Abstract
ObjectiveAntiproliferative 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.Research Design and MethodsPatients 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.MethodsThe 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.ResultsThirty-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.ConclusionsThe 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.
Highlights
Bronchial carcinoids are a rare group of well-differentiated lung neuroendocrine tumors (NETs) with an incidence in western countries ranging from 0.2 to 2/100 000 persons/year [1]
We retrospectively reviewed data of consecutive patients with metastatic lung NET, treated with first line somatostatin analogs (SSAs) monotherapy, from January 2014 to December 2019, at the Medical Oncology Unit of ASST Spedali Civili di Brescia and at the Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors of the European Institute of Oncology of Milan (IEO)
One tumor, classified as atypical carcinoid, had Ki-67≥20%. This latter tumor was classified as an atypical carcinoid due to the well-differentiated phenotype
Summary
Bronchial carcinoids are a rare group of well-differentiated lung neuroendocrine tumors (NETs) with an incidence in western countries ranging from 0.2 to 2/100 000 persons/year [1]. Lung NETs frequently express somatostatin receptors, somatostatin analogs (SSAs), such as lanreotide autogel (LAN) and octreotide long-acting release (LAR), are frequently used therapies and recommended by available guidelines [2, 13, 14]. These drugs are well tolerated and have demonstrated both anti-secretory and anti-proliferative effects in NET patients. One of them enrolled patients undergoing SSAs both as first, and second line approach [21], only one study retrospectively evaluated patients treated with first line SSAs [22]
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