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Prognostic and Predictive Role of Body Composition in Metastatic Neuroendocrine Tumor Patients Treated with Everolimus: A Real-World Data Analysis
SIMPLE SUMMARY: Neuroendocrine tumors (NETs) are rare neoplasms that often present upregulation of the mammalian rapamycin targeting pathway (mTOR) with consequent uncontrolled growth and proliferation. This pathway is also involved in the metabolism of adipose tissue and in the regulation of skelet...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9264955/ https://www.ncbi.nlm.nih.gov/pubmed/35805003 http://dx.doi.org/10.3390/cancers14133231 |
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author | Ranallo, Nicoletta Iamurri, Andrea Prochoswski Foca, Flavia Liverani, Chiara De Vita, Alessandro Mercatali, Laura Calabrese, Chiara Spadazzi, Chiara Fabbri, Carlo Cavaliere, Davide Galassi, Riccardo Severi, Stefano Sansovini, Maddalena Tartaglia, Andreas Pieri, Federica Crudi, Laura Bianchini, David Barone, Domenico Martinelli, Giovanni Frassineti, Giovanni Luca Ibrahim, Toni Calabrò, Luana Berardi, Rossana Bongiovanni, Alberto |
author_facet | Ranallo, Nicoletta Iamurri, Andrea Prochoswski Foca, Flavia Liverani, Chiara De Vita, Alessandro Mercatali, Laura Calabrese, Chiara Spadazzi, Chiara Fabbri, Carlo Cavaliere, Davide Galassi, Riccardo Severi, Stefano Sansovini, Maddalena Tartaglia, Andreas Pieri, Federica Crudi, Laura Bianchini, David Barone, Domenico Martinelli, Giovanni Frassineti, Giovanni Luca Ibrahim, Toni Calabrò, Luana Berardi, Rossana Bongiovanni, Alberto |
author_sort | Ranallo, Nicoletta |
collection | PubMed |
description | SIMPLE SUMMARY: Neuroendocrine tumors (NETs) are rare neoplasms that often present upregulation of the mammalian rapamycin targeting pathway (mTOR) with consequent uncontrolled growth and proliferation. This pathway is also involved in the metabolism of adipose tissue and in the regulation of skeletal muscle synthesis. The mTOR therefore represents an attractive therapeutic target. Everolimus acts by selectively inhibiting the mTOR pathway with an antiproliferative effect. The aim of this study is to investigate the prognostic and predictive role of body composition indices (muscle and adipose) in metastatic NETs patients treated with everolimus. ABSTRACT: Neuroendocrine tumors (NETs) are rare neoplasms frequently characterized by an upregulation of the mammalian rapamycin targeting (mTOR) pathway resulting in uncontrolled cell proliferation. The mTOR pathway is also involved in skeletal muscle protein synthesis and in adipose tissue metabolism. Everolimus inhibits the mTOR pathway, resulting in blockade of cell growth and tumor progression. The aim of this study is to investigate the role of body composition indexes in patients with metastatic NETs treated with everolimus. The study population included 30 patients with well-differentiated (G1-G2), metastatic NETs treated with everolimus at the IRCCS Romagnolo Institute for the Study of Tumors (IRST) “Dino Amadori”, Meldola (FC), Italy. The body composition indexes (skeletal muscle index [SMI] and adipose tissue indexes) were assessed by measuring on a computed tomography (CT) scan the cross-sectional area at L3 at baseline and at the first radiological assessment after the start of treatment. The body mass index (BMI) was assessed at baseline. The median progression-free survival (PFS) was 8.9 months (95% confidence interval [CI]: 3.4–13.7 months). The PFS stratified by tertiles was 3.2 months (95% CI: 0.9–10.1 months) in patients with low SMI (tertile 1), 14.2 months (95% CI: 2.3 months-not estimable [NE]) in patients with intermediate SMI (tertile 2), and 9.1 months (95% CI: 2.7 months-NE) in patients with high SMI (tertile 3) (p = 0.039). Similarly, the other body composition indexes also showed a statistically significant difference in the three groups on the basis of tertiles. The median PFS was 3.2 months (95% CI: 0.9–6.7 months) in underweight patients (BMI ≤ 18.49 kg/m(2)) and 10.1 months (95% CI: 3.7–28.4 months) in normal-weight patients (p = 0.011). There were no significant differences in terms of overall survival. The study showed a correlation between PFS and the body composition indexes in patients with NETs treated with everolimus, underlining the role of adipose and muscle tissue in these patients. |
format | Online Article Text |
id | pubmed-9264955 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-92649552022-07-09 Prognostic and Predictive Role of Body Composition in Metastatic Neuroendocrine Tumor Patients Treated with Everolimus: A Real-World Data Analysis Ranallo, Nicoletta Iamurri, Andrea Prochoswski Foca, Flavia Liverani, Chiara De Vita, Alessandro Mercatali, Laura Calabrese, Chiara Spadazzi, Chiara Fabbri, Carlo Cavaliere, Davide Galassi, Riccardo Severi, Stefano Sansovini, Maddalena Tartaglia, Andreas Pieri, Federica Crudi, Laura Bianchini, David Barone, Domenico Martinelli, Giovanni Frassineti, Giovanni Luca Ibrahim, Toni Calabrò, Luana Berardi, Rossana Bongiovanni, Alberto Cancers (Basel) Article SIMPLE SUMMARY: Neuroendocrine tumors (NETs) are rare neoplasms that often present upregulation of the mammalian rapamycin targeting pathway (mTOR) with consequent uncontrolled growth and proliferation. This pathway is also involved in the metabolism of adipose tissue and in the regulation of skeletal muscle synthesis. The mTOR therefore represents an attractive therapeutic target. Everolimus acts by selectively inhibiting the mTOR pathway with an antiproliferative effect. The aim of this study is to investigate the prognostic and predictive role of body composition indices (muscle and adipose) in metastatic NETs patients treated with everolimus. ABSTRACT: Neuroendocrine tumors (NETs) are rare neoplasms frequently characterized by an upregulation of the mammalian rapamycin targeting (mTOR) pathway resulting in uncontrolled cell proliferation. The mTOR pathway is also involved in skeletal muscle protein synthesis and in adipose tissue metabolism. Everolimus inhibits the mTOR pathway, resulting in blockade of cell growth and tumor progression. The aim of this study is to investigate the role of body composition indexes in patients with metastatic NETs treated with everolimus. The study population included 30 patients with well-differentiated (G1-G2), metastatic NETs treated with everolimus at the IRCCS Romagnolo Institute for the Study of Tumors (IRST) “Dino Amadori”, Meldola (FC), Italy. The body composition indexes (skeletal muscle index [SMI] and adipose tissue indexes) were assessed by measuring on a computed tomography (CT) scan the cross-sectional area at L3 at baseline and at the first radiological assessment after the start of treatment. The body mass index (BMI) was assessed at baseline. The median progression-free survival (PFS) was 8.9 months (95% confidence interval [CI]: 3.4–13.7 months). The PFS stratified by tertiles was 3.2 months (95% CI: 0.9–10.1 months) in patients with low SMI (tertile 1), 14.2 months (95% CI: 2.3 months-not estimable [NE]) in patients with intermediate SMI (tertile 2), and 9.1 months (95% CI: 2.7 months-NE) in patients with high SMI (tertile 3) (p = 0.039). Similarly, the other body composition indexes also showed a statistically significant difference in the three groups on the basis of tertiles. The median PFS was 3.2 months (95% CI: 0.9–6.7 months) in underweight patients (BMI ≤ 18.49 kg/m(2)) and 10.1 months (95% CI: 3.7–28.4 months) in normal-weight patients (p = 0.011). There were no significant differences in terms of overall survival. The study showed a correlation between PFS and the body composition indexes in patients with NETs treated with everolimus, underlining the role of adipose and muscle tissue in these patients. MDPI 2022-06-30 /pmc/articles/PMC9264955/ /pubmed/35805003 http://dx.doi.org/10.3390/cancers14133231 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Ranallo, Nicoletta Iamurri, Andrea Prochoswski Foca, Flavia Liverani, Chiara De Vita, Alessandro Mercatali, Laura Calabrese, Chiara Spadazzi, Chiara Fabbri, Carlo Cavaliere, Davide Galassi, Riccardo Severi, Stefano Sansovini, Maddalena Tartaglia, Andreas Pieri, Federica Crudi, Laura Bianchini, David Barone, Domenico Martinelli, Giovanni Frassineti, Giovanni Luca Ibrahim, Toni Calabrò, Luana Berardi, Rossana Bongiovanni, Alberto Prognostic and Predictive Role of Body Composition in Metastatic Neuroendocrine Tumor Patients Treated with Everolimus: A Real-World Data Analysis |
title | Prognostic and Predictive Role of Body Composition in Metastatic Neuroendocrine Tumor Patients Treated with Everolimus: A Real-World Data Analysis |
title_full | Prognostic and Predictive Role of Body Composition in Metastatic Neuroendocrine Tumor Patients Treated with Everolimus: A Real-World Data Analysis |
title_fullStr | Prognostic and Predictive Role of Body Composition in Metastatic Neuroendocrine Tumor Patients Treated with Everolimus: A Real-World Data Analysis |
title_full_unstemmed | Prognostic and Predictive Role of Body Composition in Metastatic Neuroendocrine Tumor Patients Treated with Everolimus: A Real-World Data Analysis |
title_short | Prognostic and Predictive Role of Body Composition in Metastatic Neuroendocrine Tumor Patients Treated with Everolimus: A Real-World Data Analysis |
title_sort | prognostic and predictive role of body composition in metastatic neuroendocrine tumor patients treated with everolimus: a real-world data analysis |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9264955/ https://www.ncbi.nlm.nih.gov/pubmed/35805003 http://dx.doi.org/10.3390/cancers14133231 |
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