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CT evaluation of response in advanced gastroenteropancreatic neuroendocrine tumors treated with long-acting-repeatable octreotide: what is the optimal size variation threshold?

CT evaluation of response in advanced gastroenteropancreatic neuroendocrine tumors treated with... Objective To identify a reliable early indicator of deriving progression-free survival (PFS) benefit in patients with advanced gastroenteropancreatic neuroendocrine tumors (GEP-NETs) treated with octreotide long-acting repeatable (LAR). Methods We investigated the images of 50 patients with well-differentiated advanced GEP-NETs treated with LAR octreotide and underwent baseline and follow-up thoracic, abdominal, and pelvic computed tomography. Receiver-operating characteristic (ROC) analysis and the Kaplan-Meier method were used to identify the optimal threshold to distinguish between those with and without significant improvement of PFS. Results The optimal threshold for determining a response to octreotide LAR was -10% ΔSLD, with a sensitivity and specificity of 85.7% and 80%, respectively. At this threshold, 19 patients were responders and 31 were non-responders; the median PFS was 20.2 and 7.6 months in responders and non-responders (hazard ratio, 2.66; 95% confidence interval, 1.32–5.36). Conclusion A 10% shrinkage in tumor size is an optimal early predictor of response to octreotide LAR in advanced GEP-NETs. Key points � Octreotide LAR can significantly prolong PFS among patients with well-differentiated advanced GEP-NETs. � No optimal tumor size-based response criteria are reported in GEP-NETs with octreotide. � Ten percent tumor shrinkage is a reliable indicator of the response to octreotide for advanced GEP-NETs. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Radiology Springer Journals

CT evaluation of response in advanced gastroenteropancreatic neuroendocrine tumors treated with long-acting-repeatable octreotide: what is the optimal size variation threshold?

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References (32)

Publisher
Springer Journals
Copyright
Copyright © 2018 by European Society of Radiology
Subject
Medicine & Public Health; Imaging / Radiology; Diagnostic Radiology; Interventional Radiology; Neuroradiology; Ultrasound; Internal Medicine
ISSN
0938-7994
eISSN
1432-1084
DOI
10.1007/s00330-018-5512-1
Publisher site
See Article on Publisher Site

Abstract

Objective To identify a reliable early indicator of deriving progression-free survival (PFS) benefit in patients with advanced gastroenteropancreatic neuroendocrine tumors (GEP-NETs) treated with octreotide long-acting repeatable (LAR). Methods We investigated the images of 50 patients with well-differentiated advanced GEP-NETs treated with LAR octreotide and underwent baseline and follow-up thoracic, abdominal, and pelvic computed tomography. Receiver-operating characteristic (ROC) analysis and the Kaplan-Meier method were used to identify the optimal threshold to distinguish between those with and without significant improvement of PFS. Results The optimal threshold for determining a response to octreotide LAR was -10% ΔSLD, with a sensitivity and specificity of 85.7% and 80%, respectively. At this threshold, 19 patients were responders and 31 were non-responders; the median PFS was 20.2 and 7.6 months in responders and non-responders (hazard ratio, 2.66; 95% confidence interval, 1.32–5.36). Conclusion A 10% shrinkage in tumor size is an optimal early predictor of response to octreotide LAR in advanced GEP-NETs. Key points � Octreotide LAR can significantly prolong PFS among patients with well-differentiated advanced GEP-NETs. � No optimal tumor size-based response criteria are reported in GEP-NETs with octreotide. � Ten percent tumor shrinkage is a reliable indicator of the response to octreotide for advanced GEP-NETs.

Journal

European Radiology – Springer Journals

Published: Jun 6, 2018

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