TY - JOUR
T1 - Association between objective response rate and overall survival in metastatic neuroendocrine tumors treated with radioembolization
T2 - a systematic literature review and regression analysis
AU - Pollock, Richard F.
AU - Brennan, Victoria K.
AU - Peters, Ralph
AU - Paprottka, Philipp M.
N1 - Publisher Copyright:
© 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
PY - 2020/11
Y1 - 2020/11
N2 - Objectives: Neuroendocrine tumors (NETs) are a heterogeneous group of cancers arising from neuroendocrine cells. The aim was to evaluate objective response rate (ORR) as a predictor of overall survival (OS) in patients with metastatic NETs (mNETs) treated with radioembolization (RE). Methods: Randomized controlled trials and observational studies of RE treatment of mNETs were identified by systematic literature review (SLR). Pooled ORR and OS estimates were calculated and a weighted generalized linear model (GLM) of ORR as a predictor of OS was derived, stratified by ORR assessment criteria and RE type (Yttrium-90 resin or glass microspheres). Results: The SLR identified 32 observational studies. Mean ORR was 41% (95% confidence interval 38–45%). The Yttrium-90 resin and glass microsphere GLMs accounted for 59% and 57% of OS deviance, respectively. ORR was a significant predictor of OS in the resin microspheres model (p < 0.001), but not the glass microspheres model (p = 0.11). Conclusions: A weighted GLM showed a significant relationship between ORR and OS in patients with mNETs treated with Yttrium-90 resin microspheres. ORR could therefore potentially be an OS surrogate in future trials of Yttrium-90 resin microspheres. Further research is needed to confirm the relationship between ORR and OS and the difference between resin and glass microspheres.
AB - Objectives: Neuroendocrine tumors (NETs) are a heterogeneous group of cancers arising from neuroendocrine cells. The aim was to evaluate objective response rate (ORR) as a predictor of overall survival (OS) in patients with metastatic NETs (mNETs) treated with radioembolization (RE). Methods: Randomized controlled trials and observational studies of RE treatment of mNETs were identified by systematic literature review (SLR). Pooled ORR and OS estimates were calculated and a weighted generalized linear model (GLM) of ORR as a predictor of OS was derived, stratified by ORR assessment criteria and RE type (Yttrium-90 resin or glass microspheres). Results: The SLR identified 32 observational studies. Mean ORR was 41% (95% confidence interval 38–45%). The Yttrium-90 resin and glass microsphere GLMs accounted for 59% and 57% of OS deviance, respectively. ORR was a significant predictor of OS in the resin microspheres model (p < 0.001), but not the glass microspheres model (p = 0.11). Conclusions: A weighted GLM showed a significant relationship between ORR and OS in patients with mNETs treated with Yttrium-90 resin microspheres. ORR could therefore potentially be an OS surrogate in future trials of Yttrium-90 resin microspheres. Further research is needed to confirm the relationship between ORR and OS and the difference between resin and glass microspheres.
KW - Neuroendocrine tumors
KW - neoplasm metastasis
KW - regression analysis
KW - response evaluation criteria in solid tumors
KW - survival rate
UR - http://www.scopus.com/inward/record.url?scp=85094174775&partnerID=8YFLogxK
U2 - 10.1080/14737140.2020.1814748
DO - 10.1080/14737140.2020.1814748
M3 - Article
C2 - 32930618
AN - SCOPUS:85094174775
SN - 1473-7140
VL - 20
SP - 997
EP - 1009
JO - Expert Review of Anticancer Therapy
JF - Expert Review of Anticancer Therapy
IS - 11
ER -
