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Article Dans Une Revue Cancers Année : 2021

Is the Morphological Subtype of Extra-Pulmonary Neuroendocrine Carcinoma Clinically Relevant?

Melissa Frizziero
  • Fonction : Auteur
Alice Durand
Rodrigo Taboada
Elisa Zaninotto
  • Fonction : Auteur
Claudio Luchini
Bipasha Chakrabarty
  • Fonction : Auteur
Valérie Hervieu
  • Fonction : Auteur
Laura Claro
  • Fonction : Auteur
Cong Zhou
Sara Cingarlini
  • Fonction : Auteur
Michele Milella
  • Fonction : Auteur
Rachel Riechelmann
Angela Lamarca
  • Fonction : Auteur
Richard Hubner
  • Fonction : Auteur
Wasat Mansoor
  • Fonction : Auteur
Juan Valle
  • Fonction : Auteur
Mairéad Mcnamara

Résumé

Extra-pulmonary neuroendocrine carcinomas (EP-NECs) are lethal cancers with limited treatment options. Identification of contributing factors to the observed heterogeneity of clinical outcomes within the EP-NEC family is warranted, to enable identification of effective treatments. A multicentre retrospective study investigated potential differences in “real-world” treatment/survival outcomes between small-cell (SC) versus (vs.) non-SC EP-NECs. One-hundred and seventy patients were included: 77 (45.3%) had SC EP-NECs and 93 (54.7%) had non-SC EP-NECs. Compared to the SC subgroup, the non-SC subgroup had the following features: (1) a lower mean Ki-67 index (69.3% vs. 78.7%; p = 0.002); (2) a lower proportion of cases with a Ki-67 index of ≥55% (73.9% vs. 88.7%; p = 0.025); (3) reduced sensitivity to first-line platinum/etoposide (objective response rate: 31.6% vs. 55.1%, p = 0.015; and disease control rate; 59.7% vs. 79.6%, p = 0.027); (4) worse progression-free survival (PFS) (adjusted-HR = 1.615, p = 0.016) and overall survival (OS) (adjusted-HR = 1.640, p = 0.015) in the advanced setting. Within the advanced EP-NEC cohort, subgroups according to morphological subtype and Ki-67 index (<55% vs. ≥55%) had significantly different PFS (adjusted-p = 0.021) and OS (adjusted-p = 0.051), with the non-SC subgroup with a Ki-67 index of <55% and non-SC subgroup with a Ki-67 index of ≥55% showing the best and worst outcomes, respectively. To conclude, the morphological subtype of EP-NEC provides complementary information to the Ki-67 index and may aid identification of patients who could benefit from alternative first-line treatment strategies to platinum/etoposide.

Dates et versions

hal-04492480 , version 1 (06-03-2024)

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Paternité - Pas d'utilisation commerciale - Pas de modification

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Melissa Frizziero, Alice Durand, Rodrigo Taboada, Elisa Zaninotto, Claudio Luchini, et al.. Is the Morphological Subtype of Extra-Pulmonary Neuroendocrine Carcinoma Clinically Relevant?. Cancers, 2021, 13 (16), pp.4152. ⟨10.3390/cancers13164152⟩. ⟨hal-04492480⟩
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