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01-12-2018 | Gastrointestinal

CT evaluation of response in advanced gastroenteropancreatic neuroendocrine tumors treated with long-acting-repeatable octreotide: what is the optimal size variation threshold?

Authors: Yanji Luo, Jie Chen, Bingqi Shen, Meng Wang, Huasong Cai, Ling Xu, Luohai Chen, Minhu Chen, Zi-Ping Li, Shi-Ting Feng

Published in: European Radiology | Issue 12/2018

Abstract

Objective

To identify a reliable early indicator of deriving progression-free survival (PFS) benefit in patients with advanced gastroenteropancreatic neuroendocrine tumors (GEP-NETs) treated with octreotide long-acting repeatable (LAR).

Methods

We investigated the images of 50 patients with well-differentiated advanced GEP-NETs treated with LAR octreotide and underwent baseline and follow-up thoracic, abdominal, and pelvic computed tomography. Receiver-operating characteristic (ROC) analysis and the Kaplan-Meier method were used to identify the optimal threshold to distinguish between those with and without significant improvement of PFS.

Results

The optimal threshold for determining a response to octreotide LAR was -10% ΔSLD, with a sensitivity and specificity of 85.7% and 80%, respectively. At this threshold, 19 patients were responders and 31 were non-responders; the median PFS was 20.2 and 7.6 months in responders and non-responders (hazard ratio, 2.66; 95% confidence interval, 1.32–5.36).

Conclusion

A 10% shrinkage in tumor size is an optimal early predictor of response to octreotide LAR in advanced GEP-NETs.

Key points

• Octreotide LAR can significantly prolong PFS among patients with well-differentiated advanced GEP-NETs.

• No optimal tumor size-based response criteria are reported in GEP-NETs with octreotide.

• Ten percent tumor shrinkage is a reliable indicator of the response to octreotide for advanced GEP-NETs.

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Title: CT evaluation of response in advanced gastroenteropancreatic neuroendocrine tumors treated with long-acting-repeatable octreotide: what is the optimal size variation threshold?
Authors: Yanji Luo
Jie Chen
Bingqi Shen
Meng Wang
Huasong Cai
Ling Xu
Luohai Chen
Minhu Chen
Zi-Ping Li
Shi-Ting Feng
Publication date: 01-12-2018
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 12/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-018-5512-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

CT evaluation of response in advanced gastroenteropancreatic neuroendocrine tumors treated with long-acting-repeatable octreotide: what is the optimal size variation threshold?

Abstract

Objective

Methods

Results

Conclusion

Key points

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

Key points

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