1. Is There an Additional Value of Using Somatostatin Receptor Subtype 2a Immunohistochemistry Compared to Somatostatin Receptor Scintigraphy Uptake in Predicting Gastroenteropancreatic Neuroendocrine Tumor Response?
- Author
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Gaston J H Franssen, Kimberly Kamp, Leo J. Hofland, Roxanne C.S. van Adrichem, Richard A Feelders, Katharina Biermann, Dik J. Kwekkeboom, Carolien H M van Deurzen, Wouter W. de Herder, Internal Medicine, Pathology, Surgery, and Radiology & Nuclear Medicine
- Subjects
Adult ,Male ,medicine.medical_specialty ,endocrine system ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Enolase ,Octreotide ,Antineoplastic Agents ,030209 endocrinology & metabolism ,Neuroendocrine tumors ,Gastroenterology ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,Endocrinology ,Stomach Neoplasms ,Internal medicine ,Intestinal Neoplasms ,parasitic diseases ,medicine ,Humans ,Somatostatin receptor 2 ,Receptors, Somatostatin ,Stage (cooking) ,Radionuclide Imaging ,Aged ,Endocrine and Autonomic Systems ,business.industry ,Middle Aged ,medicine.disease ,Immunohistochemistry ,Primary tumor ,Gene Expression Regulation, Neoplastic ,Pancreatic Neoplasms ,Radiation therapy ,Neuroendocrine Tumors ,Treatment Outcome ,030220 oncology & carcinogenesis ,Female ,business ,medicine.drug - Abstract
Background and Aims: It is unknown whether tumoral somatostatin receptor subtype 2a (sst2a) immunohistochemistry (IHC) has additional value compared to somatostatin receptor scintigraphy (SRS) uptake using OctreoScan® in predicting response to peptide receptor radiotherapy using 177Lu-octreotate (PRRT) in patients with gastroenteropancreatic neuroendocrine tumors (GEP-NETs). The aims of this study were: (1) to establish the percentage of sst2a immunopositivity in GEP-NET samples of PRRT-treated patients, (2) to determine the relationship between best GEP-NET response using RECIST 1.0 criteria 1 year after PRRT and tumoral sst2a IHC, and (3) to compare characteristics of patients with sst2a IHC-negative and -positive tumors. Methods: All 73 consecutive patients were selected for PRRT based on a positive SRS. Radiological response was scored according to RECIST 1.0 criteria. sst2a status was detected on tumor samples by IHC. Results: In total, 93% of GEP-NET samples showed sst2a IHC positivity. No statistically significant relationship was observed between in vitro sst2a expression and in vivo best GEP-NET response 1 year after PRRT (p = 0.47). Sex, primary tumor site, disease stage, ENETS TNM classification, Ki-67 index, highest serum chromogranin-A level, and highest neuron-specific enolase level were not significantly different between patients with negative and positive sst2a tumoral IHC with the exception of age at diagnosis (p = 0.007). Conclusions: sst2a IHC of tumor samples has no additional value compared to SRS uptake using OctreoScan® in predicting tumor response after PRRT.
- Published
- 2016