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Metastatic neuroendocrine neoplasia treatments in patients over 70 years of age

The incidence of neuroendocrine neoplasia (NEN) is higher in individuals ≥70 years of age (elderly) who are underrepresented in clinical trials because of comorbidities and low performance status. We retrospectively analyzed the outcome of elderly patients with metastatic NEN (mNEN). Comorbidities w...

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Autores principales: Bongiovanni, Alberto, Recine, Federica, Foca, Flavia, Fausti, Valentina, Riva, Nada, Fabbri, Greta, Severi, Stefano, Liverani, Chiara, De Vita, Alessandro, Spadazzi, Chiara, Miserocchi, Giacomo, Mercatali, Laura, Amadori, Dino, Ibrahim, Toni
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Bioscientifica Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6311458/
https://www.ncbi.nlm.nih.gov/pubmed/30530877
http://dx.doi.org/10.1530/EC-18-0478
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author Bongiovanni, Alberto
Recine, Federica
Foca, Flavia
Fausti, Valentina
Riva, Nada
Fabbri, Greta
Severi, Stefano
Liverani, Chiara
De Vita, Alessandro
Spadazzi, Chiara
Miserocchi, Giacomo
Mercatali, Laura
Amadori, Dino
Ibrahim, Toni
author_facet Bongiovanni, Alberto
Recine, Federica
Foca, Flavia
Fausti, Valentina
Riva, Nada
Fabbri, Greta
Severi, Stefano
Liverani, Chiara
De Vita, Alessandro
Spadazzi, Chiara
Miserocchi, Giacomo
Mercatali, Laura
Amadori, Dino
Ibrahim, Toni
author_sort Bongiovanni, Alberto
collection PubMed
description The incidence of neuroendocrine neoplasia (NEN) is higher in individuals ≥70 years of age (elderly) who are underrepresented in clinical trials because of comorbidities and low performance status. We retrospectively analyzed the outcome of elderly patients with metastatic NEN (mNEN). Comorbidities were summarized by Charlson Comorbidity Index (CCI), Kaplan–Meier method was applied to estimate overall survival (OS) and Cox’s proportional hazard model was used to assess the impact of known prognostic factors. We retrieved data on 145 mNEN patients aged ≥70 years seen at our center from June 2007 to March 2016. Fifty-six (38.6%) were aged ≥75 years. ECOG PS was 0 in 45.7% of cases and CCI was 0 in 41.0% and 1 in 37.4%. A total of 75.4% of patients had grade (G)1/G2 NEN and 24.6%, G3. Octreoscan/Gallium PET/CT and FDG-PET/CT were positive in 94.2% and 70.3% of cases, respectively. Median follow-up was 72.3 (53.2–85.1) months. Seventy-nine patients received first-line somatostatin analogs (SSA), 23 peptide receptor radionuclide therapy (PRRT) and 36 chemotherapy (CHT). Seven did not undergo first-line therapy and 102 received more than one line. Median overall survival (mOS) was 5.1 years (95% CI: 3.4–6.6). No differences in mOS were seen according to CCI. First-line PRRT patients had a mOS of 6.5 years (95% CI: 3.3–not reached (NR)), SSA 5.7 years (95% CI: 4.2–7) and CHT 5.9 years (95% CI: 0.4–NR). mOS in CHT-treated G3 patients was 1.5 years (1.0–2.5). ECOG PS and FDG PET/CT were identified as independent prognostic factors. Results suggest that the above treatments positively impacted OS in elderly mNEN patients, including those aged ≥75 years.
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spelling pubmed-63114582019-01-03 Metastatic neuroendocrine neoplasia treatments in patients over 70 years of age Bongiovanni, Alberto Recine, Federica Foca, Flavia Fausti, Valentina Riva, Nada Fabbri, Greta Severi, Stefano Liverani, Chiara De Vita, Alessandro Spadazzi, Chiara Miserocchi, Giacomo Mercatali, Laura Amadori, Dino Ibrahim, Toni Endocr Connect Research The incidence of neuroendocrine neoplasia (NEN) is higher in individuals ≥70 years of age (elderly) who are underrepresented in clinical trials because of comorbidities and low performance status. We retrospectively analyzed the outcome of elderly patients with metastatic NEN (mNEN). Comorbidities were summarized by Charlson Comorbidity Index (CCI), Kaplan–Meier method was applied to estimate overall survival (OS) and Cox’s proportional hazard model was used to assess the impact of known prognostic factors. We retrieved data on 145 mNEN patients aged ≥70 years seen at our center from June 2007 to March 2016. Fifty-six (38.6%) were aged ≥75 years. ECOG PS was 0 in 45.7% of cases and CCI was 0 in 41.0% and 1 in 37.4%. A total of 75.4% of patients had grade (G)1/G2 NEN and 24.6%, G3. Octreoscan/Gallium PET/CT and FDG-PET/CT were positive in 94.2% and 70.3% of cases, respectively. Median follow-up was 72.3 (53.2–85.1) months. Seventy-nine patients received first-line somatostatin analogs (SSA), 23 peptide receptor radionuclide therapy (PRRT) and 36 chemotherapy (CHT). Seven did not undergo first-line therapy and 102 received more than one line. Median overall survival (mOS) was 5.1 years (95% CI: 3.4–6.6). No differences in mOS were seen according to CCI. First-line PRRT patients had a mOS of 6.5 years (95% CI: 3.3–not reached (NR)), SSA 5.7 years (95% CI: 4.2–7) and CHT 5.9 years (95% CI: 0.4–NR). mOS in CHT-treated G3 patients was 1.5 years (1.0–2.5). ECOG PS and FDG PET/CT were identified as independent prognostic factors. Results suggest that the above treatments positively impacted OS in elderly mNEN patients, including those aged ≥75 years. Bioscientifica Ltd 2018-12-07 /pmc/articles/PMC6311458/ /pubmed/30530877 http://dx.doi.org/10.1530/EC-18-0478 Text en © 2018 The authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Research
Bongiovanni, Alberto
Recine, Federica
Foca, Flavia
Fausti, Valentina
Riva, Nada
Fabbri, Greta
Severi, Stefano
Liverani, Chiara
De Vita, Alessandro
Spadazzi, Chiara
Miserocchi, Giacomo
Mercatali, Laura
Amadori, Dino
Ibrahim, Toni
Metastatic neuroendocrine neoplasia treatments in patients over 70 years of age
title Metastatic neuroendocrine neoplasia treatments in patients over 70 years of age
title_full Metastatic neuroendocrine neoplasia treatments in patients over 70 years of age
title_fullStr Metastatic neuroendocrine neoplasia treatments in patients over 70 years of age
title_full_unstemmed Metastatic neuroendocrine neoplasia treatments in patients over 70 years of age
title_short Metastatic neuroendocrine neoplasia treatments in patients over 70 years of age
title_sort metastatic neuroendocrine neoplasia treatments in patients over 70 years of age
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6311458/
https://www.ncbi.nlm.nih.gov/pubmed/30530877
http://dx.doi.org/10.1530/EC-18-0478
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