Abstract 222P
Background
Frontline treatment with somatostatin analogs (SSA) in advanced low-intermediate grade neuroendocrine tumors (NET) of digestive origin were extensively evaluated; nevertheless, there is a lack of information about this management in lung NETs, which represent less than 1% of all thoracic malignancies. Higher grade tumors, including large-cell neuroendocrine carcinomas (LCNEC) are usually treated with platinum-based chemotherapy combos.
Methods
Patients with advanced thoracic NETs who started treatment between 2012–2021 at Hospital de Oncología, Centro Médico Nacional Siglo XXI, at Mexico City were retrospectively evaluated. The outcome measure was progression-free survival (PFS). We also explored the outcomes according to site of origin (lung vs mediastinal NET).
Results
41 patients were evaluated; those with typical carcinoid (n = 15) and atypical carcinoid diagnosis (n = 21) were treated with first-line SSAs: 23 patients with octreotide LAR and 11 with lanreotide. Subjects with LCNEC diagnosis (n = 6) were treated with first-line platinum/etoposide chemotherapy during 4–6 cycles. 27 patients had ECOG score of 1 (65.8%) and only in one of the cases the ECOG score was 3. Seventeen patients had locally advanced/unresectable tumors at diagnosis, six with liver metastases, five had lung metastases, three patients with CNS metastases and also three had lymph node involvement. At this time, only 15 patients had disease progression. 20% of them (n = 3) had LCNEC. Median Progression-Free Survivals were calculated on these patients with 12.0 months (9.22–14.77) for lung NETs and 29.0 months (8.26–17.73) for mediastinal NET. No statistical significance was reached despite the site of origin (HR for PFS of lung origin = 2.75; p = 0.097).
Conclusions
SSAs are an effective option as frontline treatment in patients with advanced lung typical and atypical carcinoid tumors. Patients with LCNEC remain with a poorer prognosis.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.