ECE2019 Guided Posters Adrenal and Neuroendocrine - Tumour (14 abstracts)
1Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy; 2Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy; 3Department of Advanced Biomedical Sciences, Radiology, Section of Diagnostic Imaging, Federico II University of Naples, Naples, Italy; 4Endoscopic Surgery, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy.
Background & Aim: Pancreatic neuroendocrine tumors (pNETs) are detected in >80% of MEN1 patients. MEN1 pNETs are well differentiated G1-G2 NETs. They are usually not surged unless a size >12 cm or a growth rate >0.5 cm per year. Somatostatin analogues represent one of the main therapeutic option in patients affected with G1-G2 NETs. However, neither somatostatin analogues nor other therapies have been prospectively evaluated in clinical trials specifically focusing on MEN1-related pNETs. The aim of this study was to prospectively evaluate the effectiveness of lanreotide in patients with MEN1-related pNETs <2 cm.
Patients & Methods: From 1 January 2012 to 30 December 2018, all MEN1 patients admitted to the Federico II NET Unit of Naples who were diagnosed with one or more pNETs <2 cm of maximal diameter, were considered for this study. Study design was prospective observational, with comparison of patients treated with lanreotide autogel 120 mg every 28 days (LAN group) and patients not receiving any therapy (Follow-up group). All PNETs ≥10 mm by CT scan or MRI were taken in account as target lesions. Median PFS was evaluated according to Recist 1.1 criteria. All patients were radiologically evaluated every 6 months. A written informed consent was signed from all participants. The study was approved by the local Ethic Committee.
Results: Forty-two patients (19 M and 23 F, mean age 42.7 years, range 2065 years) were enrolled. LAN group included 23 patients and Follow-up group included 19 patients. Median follow-up was 66.5 months. As a whole, 49 pNETs ≥10 mm were identified. In the LAN group, 19 patients had stable disease at the last follow-up, while 4 had tumor progression (size increase in three and increased number of lesions in one). In the Follow-up group, 13 patients had pNET progression (size increase in ten, increased number of lesions in three, both in two), while 6 were stable. The median PFS was significantly longer in LAN group than in Follow-up group (median not reached vs 40 months, P<0.001).
Conclusions: This is the first prospective study evaluating the efficacy of somatostatin analogues in MEN1 patients with pNETs. These findings highlight that lanreotide autogel is effective as anti-proliferative therapy in MEN1-related pNETs <2 cm, suggesting the use of these compounds to arrest the development of tumor lesions as well as to delay or avoid pancreatic surgery.