Prediction of Progression-Free Survival in Patients With Advanced, Well-Differentiated, Neuroendocrine Tumors Being Treated With a Somatostatin Analog : The GETNE-TRASGU Study
Carmona-Bayonas, Alberto (Hospital General Universitario Morales Meseguer (Múrcia))
Jiménez-Fonseca, Paula (Hospital Universitario Central de Asturias)
Lamarca, Ángela (The Christie NHS Foundation Trust, Manchester)
Barriuso, Jorge (University of Manchester)
Castaño, Ángel (Hospital Universitario de Fuenlabrada ( Madrid))
Benavent, Marta (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
Alonso, Vicente (Hospital Universitario Miguel Servet (Saragossa))
Riesco-Martínez, María del Carmen (Hospital Universitario 12 de Octubre (Madrid))
Alonso-Gordoa, Teresa (Hospital Universitario Ramón y Cajal (Madrid))
Custodio, Ana (Hospital Universitario La Paz (Madrid))
Sánchez Cánovas, Manuel (Instituto Murciano de Investigación Biosanitaria)
Hernando Cubero, Jorge (Vall d'Hebron Institut d'Oncologia)
López, Carlos (Hospital Universitario Marqués de Valdecilla (Santander, Cantabria))
Lacasta, Adelaida (Hospital Universitario de Donostia (Sant Sebastià, País Basc))
Fernández Montes, Ana (Complejo Hospitalario Universitario de Ourense)
Marazuela, Mónica (Hospital Universitario de la Princesa (Madrid))
Crespo, Guillermo (Complejo Asistencial Universitario de Burgos)
Escudero, Pilar (Hospital Clínico Universitario "Lozano Blesa" de Zaragoza)
Diaz, José Ángel (Hospital Clínico San Carlos (Madrid))
Feliciangeli, Eduardo (Hospital General Universitario Santa Lucía (Cartagena, Múrcia))
Gallego, Javier (Hospital General Universitario de Elche)
Llanos, Marta (Hospital Universitario de Canarias (La Laguna))
Segura, Ángel (Hospital Universitari i Politècnic La Fe (València))
Vilardell, Felip (Hospital Arnau de Vilanova (Lleida, Catalunya))
Percovich, Juan Carlos (Hospital General Universitario Gregorio Marañón)
Grande, Enrique (MD Anderson Cancer Center Madrid)
Capdevila Castillón, Jaume (Hospital Universitari Vall d'Hebron)
Valle, Juan W. (University of Manchester, Manchester)
García-Carbonero, Rocío (Hospital Universitario 12 de Octubre (Madrid))
Universitat Autònoma de Barcelona

Data:	2019
Resum:	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.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Publicat a:	Journal of Clinical Oncology, Vol. 37 (august 2019) , p. 2571-2580, ISSN 1527-7755

DOI: 10.1200/JCO.19.00980
PMID: 31390276

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