Abstract 248P
Background
Clinicopathological features and outcomes of neuroendocrine tumors (NETs) differ from those observed in Western populations and vary across Indian states. There is limited data regarding the same from India.This study was done by the Network of Oncology Clinical Trials of India (NOCI), a BIRAC-funded network, that aims to fill this gap from a multicentric perspective.
Methods
Data of patients with NETs [ Grade (Gr)- 1, 2, 3 (Well differentiated); NEC was excluded] registered at six centers in India between January 2018 and December 2022 were collected from patient records (retrospectively). We collected details regarding their sociodemographic profiles, histopathology, treatment, and outcomes (progression-free survival, PFS).
Results
Out of the 174 patients (median age: 52 years, 63% male) of NETs treated during the study period, 85.6% (n=149) were gastroenteropancreatic (GEP-NETs). Of these, 27.5% and 24.7% of patients had primary tumors in the small intestine and pancreas, respectively, with abdominal pain as the most common presenting symptom (56.3 %).Gr2 was commonest (n=51)>Gr1 (n=48)>Gr3 (n=25). Grading was unavailable in 50 (28%) patients. Over 70% of patients had metastatic disease, (liver (53.2 %)> lung (11.4 %)> bone (10.6%). Only 34% of patients had upfront surgery. Long-acting octreotide (28.5 %), platinum+etoposide (24 %), Capecitabine+Temozolomide (10.3%) were commonly used, and 11.4% of patients received peptide receptor radionuclide therapy (PRRT). The median PFS was lower in Gr3 patients (12 months) when compared to Gr2 (15 months), and Gr1 (19 months). Patients with liver metastasis had better survival (18 months) when compared to those with bone (16 months), and lung (15 months); p= 0.037. Table: 248P
| Grade | Localized disease (mPFS) | p-value | Metastatic disease (mPFS) | p-value | Independent of disease spread | p-value |
| Gr 1 | 22 mts | 0.308 | 16 mts | 0.055 | 19 mts | 0.015 |
| Gr 2 | 15 mts | 15 mts | 15 mts | |||
| Gr 3 | 12 mts | 11 mts | 12 mts | |||
| Gr unknown | 16 mts | 19 mts | 18 mts |
Conclusions
In one of the largest series of NETs from India, we note that GEP-NETs are the commonest, and grade remains the most important prognostic factor. Very few patients have access to PRRT, and most of them receive only chemotherapy agents.
Clinical trial identification
CTRI/2022/01/039233.
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Biotechnology Industry Research Assistance Council (BIRAC).
Disclosure
S.S. Panda: Financial Interests, Institutional, Funding: BIRAC. All other authors have declared no conflicts of interest.