scholarly journals Clinical and epidemiological profile of neuroendocrine tumors: An experience from a regional cancer center from Western India

2019 ◽  
Vol 08 (03) ◽  
pp. 198-202
Author(s):  
Rahul Suhas Kulkarni ◽  
Asha S. Anand ◽  
Sonia K. Parikh ◽  
Harsha P. Panchal ◽  
Apurva A. Patel ◽  
...  

Abstract Background: Most of the data on neuroendocrine tumors (NETs) are from the Western literature. Indian studies regarding clinicopathological characteristics and treatment outcomes are lacking. Methods: This is a prospective observational study of all new patients with NETs (except small-cell lung cancer) registered at our tertiary care cancer institute from November 2014 to November 2016. A total of 97 new patients were registered, of which 20 were lost to follow-up before starting any planned treatment. Epidemiological and clinicopathological features of all these 97 patients were studied, and the remaining 77 patients were analyzed for treatment response and survival analysis. Results: The median age at diagnosis was 49 years (20–74 years) with male preponderance (M: F = 1.85:1). The most common primary site of origin was pancreas (34/97 = 35%), followed by unknown primary origin (19%), small intestine (9%), and pulmonary (6%). Of 97 patients, 91 (93.8%) presented with nonfunctional symptoms, 3 (3.1%) had purely functional symptoms, and 3 (3.1%) presented with both functional and nonfunctional symptoms. The most common presenting symptom was abdominal pain (59.7%), followed by jaundice (9.3%), whereas watery diarrhea (83.3%) and flushing (66.7%) were the most common functional symptoms. Sixty-six percent (64/97) of cases were metastatic at presentation. A strong correlation was noted between the primary site of origin and metastatic presentation (P = 0.016). Chemotherapy was the most common primary therapy (40.2%), followed by surgery (28.6%), watchful waiting (15.6%), and somatostatin analogs (11.7%). The median event-free survival was highest for patients undergoing surgery (10 months). Conclusions: The clinicopathological profile of NETs in the Indian population differs from Western countries. Majority of patients present with metastatic disease, thus representing a need for creating awareness among patients and medical fraternity and formulating Indian guidelines for optimized treatment.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15696-e15696
Author(s):  
Aman Chauhan ◽  
Leaundra Murray ◽  
Arun Kumar Arumugam Raajasekar ◽  
Zin Myint ◽  
Lowell Brian Anthony

e15696 Background: Neuroendocrine tumor of unknown primary constitutes about 10-15 % of all neuroendocrine tumors. Identification of primary site can helps alter the management. Sunitinib is FDA approved for management of pancreatic neuroendocrine tumors, everolimus is approved for gastroenteropancreatic and bronchial NETs, immune checkpoint inhibitors are active in Merkel cell carcinoma and MIBG treatment is standard of care for pheochromocytoma. Methods: Patients with neuroendocrine tumor with unknown primary were identified from Markey Cancer Center database over a five-year period (2012-2016). Patient who underwent 92-gene reverse transcriptase polymerase chain reaction cancer classification assay (BioTheranostics Tissue Type ID) were analyzed. IRB approval was obtained. Results: 56 patients with neuroendocrine tumors with unknown primary were identified. Median age of cohort was 61 years. 28/56 patients were males. 92 gene cancer ID assay was used in 38 out of 56 patients. Primary site of tumor was identified with > 95% certainty in 36 out of 38 patients. The test reported pancreatic NET as the primary site for 10 patients, gastrointestinal NETs for 14 patients, bronchial carcinoid for 5, large call NEC for 3, Merkel cell carcinoma for two and pheochromocytoma in one patient. Conclusions: Tissue type ID was able to identify a primary site in NETs of unknown primary in majority (94.7%) of cases. The result had direct implication in management of patients with regards to FDA approved treatment options in 13/38 patients (pNETs, merkel cell and pheochromocytoma).


2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15691-e15691
Author(s):  
Aman Chauhan ◽  
Arun Kumar Arumugam Raajasekar ◽  
Zin Myint ◽  
Leaundra Murray ◽  
Lowell Brian Anthony

e15691 Background: Better diagnostics, recognition and knowledge of neuroendocrine tumors (NETs) have led to consistent growth in incidence and prevalence of the disease. Being an orphan disease, therapeutic options are limited. Scarce data exists regarding use of Capecitabine and Temozolomide (CAPTEM) in neuroendocrine tumors. There are no published data on use of CAPTEM in neuroendocrine tumors of unknown primary. NETs of unknown primary accounts for 10-15 % of NETs. Historically NETs with unknown primary are thought to be relatively aggressive, conferring a poorer prognosis. Methods: Patients with neuroendocrine tumor with unknown primary were identified from Markey Cancer Center database over a five-year period (2012-2016). Patients treated with CAPTEM regimen were analyzed for radiological response in first scan, time to progression on treatment and toxicity. IRB approval was obtained. Results: 56 patients with neuroendocrine tumors of unknown primary were identified. 12 patients were treated with CAPTEM. Median age of study cohort was 62 years. 6/12 were females. Seven patients were grade II, 4 were grade III and only one was grade I NET. CAPTEM was used as front line systemic therapy in 9 patients. Mean duration of treatment before progression was 10.8 months. 6 patients showed reduction in metastatic tumor volume at first q 3 monthly CT scan. 3 patients had stable disease and 3 patients showed disease progression at first surveillance scan. Following were the rates of common side-effects. Grade 2 thrombocytopenia (n = 4), Grade 1 lymphocytopenia (n = 3), hand/foot syndrome Grade 1 (n = 1), Grade 3(n = 1), Fatigue, Grade 1 (n = 6) Conclusions: CAPTEM shows activity in neuroendocrine tumor of unknown primary. Currently FDA approved treatment options for grade I and grade II GI NETs includes somatostatin analogs and everolimus. Both of which are cytostatic and of limited use in case of visceral crisis or bulky disease where disease shrinkage is required. CAPTEM should be considered for grade II NETS of unknown primary.


2021 ◽  
Vol 93 (6) ◽  
pp. AB13-AB14
Author(s):  
Martin Coronel ◽  
Abraham Yu ◽  
Shria Kumar ◽  
Phillip S. Ge ◽  
Graciela M. Nogueras-González ◽  
...  

2013 ◽  
Vol 24 ◽  
pp. ix59
Author(s):  
S. Nitta ◽  
M. Ando ◽  
K. Yamaguchi ◽  
C. Kondo ◽  
H. Taniguchi ◽  
...  

2016 ◽  
Vol 48 ◽  
pp. e150-e151
Author(s):  
I. Fanetti ◽  
F. Cavalcoli ◽  
A. Zilli ◽  
D. Conte ◽  
S. Massironi

2006 ◽  
Vol 11 (6) ◽  
pp. 421-425 ◽  
Author(s):  
Satomi Yakushiji ◽  
Masashi Ando ◽  
Kan Yonemori ◽  
Tsutomu Kohno ◽  
Chikako Shimizu ◽  
...  

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 6044-6044 ◽  
Author(s):  
Kedar Kirtane ◽  
Jameel Muzaffar ◽  
Robbert Slebos ◽  
Christine H. Chung

6044 Background: Human papillomavirus status is known to be prognostic for patients with HNSCC. Current data suggests that HPV-positive HNSCC tumors exhibit increased infiltration of immune cells and higher levels of T-cell exhaustion markers compared with HPV-negative tumors, possibly suggesting a difference in response patterns to immunotherapy. We evaluated whether HPV status is associated with duration of response in patients receiving anti-PD-1 inhibitors. Methods: We performed a retrospective chart review of 54 patients at Moffitt Cancer Center who received either pembrolizumab (N = 32) or nivolumab (N = 22) from February 2016 to July 2018 for R/M HNSCC. We collected the following data for our patient population: primary site of disease, stage, smoking status, duration of treatment, and overall survival (OS). Overall survival time was defined as the date of starting anti-PD-1 inhibitors to death. Primary disease site was oropharynx (N = 25), oral cavity (N = 13), larynx (N = 11), nasopharynx (N = 3) and unknown primary (N = 2). HPV status was available for 37 patients. Analysis of survival and time on treatment was done using log-rank test. Results: Overall survival was not different with respect to primary site of disease, smoking, ECOG status, or type of anti-PD-1 inhibitor, but was significantly longer for patients with HPV-positive vs HPV-negative HNSCCs (17 months vs 4.5 months; log rank p < 0.001). Time on anti-PD-1 inhibitor was also significantly longer for patients with HPV-positive HNSCCs (7 months vs 3 months; log rank p < 0.001). Conclusions: Our data suggests patients with HPV-positive R/M HNSCCs have longer duration of response and OS on anti-PD-1 inhibitors compared to HPV-negative patients.


2011 ◽  
Vol 97 (5) ◽  
pp. 564-567 ◽  
Author(s):  
Laura Catena ◽  
Ettore Bichisao ◽  
Massimo Milione ◽  
Monica Valente ◽  
Marco Platania ◽  
...  

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