KEY TAKEAWAYS
- The study aimed to investigate the prognostic value of SII and clinicopathological features in patients with NETs treated with 177Lu-Dotatate LU.
- Researchers noticed that PRRT is more effective in lower tumor burden and pancreatic NETs; further investigation is ongoing.
Peptide receptor radionuclide therapy (PRRT) with 177Lu-Dotatate (Lutathera®) (LU) has been proven to be effective in gastroenteropancreatic neuroendocrine tumors (NETs). They knew that systemic inflammatory (SI) parameters could translate into poorer oncological outcomes, however, it remains unknown in patients treated with PRRT.
Eduardo Terán Brage and the team aimed to analyze the prognostic value of clinicopathological features and SI biomarkers in NETs receiving LU.
They performed an inclusive analysis in a retrospective and multicentric study of NETs undergoing treatment with 177Lu-Dotatate LU between 2016 and 2024. Characteristics and SI markers were analyzed at baseline blood tests to calculate the following ratios: neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR), platelet to lymphocyte ratio (PLR), and albumin to lymphocyte ratio (ALR). The cut-off values were determined as the median of each ratio, and these values were correlated with progression-free survival (PFS) and overall survival (OS).
About 44 patients with NETs were included. Median age was 57 (range 35-75), with 54.5% being male. Tumor grade (G) was G1 (29.5%) and G2/3 (70.5%). NETs were of gastrointestinal (n=16), pancreatic (n=15), pulmonary (n=7), and unknown (n=6) origin. 79.5% of patients debuted in advanced stage, and 56.8% received ≥2 lines of treatment prior to PRRT.
In the sample, poorer PFS was observed in patients with higher tumor G (23.6m vs 36.5m; P=0.26), pulmonary vs pancreatic NETs (16.3m vs 27.7m; P=0.02), ≥2 metastatic sites (23.6m vs 36.5m; P=0.58), and those treated with ≥2 previous lines (21.6m vs 25m; P=0.74). Baseline analytical SI parameters of good prognosis were identified as lower rates of NLR, MLR, PLR, and ALR. Additionally, systemic inflammatory index (SII) (as a set of the parameters analyzed) favored patients with a score ≤2 in PFS (34.7m vs 12.8m, P=0.07) and in OS (NR vs 29.6m; P=0.09).
The study concluded that PRRT offers better results in patients with lower tumor burden and pancreatic NETs. Additionally, a SII score ≤2 may predict a better prognosis in PFS and OS, although prospective validation is required.
The study received no funds.
Brage E.T., Campaña-Díaz E, Martín M.N., et al. (2024). “Systemic inflammatory index (SII) in neuroendocrine tumors (NETs) treated with peptide receptor radionuclide therapy (PRRT).” Presented at ESMO-GI 2024, (Abstract 218P).
