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ePoster Display

1105P - Predictive factors of adverse events onset in GEPNET patients treated with PRRT

Date

16 Sep 2021

Session

ePoster Display

Presenters

Federica Scalorbi

Citation

Annals of Oncology (2021) 32 (suppl_5): S906-S920. 10.1016/annonc/annonc678

Authors

F. Scalorbi1, G. Argiroffi1, A. Lorenzoni1, M. Baccini2, L. Gherardini2, V. Fuoco1, N. Prinzi3, S. Pusceddu4, G. Calareso5, E. Garanzini5, G. Centonze6, M. Milione7, C. Chiesa1, E. Seregni1, M. Maccauro1

Author affiliations

  • 1 Nuclear Medicine Department, Istituto Nazionale Tumori, 20133BJ - Milan/IT
  • 2 Dipartimento Di Statistica, Informatica, Applicazioni, University of Florence, 50134 - Florence/IT
  • 3 Medical Oncology Department, Istituto Nazionale dei Tumori di Milano - Fondazione IRCCS, 20133 - Milan/IT
  • 4 Medical Oncology, Istituto Nazionale dei Tumori di Milano - Fondazione IRCCS, 20133 - Milan/IT
  • 5 Radiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 - Milan/IT
  • 6 Pathology Unit, Istituto Nazionale Tumori, 20133BJ - Milan/IT
  • 7 Department Of Pathology And Laboratory Medicine, Istituto Nazionale dei Tumori di Milano - Fondazione IRCCS, 20133 - Milan/IT
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Abstract 1105P

Background

PRRT side-effects prediction is a crucial point in the management of GEPNET.

Methods

GEPNETs patients treated in our centre with PRRT (177Lu-Oxodotreotide, 4 administrations,7.4 GBq) from 04-2019 to 12-2020 were considered. Haematopoietic, liver and renal toxicities were collected during PRRT and graded according to CTCAE v5. The population was subdivided as midgut/foregut, G1/G2 (see WHO 2019) and categorical grouped according to ECOG, number of metastatic sites, previous treatment lines (1 or ≥2) and therapies received before PRRT (splenectomy, Everolimus, alkylating chemotherapy). To test independence between CTCAE and patient characteristics Pearson and Wallis test were assessed. Logistic regression with Firth correction and bootstrap were performed to determine predictability of CTCAE onset.

Results

67 patients (31(46.3%) males, mean age 63) were considered. Thirty-eight (56.7%) were midgut, 29 (43.3%) foregut, 24 (35.8%) G1 and 43 (64.2%) G2. Chemotherapy and Everolimus were the previous treatments in 13 (19.4%) patients, in both cases. Patients were treated with PRRT as 3rd or further lines in 34.3% (23) of the whole population and 48.3% (14) of foregut. All the patients showed at least one G1-G2 CTCAE, in particular anaemia (46,68.6%), thrombocytopaenia (32, 47.8%) and leukopaenia (30, 44.8%). G3-G4 were rare events, reported in 5(7.5%) cases considering haematological alterations (2 neutropaenia, 1 anaemia, 2 thrombocytopaenia) and 2 (3%) cases for liver (1 ALT, 1 INR alteration). Anaemia and thrombocytopaenia occurred in the same patient, causing discontinuation; all the other G3-G4 were transitional. No G3-G4 renal CTCAE were reported. Logistic regression showed that line of PRRT administration was the most powerful predictor of thrombocytopaenia (log Odds Ratio:1.54, CI 0.24 -3.03, p:0.019), anaemia (logOR 5.63, CI 1.19-12.84, p:0.004) and GGT alteration (logOR 1.88, CI 0.29-3.53, p: 0.02). Primary tumour histology (midgut versus foregut) was a good predictor of ALT (logOR 1.24, CI 0.045 -2.48, p: 0.04) and GGT alteration (logOR 1.3, CI -0.02-2.87, p: 0.05).

Conclusions

Line of PRRT administration is a strong predictor of CTCAE onset during PRRT. The results, if confirmed in larger cohorts, can have a huge impact on PRRT decision-making.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

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