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Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

4484 - Development and internal validation of a predictive nomogram of progression-free survival in well-differentiated stage IV gastroenteropancreatic neuroendocrine tumours treated with somatostatin analogues: GETNE-TRASGU study.

Date

21 Oct 2018

Session

Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

Presenters

Rocio Garcia-Carbonero

Citation

Annals of Oncology (2018) 29 (suppl_8): viii467-viii478. 10.1093/annonc/mdy293

Authors

R. Garcia-Carbonero1, V. Alonso2, J. Capdevila Castillon3, M. Sanchez Canovas4, T. Alonso5, M. Benavent6, A. Custodio7, G. Crespo Herrero8, C. Lopez9, J. Hernando10, M.C. Riesco Martinez1, P. Escudero11, J. Gallego Plazas12, M. Marazuela13, J.A. Diaz14, M. Llanos-Munoz15, A. La Casta16, J.C. Percovich17, P. Jimenez-Fonseca18, A. Carmona-Bayonas19

Author affiliations

  • 1 Medical Oncology, University Hospital 12 De Octubre, 28041 - Madrid/ES
  • 2 Medical Oncology Service, Hospital Miguel Servet, 50009 - Zaragoza/ES
  • 3 Gastrointestinal And Endocrine Tumor Unit, Vall d'Hebron University Hospital, 08035 - Barcelona/ES
  • 4 Medical Oncology Service, Hospital Universitario Morales Meseguer, 300008 - Murcia/ES
  • 5 Medical Oncology, Hospital Ramón y Cajal, 28034 - Madrid/ES
  • 6 Medical Oncology Service, Hospital Universitario Virgen del Rocío, 41013 - Sevilla/ES
  • 7 Medical Oncology Department, Hospital Universitario La Paz, 28046 - Madrid/ES
  • 8 Medical Oncology Service, Hospital Universitario de Burgos, 9006 - Burgos/ES
  • 9 Medical Oncology, Marques de Valdecilla University Hospital, Santander/ES
  • 10 Gastrointestinal And Endocrine Tumor Unit, Vall d'Hebron University Hospital. Vall Hebron Institute of Oncology (VHIO), 08035 - Barcelona/ES
  • 11 Medical Oncology Service, Hospital Clinico Universitario Lozano Blesa, 50009 - Zaragoza/ES
  • 12 Medical Oncology Service, Hospital General Universitario de Elche, 3203 - Elche/ES
  • 13 Endocrinology, Hospital Universitario La Princesa, 28006 - Madrid/ES
  • 14 Endocrinology, Hospital Universitario Clínico San Carlos, 28040 - Madrid/ES
  • 15 Medical Oncology Service, Hospital Universitario de Canarias, 38320 - San Cristobal de la Laguna/ES
  • 16 Medical Oncology, Donosti University Hospital, Donosti/ES
  • 17 Endocrinology, Hospital Universitario Gregorio Marañon, 28007 - Madrid/ES
  • 18 Medical Oncology, Hospital Universitario Central de Asturias, 33011 - Oviedo/ES
  • 19 Medical Oncology, Hospital Universitario Morales Meseguer, Murcia/ES
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Resources

Abstract 4484

Background

Treatment with somatostatin analogs (SSA) in monotherapy is the most attractive first-line option for most patients with well-differentiated stage IV unresectable gastroenteropancreatic neuroendocrine tumors (GEP-NETs). The objective is to develop and internally validate tool for predicting progression-free survival (PFS) during treatment with SSA.

Methods

The GETNE-TRASGU study is a subanalysis of the Spanish Group of NETs registry (R-GETNE). The cohort contains 309 patients treated between 2000-2017 with SSA in the first-line of advanced disease. PFS data were evaluated using Cox proportional risk regression and graphically represented as a nomogram. Missing data were controlled by multiple imputation. Bootstrap Harrell's c-index with 150 replications was used to assess discrimination.

Results

The median PFS was 25.5 months (95% CI, 20.8-30.8). The nomogram contains 5 covariates significantly associated with PFS: Ki67% index, neutrophil-lymphocyte ratio (NLR), extrahepatic metastases, liver tumor burden and primary tumor location. The median PFS was 3.7 (95% CI, 2.5-not computable) in poor prognosis group, 8.3 (95% CI, 6.0-30.0) in intermediate-bad, 18.4 (95% CI, 14.3-23.6) in intermediate-good, and 37.1 months (95% CI, 30.8-53.5) in good prognosis group. Ki67% (continuous variable) predicted PFS with HR 1.03 (95% CI, 1.01-1.06), RNL (continuous variable) with HR 1.08 (95%CI, 1.01-1.16), extrahepatic metastases with HR 1.70 (I95% CI 1.23-2.32), liver tumor burden >50% with HR 2.07 (95% CI, 1.28-3.34); compared with intestinal (reference), pancreatic with HR 2.18 (95%CI, 1.56-3.04), rectal with HR 1.99 (95% CI, 1.11-3.58), unknown origin with HR 1.71 (95% CI, 1.02-2.85), and other tumors with HR 2.58 (95% CI, 1.22-5.43). This model shows adequate calibration, with acceptable discrimination capability [c-index of 0.641 (95% CI, 0.60-0.68)].

Conclusions

The GETNE-TRASGU nomogram allows stratification of patients with advanced and well-differentiated GEP-NETs into four prognostic groups, with potential implications for treatment selection.

Clinical trial identification

Legal entity responsible for the study

Grupo Español de Tumores Endocrinos y Neuroendocrinos (GETNE).

Funding

Grupo Español de Tumores Endocrinos y Neuroendocrinos (GETNE).

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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