Is the new WHO classification of neuroendocrine tumours useful for selecting an appropriate treatment?
| Autor: | J. Rosai, Stefano Iacobelli, Ettore Bichisao, Roberto Buzzoni, S De Dosso, Luigi Mariani, S. Della Torre, Emilio Bajetta, G. Procopio, Laura Catena, Leonardo Ferrari |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Adult
Male medicine.medical_specialty Lung Neoplasms Antineoplastic Agents Hormonal medicine.medical_treatment Octreotide Disease Neuroendocrine tumors World Health Organization Progressive Neoplastic Disease Internal medicine Biomarkers Tumor medicine Humans Thyroid Neoplasms Adverse effect Aged Neoplasm Staging Aged 80 and over business.industry Cell Differentiation Hematology Middle Aged medicine.disease Surgery Pancreatic Neoplasms Neuroendocrine Tumors Oncology Tolerability Female Hormone therapy business Progressive disease medicine.drug |
| Zdroj: | Annals of Oncology. 16:1374-1380 |
| ISSN: | 0923-7534 |
| Popis: | Background: Neuroendocrine tumours (NETs) are a rare and heterogeneous group of neoplasms. The most recent WHO classification provides clinical tools and indications to make the diagnosis and to suggest the correct treatment in different subgroups of patients. The aim of this trial was to apply the new classification criteria in clinical practice and, accordingly, to choose the most appropriate treatment. Patients and methods: Thirty-one evaluable patients, not previously treated, classified as advanced well differentiated NETs according to the new classification, were given long-acting release octreotide 30 mg every 28 days until evidence of disease progression. The treatment activity was evaluated according to objective, biochemical and symptomatic responses. Safety and tolerability were also assessed. Results: Two partial objective tumour responses were obtained (6%), stabilization occurred in 16 patients (52%) and 95% of patients had a disease stabilisation lasting ≥6 months. However, eight patients showed rapid disease progression within 6 months of therapy and six patients after 6 months. Biochemical responses, evaluated by changes in serum chromogranine A levels were reported in 20/24 patients (83%). Symptomatic responses were observed in 6/14 patients (43%): a complete syndrome remission in one patient, partial syndrome remission in five patients, no change in four patients and progressive disease in four patients. The median overall survival was not reached, and the median time to disease progression was 18 months (range 1–49 months). The treatment was well tolerated, no severe adverse events were observed and no patient withdrew from the study because of adverse events. Conclusions: The WHO classification enables identification of low-grade NET patients who may be suitable for hormonal treatment. Octreotide LAR was seen to be effective in controlling the disease and was well tolerated. However, eight patients failed to respond to the treatment, despite histological evidence of a well differentiated tumour according to the new classification. This suggests that further histological examination should be carried out, especially in patients with visceral metastases and a short disease-free interval. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|