Ranallo Nicoletta, Iamurri Andrea Prochoswski, Foca Flavia, Liverani Chiara, De Vita Alessandro, Mercatali Laura, Calabrese Chiara, Spadazzi Chiara, Fabbri Carlo, Cavaliere Davide, Galassi Riccardo, Severi Stefano, Sansovini Maddalena, Tartaglia Andreas, Pieri Federica, Crudi Laura, Bianchini David, Barone Domenico, Martinelli Giovanni, Frassineti Giovanni Luca, Ibrahim Toni, Calabrò Luana, Berardi Rossana, Bongiovanni Alberto
Osteoncology and Rare Tumors Center, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", 47014 Meldola, Italy.
Radiology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", 47014 Meldola, Italy.
Cancers (Basel). 2022 Jun 30;14(13):3231. doi: 10.3390/cancers14133231.
Neuroendocrine tumors (NETs) are rare neoplasms frequently characterized by an upregulation of the mammalian rapamycin targeting (mTOR) pathway resulting in uncontrolled cell proliferation. The mTOR pathway is also involved in skeletal muscle protein synthesis and in adipose tissue metabolism. Everolimus inhibits the mTOR pathway, resulting in blockade of cell growth and tumor progression. The aim of this study is to investigate the role of body composition indexes in patients with metastatic NETs treated with everolimus. The study population included 30 patients with well-differentiated (G1-G2), metastatic NETs treated with everolimus at the IRCCS Romagnolo Institute for the Study of Tumors (IRST) "Dino Amadori", Meldola (FC), Italy. The body composition indexes (skeletal muscle index [SMI] and adipose tissue indexes) were assessed by measuring on a computed tomography (CT) scan the cross-sectional area at L3 at baseline and at the first radiological assessment after the start of treatment. The body mass index (BMI) was assessed at baseline. The median progression-free survival (PFS) was 8.9 months (95% confidence interval [CI]: 3.4-13.7 months). The PFS stratified by tertiles was 3.2 months (95% CI: 0.9-10.1 months) in patients with low SMI (tertile 1), 14.2 months (95% CI: 2.3 months-not estimable [NE]) in patients with intermediate SMI (tertile 2), and 9.1 months (95% CI: 2.7 months-NE) in patients with high SMI (tertile 3) ( = 0.039). Similarly, the other body composition indexes also showed a statistically significant difference in the three groups on the basis of tertiles. The median PFS was 3.2 months (95% CI: 0.9-6.7 months) in underweight patients (BMI ≤ 18.49 kg/m) and 10.1 months (95% CI: 3.7-28.4 months) in normal-weight patients ( = 0.011). There were no significant differences in terms of overall survival. The study showed a correlation between PFS and the body composition indexes in patients with NETs treated with everolimus, underlining the role of adipose and muscle tissue in these patients.
神经内分泌肿瘤（NETs）是一种罕见的肿瘤，其特征通常是哺乳动物雷帕霉素靶蛋白（mTOR）通路上调，导致细胞增殖失控。mTOR通路还参与骨骼肌蛋白质合成和脂肪组织代谢。依维莫司可抑制mTOR通路，从而阻断细胞生长和肿瘤进展。本研究旨在探讨身体成分指标在接受依维莫司治疗的转移性NETs患者中的作用。研究人群包括30例在意大利梅尔多拉（费利切）的IRCCS罗马尼奥洛肿瘤研究所（IRST）“迪诺·阿马多里”接受依维莫司治疗的高分化（G1-G2）转移性NETs患者。通过在计算机断层扫描（CT）上测量基线时以及治疗开始后的首次影像学评估时L3水平的横截面积，评估身体成分指标（骨骼肌指数[SMI]和脂肪组织指数）。在基线时评估体重指数（BMI）。中位无进展生存期（PFS）为8.9个月（95%置信区间[CI]：3.4 - 13.7个月）。按三分位数分层的PFS在低SMI患者（第1三分位数）中为3.2个月（95% CI：0.9 - 10.1个月），在中等SMI患者（第2三分位数）中为14.2个月（95% CI：2.3个月 - 不可估计[NE]），在高SMI患者（第3三分位数）中为9.1个月（95% CI：2.7个月 - NE）（P = 0.039）。同样，其他身体成分指标在基于三分位数的三组中也显示出统计学上的显著差异。体重过轻患者（BMI≤18.49 kg/m²）的中位PFS为3.2个月（95% CI：0.9 - 6.7个月），正常体重患者的中位PFS为10.1个月（95% CI：3.7 - 28.4个月）（P = 0.011）。总生存期方面无显著差异。该研究表明，在接受依维莫司治疗的NETs患者中，PFS与身体成分指标之间存在相关性，强调了脂肪和肌肉组织在这些患者中的作用。
