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Design and Validation of the GI-NEC Score to Prognosticate Overall Survival in Patients With High-Grade Gastrointestinal Neuroendocrine Carcinomas.

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Lamarca, Angela Walter, Thomas Pavel, Marianne Borbath, Ivan [UCL] Freis, Patricia Barriuso, Jorge

Background: Prognostic markers for risk stratification of patients with gastrointestinal high-grade neuroendocrine carcinomas (GI-NECs) are lacking; we designed and validated a prognostic score for overall survival (OS). Methods: Consecutive patients diagnosed in five neuroendocrine specialist European centers were included. Patients were divided into three cohorts: a training cohort (TC), an external validation cohort (EVC), and a prospective validation cohort (PVC). Prognostic factors were identified by log-rank test, Cox-regression, and logistic regression analyses. The derived score was internally and externally validated. All statistical tests were two-sided. Results: Of 395 patients screened, 313 were eligible (TC = 109 patients, EVC = 184 patients, and PVC = 20 patients). The derived prognostic score included five variables: presence of liver metastases, alkaline phosphatase (ALK), lactate dehydrogenase (LDH), Eastern Cooperative Oncology Group performance status (ECOG PS), and Ki67. In multivariable analysis, the score was prognostic for OS (hazard ratio [HR] = 1.86, 95% confidence interval [CI] = 1.47 to 2.35, P < .001) and had good discrimination (C-index = 0.76) and calibration (mean error = 0.021, 90th percentile = 0.037) in the TC. These results were validated in the EVC and PVC, in which our score was able to prognosticate for OS when adjusted for other prognostic variables in the multivariable analysis (HR = 1.85, 95% CI = 1.27 to 2.71, P = .001; and HR = 4.51, 95% CI = 1.87 to 10.87, P = .001, respectively). The score classified patients into two groups with incremental risk of death: group A (0–2 points, 181 patients [63.9%], median OS = 19.4 months, 95% CI = 16.1 to 25.1) and group B (3–6 points, 102 patients [36.1%], median OS = 5.2 months, 95% CI = 3.6 to 6.9). Conclusions: The GI-NEC score identifies two distinct patient cohorts; it provides a tool for clinicians when making treatment decisions and may be used as a stratification factor in future clinical trials.

Document type Article de périodique (Journal article) – Article de recherche
Publication date 2017
Language Anglais
Journal information "National Cancer Institute. Journal (Online)" - Vol. 109, p. djw277 (2017)
Peer reviewed yes
Publisher Oxford University Press ((United State) Cari, NC)
issn 0027-8874
e-issn 1460-2105
Publication status Publié
Affiliations UCL - SSS/IREC/GAEN - Pôle d'Hépato-gastro-entérologie
UCL - (SLuc) Service d'hépato-gastro-entérologie
Links
  1. Yao James C., Hassan Manal, Phan Alexandria, Dagohoy Cecile, Leary Colleen, Mares Jeannette E., Abdalla Eddie K., Fleming Jason B., Vauthey Jean-Nicolas, Rashid Asif, Evans Douglas B., One Hundred Years After “Carcinoid”: Epidemiology of and Prognostic Factors for Neuroendocrine Tumors in 35,825 Cases in the United States, 10.1200/jco.2007.15.4377
  2. Sook Lee Sung, Lee Jae-Lyun, Ryu Min-Hee, Moon Chang Heung, Won Kim Tae, Kun Kim Woo, Shin Lee Jung, Jang Se-Jin, Kwang Khang Shin, Kang Yoon-Koo, Extrapulmonary small cell carcinoma: Single center experience with 61 patients, 10.1080/02841860601071893
  3. Sorbye H., Welin S., Langer S. W., Vestermark L. W., Holt N., Osterlund P., Dueland S., Hofsli E., Guren M. G., Ohrling K., Birkemeyer E., Thiis-Evensen E., Biagini M., Gronbaek H., Soveri L. M., Olsen I. H., Federspiel B., Assmus J., Janson E. T., Knigge U., Predictive and prognostic factors for treatment and survival in 305 patients with advanced gastrointestinal neuroendocrine carcinoma (WHO G3): The NORDIC NEC study, 10.1093/annonc/mds276
  4. Sorbye Halfdan, Strosberg Jonathan, Baudin Eric, Klimstra David S., Yao James C., Gastroenteropancreatic high-grade neuroendocrine carcinoma : Neuroendocrine Carcinoma, 10.1002/cncr.28721
  5. Mitry E, Baudin E, Ducreux M, Sabourin J-C, Rufié P, Aparicio T, Lasser P, Elias D, Duvillard P, Schlumberger M, Rougier P, Treatment of poorly differentiated neuroendocrine tumours with etoposide and cisplatin, 10.1038/sj.bjc.6690325
  6. Moertel Charles G., Kvols Larry K., O'Connell Michael J., Rubin Joseph, Treatment of neuroendocrine carcinomas with combined etoposide and cisplatin. Evidence of major therapeutic activity in the anaplastic variants of these neoplasms, 10.1002/1097-0142(19910715)68:2<227::aid-cncr2820680202>3.0.co;2-i
  7. Hadoux J., Malka D., Planchard D., Scoazec J. Y., Caramella C., Guigay J., Boige V., Leboulleux S., Burtin P., Berdelou A., Loriot Y., Duvillard P., Chougnet C. N., Deandreis D., Schlumberger M., Borget I., Ducreux M., Baudin E., Post-first-line FOLFOX chemotherapy for grade 3 neuroendocrine carcinoma, 10.1530/erc-15-0075
  8. Hentic O., Hammel P., Couvelard A., Rebours V., Zappa M., Palazzo M., Maire F., Goujon G., Gillet A., Levy P., Ruszniewski P., FOLFIRI regimen: an effective second-line chemotherapy after failure of etoposide-platinum combination in patients with neuroendocrine carcinomas grade 3, 10.1530/erc-12-0002
  9. Hadoux J Planchard D Guigay J , . Oxaliplatin-based chemotherapy for grade 3 neuroendocrine carcinoma after failure of platinum-based chemotherapy. Eur Neuro Endocr Tumour Soc. Annual Conference. 2013; poster J2.
  10. Olsen Ingrid Holst, Knigge Ulrich, Federspiel Birgitte, Hansen Carsten Palnæs, Skov Anna, Kjær Andreas, Langer Seppo W., Topotecan Monotherapy in Heavily Pretreated Patients with Progressive Advanced Stage Neuroendocrine Carcinomas, 10.7150/jca.9409
  11. Brenner Baruch, Tang Laura H., Shia Jinruh, Klimstra David S., Kelsen David P., Small Cell Carcinomas of the Gastrointestinal Tract: Clinicopathological Features and Treatment Approach, 10.1053/j.seminoncol.2006.10.022
  12. Welin Staffan, Sorbye Halfdan, Sebjornsen Sigrunn, Knappskog Stian, Busch Christian, Öberg Kjell, Clinical effect of temozolomide-based chemotherapy in poorly differentiated endocrine carcinoma after progression on first-line chemotherapy, 10.1002/cncr.26124
  13. Yamaguchi Tomohiro, Machida Nozomu, Morizane Chigusa, Kasuga Akiyoshi, Takahashi Hideaki, Sudo Kentaro, Nishina Tomohiro, Tobimatsu Kazutoshi, Ishido Kenji, Furuse Junji, Boku Narikazu, Okusaka Takuji, Multicenter retrospective analysis of systemic chemotherapy for advanced neuroendocrine carcinoma of the digestive system, 10.1111/cas.12473
  14. Strosberg Jonathan R., Cheema Asima, Weber Jill, Han Gang, Coppola Domenico, Kvols Larry K., Prognostic Validity of a Novel American Joint Committee on Cancer Staging Classification for Pancreatic Neuroendocrine Tumors, 10.1200/jco.2011.35.1817
  15. Edge SB. AJCC Cancer Staging Manual. New York: Springer-Verlag; 2010. http://www.springer.com/us/book/9780387884400.
  16. Salazar Ramon, Wiedenmann Bertram, Rindi Guido, Ruszniewski Philippe, ENETS 2011 Consensus Guidelines for the Management of Patients with Digestive Neuroendocrine Tumors: An Update, 10.1159/000335600
  17. Maestu I., Pastor M., Gómez-Codina J., Aparicio J., Oltra A., Herranz C., Montalar J., Munárriz B., Reynés G., Pretreatment prognostic factors for survival in small-cell lung cancer: A new prognostic index and validation of three known prognostic indices on 341 patients, 10.1023/a:1008212826956
  18. Cerny T., Anderson H., Bramwell V., Thatcher N., Blair V., Pretreatment prognostic factors and scoring system in 407 small-cell lung cancer patients, 10.1002/ijc.2910390204
  19. Velayoudom-Cephise F.-L., Duvillard P., Foucan L., Hadoux J., Chougnet C. N., Leboulleux S., Malka D., Guigay J., Goere D., Debaere T., Caramella C., Schlumberger M., Planchard D., Elias D., Ducreux M., Scoazec J.-Y., Baudin E., Are G3 ENETS neuroendocrine neoplasms heterogeneous?, 10.1530/erc-13-0027
  20. Bergsland EK Roy R Stephens P et al. Genomic profiling to distinguish poorly differentiated neuroendocrine carcinomas arising in different sites. ASCO Annual Meeting 2016. J Clin Oncol. 2016;34(suppl); Abstract 4020.
  21. Nghiem Paul T., Bhatia Shailender, Lipson Evan J., Kudchadkar Ragini R., Miller Natalie J., Annamalai Lakshmanan, Berry Sneha, Chartash Elliot K., Daud Adil, Fling Steven P., Friedlander Philip A., Kluger Harriet M., Kohrt Holbrook E., Lundgren Lisa, Margolin Kim, Mitchell Alan, Olencki Thomas, Pardoll Drew M., Reddy Sunil A., Shantha Erica M., Sharfman William H., Sharon Elad, Shemanski Lynn R., Shinohara Michi M., Sunshine Joel C., Taube Janis M., Thompson John A., Townson Steven M., Yearley Jennifer H., Topalian Suzanne L., Cheever Martin A., PD-1 Blockade with Pembrolizumab in Advanced Merkel-Cell Carcinoma, 10.1056/nejmoa1603702
  22. Scoazec Jean-Yves, Couvelard Anne, Une nouvelle classification OMS des tumeurs (neuro)endocrines digestives, 10.1016/j.annpat.2011.01.001
  23. Rindi G Arnold R Bosman FT , . Nomenclature and classification of neuroendocrine neoplasms of the digestive system. In: Bosman TF Carneiro F Hruban RH Theise ND eds. WHO Classification of Tumours of the Digestive System. 4th ed. Lyon, France: International Agency for Research on Cancer; 2013:13.
  24. Tang Laura H., Basturk Olca, Sue Jillian J., Klimstra David S., A Practical Approach to the Classification of WHO Grade 3 (G3) Well-differentiated Neuroendocrine Tumor (WD-NET) and Poorly Differentiated Neuroendocrine Carcinoma (PD-NEC) of the Pancreas : , 10.1097/pas.0000000000000662
  25. Heetfeld M, Chougnet C N, Olsen I H, Rinke A, Borbath I, Crespo G, Barriuso J, Pavel M, O'Toole D, Walter T, , Characteristics and treatment of patients with G3 gastroenteropancreatic neuroendocrine neoplasms, 10.1530/erc-15-0119
  26. Ahlman Hakan, Nilsson Ola, McNicol Anne M., Ruszniewski Philippe, Niederle Bruno, Ricke Jens, Jensen Robert, Kos-Kudła Beata, Öberg Kjell, O’Connor Juan M., Pavel Marianne E., Vullierme Marie-Pierre, Poorly-Differentiated Endocrine Carcinomas of Midgut and Hindgut Origin, 10.1159/000109976
  27. Bettini R., Boninsegna L., Mantovani W., Capelli P., Bassi C., Pederzoli P., Delle Fave G. F., Panzuto F., Scarpa A., Falconi M., Prognostic factors at diagnosis and value of WHO classification in a mono-institutional series of 180 non-functioning pancreatic endocrine tumours, 10.1093/annonc/mdm552
  28. Brenner Baruch, Tang Laura H., Klimstra David S., Kelsen David P., Small-Cell Carcinomas of the Gastrointestinal Tract: A Review, 10.1200/jco.2004.09.075
Bibliographic reference Lamarca, Angela ; Walter, Thomas ; Pavel, Marianne ; Borbath, Ivan ; Freis, Patricia ; et. al. Design and Validation of the GI-NEC Score to Prognosticate Overall Survival in Patients With High-Grade Gastrointestinal Neuroendocrine Carcinomas.. In: National Cancer Institute. Journal (Online), Vol. 109, p. djw277 (2017)
Permanent URL http://hdl.handle.net/2078.1/194907