RT Journal Article
T1 Prediction of Progression-Free Survival in Patients With Advanced, Well-Differentiated, Neuroendocrine Tumors Being Treated With a Somatostatin Analog: The GETNE-TRASGU Study.
A1 Carmona-Bayonas, Alberto
A1 Jiménez-Fonseca, Paula
A1 Lamarca, Ángela
A1 Barriuso, Jorge
A1 Castaño, Ángel
A1 Benavent, Marta
A1 Alonso, Vicente
A1 Riesco-Martínez, María Del Carmen
A1 Alonso-Gordoa, Teresa
A1 Custodio, Ana
A1 Sánchez Cánovas, Manuel
A1 Hernando Cubero, Jorge
A1 López, Carlos
A1 Lacasta, Adelaida
A1 Fernández Montes, Ana
A1 Marazuela, Mónica
A1 Crespo, Guillermo
A1 Escudero, Pilar
A1 Diaz, José Ángel
A1 Feliciangeli, Eduardo
A1 Gallego, Javier
A1 Llanos, Marta
A1 Segura, Ángel
A1 Vilardell, Felip
A1 Percovich, Juan Carlos
A1 Grande, Enrique
A1 Capdevila, Jaume
A1 Valle, Juan W
A1 García-Carbonero, Rocío
AB Somatostatin analogs (SSAs) are recommended for the first-line treatment of most patients with well-differentiated, gastroenteropancreatic (GEP) neuroendocrine tumors; however, benefit from treatment is heterogeneous. The aim of the current study was to develop and validate a progression-free survival (PFS) prediction model in SSA-treated patients. We extracted data from the Spanish Group of Neuroendocrine and Endocrine Tumors Registry (R-GETNE). Patient eligibility criteria included GEP primary, Ki-67 of 20% or less, and first-line SSA monotherapy for advanced disease. An accelerated failure time model was developed to predict PFS, which was represented as a nomogram and an online calculator. The nomogram was externally validated in an independent series of consecutive eligible patients (The Christie NHS Foundation Trust, Manchester, United Kingdom). We recruited 535 patients (R-GETNE, n = 438; Manchester, n = 97). Median PFS and overall survival in the derivation cohort were 28.7 (95% CI, 23.8 to 31.1) and 85.9 months (95% CI, 71.5 to 96.7 months), respectively. Nine covariates significantly associated with PFS were primary tumor location, Ki-67 percentage, neutrophil-to-lymphocyte ratio, alkaline phosphatase, extent of liver involvement, presence of bone and peritoneal metastases, documented progression status, and the presence of symptoms when initiating SSA. The GETNE-TRASGU (Treated With Analog of Somatostatin in Gastroenteropancreatic and Unknown Primary NETs) model demonstrated suitable calibration, as well as fair discrimination ability with a C-index value of 0.714 (95% CI, 0.680 to 0.747) and 0.732 (95% CI, 0.658 to 0.806) in the derivation and validation series, respectively. The GETNE-TRASGU evidence-based prognostic tool stratifies patients with GEP neuroendocrine tumors receiving SSA treatment according to their estimated PFS. This nomogram may be useful when stratifying patients with neuroendocrine tumors in future trials. Furthermore, it could be a valuable tool for making treatment decisions in daily clinical practice.
YR 2019
FD 2019-08-07
LK http://hdl.handle.net/10668/14373
UL http://hdl.handle.net/10668/14373
LA en
DS RISalud
RD Apr 16, 2025