Safety of high doses of somatostatin analogs in well differentiated NENs in elderly
Abstract Background Neuroendocrine neoplasms (NENs) are a group of heterogeneous neoplasms which can be treated with different therapies: in well differentiated (WD) NENs analogs of somatostatin (SSA) can be used considering their proved antineoplastic and antisecretory effects. This is a multicenter study to investigate the safety of high doses (HDD) analogs of somatostatin (SSA) in WD NENs with particular attention for patients over 70 years of age. Methods We collected clinical data from 13 Italian NENs dedicated Units. Patients with WD NENs, in progression on previous treatments, included SSA, and subsequently treated with HDD-SSA, were considered. Results 170 pts were included: 61.76% male, 38.24% female. The median age at the diagnosis was 58.83. Regarding the site of origin, the most frequent was gastro-intestinal system (54.71%), followed by pancreas (27.06%) and lung (8.24%). G1 NENs were 54.11%, G2 42.94% and typical lung carcinoid 2.95%; 31.76% were affected by a carcinoid syndrome or clinical conditions such as gastrinoma, insulinoma and Zollinger-Ellison. The median PFS was 20.18 months. Side effects (SEs) were registered in 25 pts (14.71%), the most frequent were cholecystitis (4%), G1 asthenia (12%), G1 hyperglycemia (8%), G1 steatorrhea (76%). We divided patients in 4 groups considering the age at the diagnosis: lower than 60 years, 61-70, 71-80 and more than 81 years. With the increase of age there was a higher percentage of SEs (Tab.1) with a maximum percentage of 20.41% in the group with an age of 71-80 years. The treatment was well tolerated without life-threatening side effects also in the group of patients with an age > 70 years. Tab. 1 Table: 520P . Age at the diagnosis (years) % side effects 10,00% 61-70 13,73% 71-80 20,41% >81 20,00% Conclusions We concluded that in this setting of patients, with an age >70 and a WD NEN in progression to standard doses of SSA, HD-SSA represents a safe and effective second line therapy with a median PFS of 20.80 months. Legal entity responsible for the study The authors. Funding Has not received any funding. Disclosure All authors have declared no conflicts of interest.