W. Lybaert MD

Neuroendocrine neoplasms grade 3: prospective overall survival data and survival after platinum-etoposide chemotherapy within an ENETS Center of Excellence

Introduction

Overall survival (OS) and progression-free survival (PFS) data of grade 3 NENs remains limited.

Aim

The aim is to report prospective survival data in grade 3 NENs treated within NETwerk.

Methods

Patient characteristics of all grade 3 NENs treated from April 2016 to May 2018 were prospectively recorded. Median OS (mOS) from diagnosis and mOS and median PFS (mPFS) after start cisplatinum/carboplatinum-etoposide chemotherapy was calculated.

Results

Of 79 included NEN grade 3 patients, there were 46 males (58,2%). Mean age at diagnosis was 68 years [range 22-90y]. In 67% (N=53) of the cases, the primary tumor was a GEP-NEN (of which 18 unknown). In our population 44% (N=35) had metastases at diagnoses, 44% (N=35) had a Ki67 index ≥ 55%, 30% (N=24) had a Ki67 index < 55%. Platinum-etoposide chemotherapy was given in 29% (N=23) of the patients. The majority (N=41) had FDG-PET imaging of which 36 were positive and 14 had somatostatin receptor imaging (SRS) of which 11 were positive. Combined FDG-SRS positivity was seen in 5 of 11 patients (45%). Overall mOS was 10.5m (95%CI: 6.6-NR). In GEP-NEN mOS was 8.3m (95% CI: 6.0-18.7), while in NENs from other origin mOS was 12m (95% CI: 6.8-NR, p = 0.2). The mOS for patients with a Ki67 index < 55% was 14.2m (95% CI: 8.9-NA) vs 8.2m (95% CI: 5.6-NA) for patients with Ki67 index ≥ 55% (p=0.3). In multivariate analysis, age at diagnosis had significant impact on OS (HR 0.95, p=0.003), while tumor origin showed trend towards significance (HR 0.49, p= 0.056). The mPFS and mOS after chemotherapy were 6.5m (95%: 4.8 -NR) and 14.2m (95% CI: 8.3-NR). For the chemotherapy-treated group no significant effect of tumor location, metastasis at diagnosis and age at diagnosis was seen on OS and PFS.

Conclusions

In this grade 3 NEN cohort, non-GEP-NENs have a better OS survival than GEP-NENs. Our results confirm the limited PFS and OS after platinum-etoposide chemotherapy in grade 3 NENs, highlighting the need for better treatment. When performed, FDG-PET and SRS-positivity is frequent and could guide treatment.

Highlights of the 2018 Annual European Neuroendocrine Tumor Society (ENETS) Congress

March 7-9, 2018, Barcelona, Spain.

(BELG J MED ONCOL 2018:12(5):252–262)

Highlights of the Gastrointestinal Cancers Symposium 2018

With the background of the famous Golden Gate Bridge and Alcatraz, the annual Gastrointestinal Cancers Symposium was held from 18–20 January 2018 in the Moscone Congress Center in San Francisco, California. In this report, the most important headlines will be discussed, with comments on the clinical relevance of the different studies.

(BELG J MED ONCOL 2018:12(3):133–141)

Prevention of chemotherapy-induced nausea and vomiting: Belgian antiemetic treatment options anno 2018

Summary

Chemotherapy-induced nausea and vomiting remains an important adverse effect of treatment in daily clinical practice. Recently, new data on combinations of antiemetic agents became available for the prevention of acute and delayed nausea/vomiting in patients receiving highly and moderately emetogenic chemotherapy. As a result, the leading international cancer societies updated their antiemesis guidelines. This text aims at providing guidance regarding these new regimens in the prophylaxis of chemotherapy-induced nausea and vomiting, with a particular focus on highly emetogenic chemotherapy.

(BELG J MED ONCOL 2018;12(2):51–60)

P.07 EXCELLENT SURVIVAL OUTCOMES FOR NET PATIENTS TREATED WITHIN NETWERK, A COLLABORATIVE ENETS CENTER OF EXCELLENCE

P.06 THE IMPACT OF NETWERK ON THE MULTIDISCIPLINARY TUMOR BOARDS

O.03 DETECTION OF AR PERTURBATIONS IN CIRCULATING TUMOUR CELLS AND CELL-FREE DNA FROM PATIENTS WITH METASTATIC CASTRATION-RESISTANT PROSTATE CANCER PREDICTS RESISTANCE TO ENDOCRINE THERAPY