Clinical and radiological response to locoregional and systemic treatments in well-differentiated gastroenteropancreatic neuroendocrine tumors with liver metastases treated at a reference center in Mexico.

Authors

null

Cesar Arce Sandoval

Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Delegacion Tlalpan, Mexico;

Cesar Arce Sandoval , Mónica Isabel Meneses Medina , Miriam Heidi Cisneros Cordero , Jorge Humberto Hernandez-Felix , Vanessa Rosas Camargo , Lucero Itzel Torres Valdiviezo , Rixci Ramirez , Jesus Alejandro Gabutti Thomas , Fidel David David Huitzil Melendez

Organizations

Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Delegacion Tlalpan, Mexico; , Instituto Nacional de Ciencias Médicas y Nutirción Salvador Zubirán, Mexico City, Mexico; , Escuela Nacional de Medicina y Homeopatía, Instituto Politécnico Nacional, Mexico City, Mexico; , Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico; , National Institute of Medical Sciences and Nutrition Salvador Zubirán, Barrio Belisario Domínguez Secc Xvi, Mexico; , Facultad de Medicina, Universidad de las Americas Puebla, Puebla, PU, Mexico; , General Hospital De Enfermedades, Guatemala, Guatemala; , National Institute of Medical Sciences and Nutrition Salvador Zubirán, Barrio Belisario Domínguez Secc Xvi, DF, Mexico;

Research Funding

No funding received
None.

Background: liver metastases (LM) from well-differentiated gastroenteropancreatic neuroendocrine tumors (wd-GEP-NET) can develop in 28-77% of patients (pts) in their lifetime. Multiple treatments can provide radiological and symptomatic response. Our aim was to evaluate responses to locoregional (LRT) and systemic (SYST) treatments in wd-GEP-NET with LM. Methods: we included consecutive records of pts with confirmed histological diagnosis of wd-GEP-NET and radiological LM, treated at our institution between 2008-2019. Relevant variables were retrospectively extracted from electronic records. Radiological response was assessed with RECIST 1.1 by radiological independent review. Results: 55 pts, 45.5% male. Median age at LM diagnosis 49 years (IQR 41-63). Primary tumor sites: 49% pancreatic, 27.3% small intestine, 11% unknown, 12.7% others. WHO 2019 grade 1, 2 and 3 in 52.7, 41.8 and 1.8%, respectively. Twentynine tumors (52.7%) were functional, with carcinoid syndrome in n20. At LM diagnosis, 91% of pts had symptomatic disease: hormonal n8, local n4, systemic n4, hormonal + local n4, local + systemic n22, hormonal + systemic n5, hormonal + local + systemic n5. LM tumoral burden was <10% in 22%, 11-50% in 43.6, > 50% in 30.9% of pts. 49.1% of pts had extra hepatic metastatic disease. LRT to LM was administered to 32 pts: TAE/TACE n26, ablation n8. SYST to 22 pts: somatostatin analog n15, Lutetium-177 n4, chemotherapy n2, everolimus n1. 1 pt did not receive treatment. Response to treatments is shown. In the LRT group, -- pts developed complications: n16 postembolization syndrome, n2 infections, n3 liver failure, n7 others. There was 1-procedure-related death. Conclusions: Patients treated with LRT at our institution achieved similar efficacy and safety results compared to those reported by previous studies.

General
N=55 (%)
RECIST 1.1 Complete response0/0
Partial response6 (11)
Stable Disease26 (47.2)
Progressive Disease12 (22)
Not evaluated11 (20)
Objective response rate6 (11)
Disease control rate32 (58.1)
Symptomatic control25 (73.5)
Overall survival from LM diagnosis.
Median (months)
CI 95%
NR

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Abstract Details

Meeting

2023 ASCO Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session B: Cancers of the Pancreas, Small Bowel, and Hepatobiliary Tract

Track

Pancreatic Cancer,Hepatobiliary Cancer,Neuroendocrine/Carcinoid,Small Bowel Cancer

Sub Track

Patient-Reported Outcomes and Real-World Evidence

Citation

J Clin Oncol 41, 2023 (suppl 4; abstr 644)

DOI

10.1200/JCO.2023.41.4_suppl.644

Abstract #

644

Poster Bd #

G13

Abstract Disclosures

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