Characteristics and treatment of patients with G3 gastroenteropancreatic neuroendocrine neoplasms
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.
Overview
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.
- 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.
Grade 3 neuroendocrine tumours are treated like aggressive grade 2 tumours (somatostatin analogues, capecitabine-temozolomide, radioligand therapy) rather than with small-cell regimens.
- Retrospective and treatment was heterogeneous.