Abstract
Pancreatic neuroendocrine tumours (pnets) often present as advanced disease. The optimal sequence of therapy is unknown. Sequential patients with advanced pnets referred to BC Cancer between 2000 and 2013 who received 1 or more treatment modalities were reviewed, and treatment patterns, progression-free survival (pfs), and overall survival (os) were characterized. Systemic treatments included chemotherapy, small-molecule therapy, and peptide receptor radionuclide therapy. In 66 cases of advanced pnets, median patient age was 61.2 years (25%-75% interquartile range: 50.8-66.2 years), and men constituted 47% of the group. First-line therapies were surgery (36%), chemotherapy (33%), and somatostatin analogues (32%). Compared with first-line systemic therapy, surgery in the first line was associated with increased pfs and os (20.6 months vs. 6.3 months and 100.3 months vs. 30.5 months respectively, p < 0.05). In 42 patients (64%) who received more than 1 line of therapy, no difference in os or pfs between second-line therapies was observed. Our results confirm the primary role of surgery for advanced pnets. New systemic treatments will further increase options.
Highlights
Pancreatic neuroendocrine tumours are rare malignancies, with an age-adjusted annual incidence rate of 0.48 per 100,000 population, and 64% of patients present with metastatic disease[1,2,3]
Compared with first-line systemic therapy, surgery in the first line was associated with increased pfs and os (20.6 months vs. 6.3 months and 100.3 months vs. 30.5 months respectively, p < 0.05)
Our results confirm the primary role of surgery for advanced pnets
Summary
Pancreatic neuroendocrine tumours (pnets) are rare malignancies, with an age-adjusted annual incidence rate of 0.48 per 100,000 population, and 64% of patients present with metastatic disease[1,2,3]. Available treatments include surgical resection, chemotherapy, targeted agents, liverdirected therapy, and peptide receptor radionuclide therapy (prrt)[4,5,6]. First-line therapies are often selected based on clinical presentation, and upfront surgical resection is considered when possible. In the second-line setting, evidence-based recommendations are limited, and choice of therapy and treatment sequence have largely been based on clinician judgment[7]. The objectives of the present study were to characterize the sequence of therapy for advanced pnets in a population-based setting and to explore differences in survival between treatment cohorts. Pancreatic neuroendocrine tumours (pnets) often present as advanced disease.
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call