# Characteristics and treatment of patients with G3 gastroenteropancreatic neuroendocrine neoplasms

Source: https://onco.cc/key-papers/paper-heetfeld-grade-3-net-erc-2015/  
OnCo record `paper-heetfeld-grade-3-net-erc-2015` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Studying 204 grade 3 neuroendocrine neoplasms showed that well-differentiated tumours with a Ki-67 in the 20 to 55 percent range respond poorly to platinum chemotherapy but survive far longer than poorly differentiated carcinomas, establishing grade 3 neuroendocrine tumour as a separate disease.

## Summary

Retrospective multicentre study of 204 patients with gastroenteropancreatic neuroendocrine neoplasms with Ki-67 over 20 percent, divided into well-differentiated neuroendocrine tumours and poorly differentiated carcinomas.

Well-differentiated grade 3 tumours had a median survival of 99 months against 17 months for carcinomas, lower response to platinum-etoposide, and better response to alkylating agents and other tumour-type treatments; Ki-67 of 55 percent separated the groups.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: Endocrine-related cancer
- Year: 2015
- DOI: 10.1530/ERC-15-0119
- Authors: Heetfeld M, Chougnet CN, Olsen IH, et al.
- Findings: Median overall survival 99 months for grade 3 neuroendocrine tumour vs 17 months for neuroendocrine carcinoma.; Platinum response 33 percent in tumours vs higher in carcinomas.
- What it means: Grade 3 neuroendocrine tumours are treated like aggressive grade 2 tumours (somatostatin analogues, capecitabine-temozolomide, radioligand therapy) rather than with small-cell regimens.
- Caveats: Retrospective and treatment was heterogeneous.

## Sources

- Endocr Relat Cancer 2015: https://doi.org/10.1530/ERC-15-0119
- PubMed: https://pubmed.ncbi.nlm.nih.gov/26113608/

## Connected records

- cancers: [Grade 3 well-differentiated neuroendocrine tumour](https://onco.cc/cancers/grade-3-net/)
- journals: [Endocrine-related cancer](https://onco.cc/journals/endocrine-related-cancer/)

---
JSON: https://onco.cc/api/v1/entities/paper-heetfeld-grade-3-net-erc-2015.json