author_facet Heetfeld, Maximilian
Kasajima, Atsuko
Koch, Arend
Milone, Francesco
Steffen, Ingo
Dietel, Manfred
Sasano, Hironobu
Wiedenmann, Bertram
Pavel, Marianne E.
Heetfeld, Maximilian
Kasajima, Atsuko
Koch, Arend
Milone, Francesco
Steffen, Ingo
Dietel, Manfred
Sasano, Hironobu
Wiedenmann, Bertram
Pavel, Marianne E.
author Heetfeld, Maximilian
Kasajima, Atsuko
Koch, Arend
Milone, Francesco
Steffen, Ingo
Dietel, Manfred
Sasano, Hironobu
Wiedenmann, Bertram
Pavel, Marianne E.
spellingShingle Heetfeld, Maximilian
Kasajima, Atsuko
Koch, Arend
Milone, Francesco
Steffen, Ingo
Dietel, Manfred
Sasano, Hironobu
Wiedenmann, Bertram
Pavel, Marianne E.
Journal of Clinical Oncology
Poorly differentiated neuroendocrine carcinoma (NEC G3): Prognostic factors and potential novel targets.
Cancer Research
Oncology
author_sort heetfeld, maximilian
spelling Heetfeld, Maximilian Kasajima, Atsuko Koch, Arend Milone, Francesco Steffen, Ingo Dietel, Manfred Sasano, Hironobu Wiedenmann, Bertram Pavel, Marianne E. 0732-183X 1527-7755 American Society of Clinical Oncology (ASCO) Cancer Research Oncology http://dx.doi.org/10.1200/jco.2013.31.15_suppl.e15071 <jats:p> e15071 </jats:p><jats:p> Background: Poorly differentiated neuroendocrine carcinomas (NEC G3) represent a subgroup of neuroendocrine neoplasms with aggressive clinical behavior and poor prognosis, but showing quite variable clinical courses. In metastatic disease objective response to first-line therapy with cisplatin/ etoposide ranges between 40-67%, however median duration of response is short (4 to 9 months). There is no established second-line therapy. Methods: Clinical data of 42 patients with gastro-entero-pancreatic NEC G3 were analyzed in retrospect. In 26 cases tissue was analyzed for cell size, expression of p-mTOR and downstream effectors (p-eIF4E and p-4EBP1), somatostatin receptor (SSTR)-subtypes and growth factor receptors (EGFR and IGF-1R). Histopathological findings were analyzed using Kaplan-Meier curve, log rank test and Cox regression. Results: Patients with large cell NEC showed a more favorable survival than patients with small cell NEC. Median overall survival (mOS) was 31 versus 11 months (P=0.034). Expression of p-mTOR and p-eIF4E was seen in 64% and 24% of cases. High expression levels of p-mTOR (mOS 9 vs 25 months, P=0.026) and expression of p-eIF4E (mOS 9 vs 25 months, P=0.015) was significantly associated with shorter survival. In multivariate Cox regression p-mTOR and p-eIF4E proved to be independent prognostic factors for survival taking cell size and TNM staging into account. EGFR (cytoplasmatic and nuclear) and IGF-1R expression was found in 73.1%, 65.4% and 69.2% of the cases respectively, without significant association to survival. Expression of SSTR subtypes, Ki67 value and response to first line chemotherapy was not of prognostic value analyzed by log rank test. Conclusions: The clinical impact of cell size discrimination requires further evaluation in NEC G3. The mTOR pathway seems to play a role in tumor growth in some NEC and may represent a novel therapeutic target. </jats:p> Poorly differentiated neuroendocrine carcinoma (NEC G3): Prognostic factors and potential novel targets. Journal of Clinical Oncology
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series Journal of Clinical Oncology
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title Poorly differentiated neuroendocrine carcinoma (NEC G3): Prognostic factors and potential novel targets.
title_unstemmed Poorly differentiated neuroendocrine carcinoma (NEC G3): Prognostic factors and potential novel targets.
title_full Poorly differentiated neuroendocrine carcinoma (NEC G3): Prognostic factors and potential novel targets.
title_fullStr Poorly differentiated neuroendocrine carcinoma (NEC G3): Prognostic factors and potential novel targets.
title_full_unstemmed Poorly differentiated neuroendocrine carcinoma (NEC G3): Prognostic factors and potential novel targets.
title_short Poorly differentiated neuroendocrine carcinoma (NEC G3): Prognostic factors and potential novel targets.
title_sort poorly differentiated neuroendocrine carcinoma (nec g3): prognostic factors and potential novel targets.
topic Cancer Research
Oncology
url http://dx.doi.org/10.1200/jco.2013.31.15_suppl.e15071
publishDate 2013
physical e15071-e15071
description <jats:p> e15071 </jats:p><jats:p> Background: Poorly differentiated neuroendocrine carcinomas (NEC G3) represent a subgroup of neuroendocrine neoplasms with aggressive clinical behavior and poor prognosis, but showing quite variable clinical courses. In metastatic disease objective response to first-line therapy with cisplatin/ etoposide ranges between 40-67%, however median duration of response is short (4 to 9 months). There is no established second-line therapy. Methods: Clinical data of 42 patients with gastro-entero-pancreatic NEC G3 were analyzed in retrospect. In 26 cases tissue was analyzed for cell size, expression of p-mTOR and downstream effectors (p-eIF4E and p-4EBP1), somatostatin receptor (SSTR)-subtypes and growth factor receptors (EGFR and IGF-1R). Histopathological findings were analyzed using Kaplan-Meier curve, log rank test and Cox regression. Results: Patients with large cell NEC showed a more favorable survival than patients with small cell NEC. Median overall survival (mOS) was 31 versus 11 months (P=0.034). Expression of p-mTOR and p-eIF4E was seen in 64% and 24% of cases. High expression levels of p-mTOR (mOS 9 vs 25 months, P=0.026) and expression of p-eIF4E (mOS 9 vs 25 months, P=0.015) was significantly associated with shorter survival. In multivariate Cox regression p-mTOR and p-eIF4E proved to be independent prognostic factors for survival taking cell size and TNM staging into account. EGFR (cytoplasmatic and nuclear) and IGF-1R expression was found in 73.1%, 65.4% and 69.2% of the cases respectively, without significant association to survival. Expression of SSTR subtypes, Ki67 value and response to first line chemotherapy was not of prognostic value analyzed by log rank test. Conclusions: The clinical impact of cell size discrimination requires further evaluation in NEC G3. The mTOR pathway seems to play a role in tumor growth in some NEC and may represent a novel therapeutic target. </jats:p>
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author Heetfeld, Maximilian, Kasajima, Atsuko, Koch, Arend, Milone, Francesco, Steffen, Ingo, Dietel, Manfred, Sasano, Hironobu, Wiedenmann, Bertram, Pavel, Marianne E.
author_facet Heetfeld, Maximilian, Kasajima, Atsuko, Koch, Arend, Milone, Francesco, Steffen, Ingo, Dietel, Manfred, Sasano, Hironobu, Wiedenmann, Bertram, Pavel, Marianne E., Heetfeld, Maximilian, Kasajima, Atsuko, Koch, Arend, Milone, Francesco, Steffen, Ingo, Dietel, Manfred, Sasano, Hironobu, Wiedenmann, Bertram, Pavel, Marianne E.
author_sort heetfeld, maximilian
container_issue 15_suppl
container_start_page 0
container_title Journal of Clinical Oncology
container_volume 31
description <jats:p> e15071 </jats:p><jats:p> Background: Poorly differentiated neuroendocrine carcinomas (NEC G3) represent a subgroup of neuroendocrine neoplasms with aggressive clinical behavior and poor prognosis, but showing quite variable clinical courses. In metastatic disease objective response to first-line therapy with cisplatin/ etoposide ranges between 40-67%, however median duration of response is short (4 to 9 months). There is no established second-line therapy. Methods: Clinical data of 42 patients with gastro-entero-pancreatic NEC G3 were analyzed in retrospect. In 26 cases tissue was analyzed for cell size, expression of p-mTOR and downstream effectors (p-eIF4E and p-4EBP1), somatostatin receptor (SSTR)-subtypes and growth factor receptors (EGFR and IGF-1R). Histopathological findings were analyzed using Kaplan-Meier curve, log rank test and Cox regression. Results: Patients with large cell NEC showed a more favorable survival than patients with small cell NEC. Median overall survival (mOS) was 31 versus 11 months (P=0.034). Expression of p-mTOR and p-eIF4E was seen in 64% and 24% of cases. High expression levels of p-mTOR (mOS 9 vs 25 months, P=0.026) and expression of p-eIF4E (mOS 9 vs 25 months, P=0.015) was significantly associated with shorter survival. In multivariate Cox regression p-mTOR and p-eIF4E proved to be independent prognostic factors for survival taking cell size and TNM staging into account. EGFR (cytoplasmatic and nuclear) and IGF-1R expression was found in 73.1%, 65.4% and 69.2% of the cases respectively, without significant association to survival. Expression of SSTR subtypes, Ki67 value and response to first line chemotherapy was not of prognostic value analyzed by log rank test. Conclusions: The clinical impact of cell size discrimination requires further evaluation in NEC G3. The mTOR pathway seems to play a role in tumor growth in some NEC and may represent a novel therapeutic target. </jats:p>
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imprint American Society of Clinical Oncology (ASCO), 2013
imprint_str_mv American Society of Clinical Oncology (ASCO), 2013
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spelling Heetfeld, Maximilian Kasajima, Atsuko Koch, Arend Milone, Francesco Steffen, Ingo Dietel, Manfred Sasano, Hironobu Wiedenmann, Bertram Pavel, Marianne E. 0732-183X 1527-7755 American Society of Clinical Oncology (ASCO) Cancer Research Oncology http://dx.doi.org/10.1200/jco.2013.31.15_suppl.e15071 <jats:p> e15071 </jats:p><jats:p> Background: Poorly differentiated neuroendocrine carcinomas (NEC G3) represent a subgroup of neuroendocrine neoplasms with aggressive clinical behavior and poor prognosis, but showing quite variable clinical courses. In metastatic disease objective response to first-line therapy with cisplatin/ etoposide ranges between 40-67%, however median duration of response is short (4 to 9 months). There is no established second-line therapy. Methods: Clinical data of 42 patients with gastro-entero-pancreatic NEC G3 were analyzed in retrospect. In 26 cases tissue was analyzed for cell size, expression of p-mTOR and downstream effectors (p-eIF4E and p-4EBP1), somatostatin receptor (SSTR)-subtypes and growth factor receptors (EGFR and IGF-1R). Histopathological findings were analyzed using Kaplan-Meier curve, log rank test and Cox regression. Results: Patients with large cell NEC showed a more favorable survival than patients with small cell NEC. Median overall survival (mOS) was 31 versus 11 months (P=0.034). Expression of p-mTOR and p-eIF4E was seen in 64% and 24% of cases. High expression levels of p-mTOR (mOS 9 vs 25 months, P=0.026) and expression of p-eIF4E (mOS 9 vs 25 months, P=0.015) was significantly associated with shorter survival. In multivariate Cox regression p-mTOR and p-eIF4E proved to be independent prognostic factors for survival taking cell size and TNM staging into account. EGFR (cytoplasmatic and nuclear) and IGF-1R expression was found in 73.1%, 65.4% and 69.2% of the cases respectively, without significant association to survival. Expression of SSTR subtypes, Ki67 value and response to first line chemotherapy was not of prognostic value analyzed by log rank test. Conclusions: The clinical impact of cell size discrimination requires further evaluation in NEC G3. The mTOR pathway seems to play a role in tumor growth in some NEC and may represent a novel therapeutic target. </jats:p> Poorly differentiated neuroendocrine carcinoma (NEC G3): Prognostic factors and potential novel targets. Journal of Clinical Oncology
spellingShingle Heetfeld, Maximilian, Kasajima, Atsuko, Koch, Arend, Milone, Francesco, Steffen, Ingo, Dietel, Manfred, Sasano, Hironobu, Wiedenmann, Bertram, Pavel, Marianne E., Journal of Clinical Oncology, Poorly differentiated neuroendocrine carcinoma (NEC G3): Prognostic factors and potential novel targets., Cancer Research, Oncology
title Poorly differentiated neuroendocrine carcinoma (NEC G3): Prognostic factors and potential novel targets.
title_full Poorly differentiated neuroendocrine carcinoma (NEC G3): Prognostic factors and potential novel targets.
title_fullStr Poorly differentiated neuroendocrine carcinoma (NEC G3): Prognostic factors and potential novel targets.
title_full_unstemmed Poorly differentiated neuroendocrine carcinoma (NEC G3): Prognostic factors and potential novel targets.
title_short Poorly differentiated neuroendocrine carcinoma (NEC G3): Prognostic factors and potential novel targets.
title_sort poorly differentiated neuroendocrine carcinoma (nec g3): prognostic factors and potential novel targets.
title_unstemmed Poorly differentiated neuroendocrine carcinoma (NEC G3): Prognostic factors and potential novel targets.
topic Cancer Research, Oncology
url http://dx.doi.org/10.1200/jco.2013.31.15_suppl.e15071