to be associated with a negative outcome on PFS after Lu-DOTATATE therapy and is a promising marker for future larger studies.