Peptide Receptor Radionuclide Therapy versus Capecitabine/Temozolomide for the Treatment of Metastatic Pancreatic Neuroendocrine Tumors
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Subject Selection and Outcomes Evaluation
2.2. Treatment Protocols
2.3. Statistical Analysis
3. Results
3.1. Demographic and Clinicopathologic Features
CAPTEM | PRRT | p-Value | |||
---|---|---|---|---|---|
n | % of available | n | % of available | ||
Total | 30 | 29 | |||
Median Age at C1D1 (IQR) | 49.34 (40.48–58.17) | 60.33 (55.79–66.05) | 0.02 * | ||
SAAB | 0.7 | ||||
Male | 14 | 46.67% | 15 | 51.72% | |
Female | 16 | 53.33% | 14 | 48.28% | |
Grade (N = 54) | 27 | 27 | 0.34 | ||
1 or 2 | 19 | 70.37% | 22 | 81.48% | |
3 | 8 | 29.63% | 5 | 18.52% | |
ECOG (N = 58) | 29 | 29 | 0.42 | ||
0 | 16 | 55.17% | 19 | 65.52% | |
1 or 2 | 13 | 44.83% | 10 | 34.49% | |
Extrahepatic Metastases | 19 | 63.33% | 20 | 68.97% | 0.65 |
Bone Metastases | 9 | 30% | 11 | 37.93% | 0.52 |
Baseline Chromogranin A Levels > 2 ULN (N = 50) | 13/21 | 61.90% | 16/29 | 55.17% | 0.63 |
Median Ki-67 Index (IQR; N = 52) | 13.30 (5.00–21.00) | 7.90 (3.50–18.50) | 0.13 | ||
MEN1/DAXX/ATRX Mutation (N = 31) | 9/17 | 52.94% | 10/14 | 71.43% | 0.29 |
Prior Surgical Intervention for Metastatic Disease | 1 | 3.33% | 14 | 48.28% | <0.001 * |
Prior Systemic Therapy other than SSA | 8 | 26.67% | 9 | 31.03% | 0.71 |
3.2. Treatments Received and Group Comparison
3.3. Primary Outcomes Evaluation–Entire Cohort
3.4. PFS1, PFS2, ORR1, and ORR2 Analysis—Cohort with Both Treatments Received
3.5. Overall Survival Analysis
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Subgroup | PRRT Number | mPFS in Months with PRRT (95% CI) | CAPTEM Number | mPFS in Months with CAPTEM (95% CI) | HR (95% CI) | p-Value |
---|---|---|---|---|---|---|
Entire Cohort | 29 | 21.90 (16.83–30.53) | 30 | 20.03 (17.30–28.60) | 0.99 (0.56–1.74) | 0.97 |
Age | ||||||
Age > 50 | 22 | 23.17 (17.87–35.37) | 14 | 20.03 (16.33–NR) | 0.89 (0.41–1.92) | 0.77 |
Age < 50 | 7 | 20.77 (13.90–NR) | 16 | 21.27 (17.10–44.60) | 1.04 (0.41–2.63) | 0.93 |
SAAB | ||||||
Male | 15 | 23.17 (20.57–NR) | 14 | 18.43 (15.70–NR) | 0.69 (0.31–1.53) | 0.36 |
Female | 14 | 16.83 (11.5–NR) | 16 | 23.00 (17.67–NR) | 1.38 (0.60–3.14) | 0.76 |
Grade (N = 54) | ||||||
One/Two | 22 | 26.47 (20.77–35.37) | 19 | 23.00 (20.03–NR) | 1.03 (0.51–2.09) | 0.92 |
Three | 5 | 7.83 (5.20–NR) | 8 | 16.33 (11.23–NR) | 7.9 (1.48–42.10) | 0.02 |
Baseline Chromogranin A Levels (N = 50) | ||||||
<2 ULN | 13 | 26.47 (11.50–NR) | 8 | 20.03 (17.67–NR) | 1.16 (0.40–3.34) | 0.79 |
>2 ULN | 16 | 21.90 (14.43–NR) | 13 | 20.03 (16.33–NR) | 0.83 (0.36–1.91) | 0.65 |
Extrahepatic Metastases | ||||||
Absent | 9 | 26.47 (20.77–NR) | 11 | 17.67 (15.70–NR) | 0.31 (0.10–0.92) | 0.03 |
Present | 20 | 20.57 (14.43–NR) | 19 | 25.20 (17.30–44.60) | 1.48 (0.73–3.03) | 0.28 |
Bone Metastases | ||||||
Absent | 18 | 24.63 (20.77–45.10) | 21 | 20.03 (17.30–52.33) | 0.66 (0.33–1.32) | 0.24 |
Present | 11 | 17.87 (10.60–NR) | 9 | 28.60 (16.33–NR) | 2.84 (0.85–9.52) | 0.09 |
MEN1/DAXX/ATRX Mutation (N = 31) | ||||||
Absent | 4 | 18.80 (7.83–NR) | 8 | 24.08 (12.33–NR) | 2.4 (0.53–10.87) | 0.26 |
Present | 10 | 28.43 (17.87–NR) | 9 | 18.67 (15.53–NR) | 0.22 (0.06–0.85) | 0.03 |
Outcomes | PRRT | CAPTEM |
---|---|---|
Objective Response Rate | ||
ORR1 (N = 18) | 4/10, 40% | 2/8, 25% |
p-value | 0.56 | |
ORR2 (N = 17) | 2/9, 22.22% | 3/8, 37.5% |
p-value | 0.55 | |
Progression-Free Survival | ||
PFS1 [mPFS (95% CI)] | 20.57 (13.90–NR) | 17.30 (15.53–NR) |
p-value | 0.27 | |
PFS2 [mPFS (95% CI)] | 12.52 (8.17–NR) | 9.57 (8.63–NR) |
p-value | 0.28 |
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Gujarathi, R.; Tobias, J.; Abou Azar, S.; Keutgen, X.M.; Liao, C.-Y. Peptide Receptor Radionuclide Therapy versus Capecitabine/Temozolomide for the Treatment of Metastatic Pancreatic Neuroendocrine Tumors. Cancers 2024, 16, 2993. https://doi.org/10.3390/cancers16172993
Gujarathi R, Tobias J, Abou Azar S, Keutgen XM, Liao C-Y. Peptide Receptor Radionuclide Therapy versus Capecitabine/Temozolomide for the Treatment of Metastatic Pancreatic Neuroendocrine Tumors. Cancers. 2024; 16(17):2993. https://doi.org/10.3390/cancers16172993
Chicago/Turabian StyleGujarathi, Rushabh, Joseph Tobias, Sara Abou Azar, Xavier M. Keutgen, and Chih-Yi Liao. 2024. "Peptide Receptor Radionuclide Therapy versus Capecitabine/Temozolomide for the Treatment of Metastatic Pancreatic Neuroendocrine Tumors" Cancers 16, no. 17: 2993. https://doi.org/10.3390/cancers16172993