Somatostatin analogues according to Ki67 index in neuroendocrine tumours: an observational retrospective-prospective analysis from real life.
Somatostatin analogues according to Ki67 index in neuroendocrine tumours: an observational retrospective-prospective analysis from real life.
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DOI：
10.18632/oncotarget.6686
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发表时间：
2016-02-02
期刊：
影响因子：
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通讯作者：
Colao A
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作者：
Faggiano A;Carratù AC;Guadagno E;Tafuto S;Tatangelo F;Riccardi F;Mocerino C;Palmieri G;Damiano V;Siciliano R;Leo S;Mauro A;Tozzi LF;Battista C;De Rosa G;Colao A
生长抑素类似物(SSA)在神经内分泌肿瘤(NETs)中显示出有限和可变的抗增殖作用。SSA的肿瘤控制是否取决于基于2010年世卫组织网络分类的分级仍不清楚。本研究的目的是根据Ki67指数评估长效SSA在NETS中的疗效。意大利的一项观察性多中心研究旨在收集接受SSA治疗的胃肠胰腺或胸腔网络患者的数据。包括回顾性和前瞻性资料，按照Ki67指数进行分析，对肿瘤标本进行免疫组织化学评估，并根据WHO分级(G1=Ki67指数0-2%，G2=Ki67指数3-20%，G3=Ki67指数和GT；20%)进行分级。在601例Net患者中，140例经组织学证实的胃肠胰腺或胸腺网或原发不明的Net患者接受了兰瑞肽自凝胶或奥曲肽LAR治疗。客观的肿瘤缓解率为11%，稳定性为58%，进展率为31%。G1和G2 Net的客观反应和肿瘤稳定性没有显著差异。G1组无进展生存期长于G2组(中位数：89个月对43个月，p=0.15)，但差异无统计学意义。Ki67+5%的受试者的中位PFS显著长于Ki67+≥为5%的受试者(89个月对35个月，p=0.005)。SSA治疗在分化良好的低/中增殖型网络中显示出显著的抗增殖作用，不仅是G1型，而且是G2型。Ki67指数为5%似乎比3%更适合选择SSA治疗的最佳候选者。
Somatostatin analogues (SSAs) have shown limited and variable antiproliferative effects in neuroendocrine tumours (NETs). Whether tumour control by SSAs depends on grading based on the 2010 WHO NET classification is still unclear. The aim of this study is to evaluate the efficacy of long-acting SSAs in NETs according to Ki67 index. An observational Italian multicentre study was designed to collect data in patients with gastro-entero-pancreatic or thoracic NETs under SSA treatment. Both retrospective and prospective data were included and they were analysed in line with Ki67 index, immunohistochemically evaluated in tumour samples and graded according to WHO classification (G1 = Ki67 index 0-2%, G2 = Ki67 index 3-20%, G3 = Ki67 index > 20%). Among 601 patients with NET, 140 with a histologically confirmed gastro-entero-pancreatic or thoracic NET or NET with unknown primary were treated with lanreotide autogel or octreotide LAR. An objective tumour response was observed in 11%, stability in 58% and progression in 31%. Objective response and tumour stability were not significantly different between G1 and G2 NETs. Progression free survival was longer but not significantly different in G1 than G2 NETs (median: 89 vs 43 months, p = 0.15). The median PFS was significantly longer in NETs showing Ki67 < 5% than in those showing Ki67 ≥5% (89 vs 35 months, p = 0.005). SSA therapy shows significant antiproliferative effects in well differentiated low/intermediate-proliferating NETs, not only G1 but also in G2 type. A Ki67 index of 5% seems to work better than 3% to select the best candidates for SSA therapy.