Abstract 218P
Background
PRRT with 177Lu-Dotatate (Lutathera®) (LU) has been proven to be effective in gastroenteropancreatic neuroendocrine tumors (NETs). We know that systemic inflammatory (SI) parameters could translate into poorer oncological outcomes, however, it remains unknown in patients (p) treated with PRRT. We aim to analyze the prognostic value of clinicopathological features and SI biomarkers in NETs receiving LU.
Methods
Retrospective and multicentric study of NETs undergoing treatment with LU between 2016 and 2024. We analyzed characteristics and SI markers at baseline blood tests for calculating the following ratios: neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR), platelet to lymphocyte ratio (PLR) and albumin to lymphocyte ratio (ALR). The cut-off values were determined as the median of each value, correlating them with progression-free survival (PFS) and overall survival (OS).
Results
We included 44p with NETs. Median age was 57 (range 35-75). Males (54.5%). Tumor grade (G) was G1 (29.5%) and G2/3 (70.5%). NETs were of gastrointestinal (n=16), pancreatic (n=15), pulmonary (n=7) and unknown (n=6) origin. 35p (79.5%) debuted in advanced stage and 25p (56.8%) received ≥2 lines of treatment prior to PRRT. In our sample we observed poorer PFS in p with higher tumor G (23.6m vs 36.5m; p=0.26), pulmonary vs pancreatic NETs (16.3m vs 27.7m; p=0.02), with ≥2 metastatic sites (23.6m vs 36.5m; p=0.58) and in those treated with ≥2 previous lines (21.6m vs 25m; p=0.74). We identified as baseline analytical SI parameters of good prognosis lower rates of NLR, MLR, PLR and ALR. Also, SII (as a set of the parameters analyzed) favored p with a score ≤2 in PFS (34.7m vs 12.8m, p=0.07) and in OS (NR vs 29.6m; p=0.09), as listed in the table. Table: 218P
| PFS median (months) | Log-rank p-value | OS median (months) | Log-rank p-value | ||
| NLR | <4 | 34.7m | p=0.27 | 40.8m | p=0.07 |
| ≥4 | 25m | 12.6m | |||
| MLR | <0,4 | 36.5m | p=0.43 | NR | p=0.49 |
| ≥0,4 | 26.2m | 40.8m | |||
| PLR | <174,9 | 27.7m | p=0.28 | NR | p=0.33 |
| ≥174,9 | 25m | 40.8m | |||
| ALR | <3,6 | 26.2m | p=0.46 | NR | p=0.79 |
| ≥3,6 | 12.8m | 39.1m | |||
| SII | 1-2 | 34.7m | p=0.07 | NR | p=0.09 |
| 3-4 | 12.8m | 29.6m |
Conclusions
Our results show that PRRT offers better results in lower tumor burden and pancreatic NETs. In addition, a SII score ≤2 may predict a better prognosis in PFS and OS, although prospective validation is required.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
R. Lozano Mejorada: Financial Interests, Personal, Invited Speaker: Janssen, Astellas, Roche, Bayer, Ipsen, AstraZeneca; Financial Interests, Personal, Advisory Board: Janssen, Merck/Pfizer, Orion Pharma, Advanced Accelerator Applications (Novartis); Financial Interests, Personal, Other, Travel/accommodation: MSD, Sanofi; Financial Interests, Personal, Other, Travel/accommodation: BMS; Non-Financial Interests, Member: Sociedad Española de Oncología Médica. All other authors have declared no conflicts of interest.