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Background: Neuroendocrine tumors are a group of heterogeneous tumors that arise in cells of the diffuse neuroendocrine system. From the UK NHS and Personal Social Services perspective, we produced a survival partition cohort-based economic analysis in Microsoft Excel® 2013 from the UK NHS and Personal Social Services perspective. The trials found that the interventions improved PFS and overall survival when compared to BSC and the BSC. PFS between everolimus and sunitinib was not significant in our indirect comparison. Everolimus significantly increased PFS in GI and lung NETs relative to BSC, as well as showing a non-significant shift toward improved OS compared to BSC. Following targeted interventions rather than after BSC-based therapy, adverse events were more frequent. In the base case for pNETs, we assumed net cost-effectiveness ratios for everolimus, based on BSC's £45,493 per quality-adjusted life-year and for sunitinib, compared to BSC's £20,717 per QALY. The ICERs were £199,233 per QALY for everolimus compared to BSC and £62,158 per QALY for a scenario study comparing 177Lu-DOTATATE with BSC. The indirect treatment comparison that our economic analysis was based on was based on a simple Bucher model, unadjusted for any differences in the baseline results across the two trials. Conclusions: Given that NICE's new stated range of £20,000–30,000 per QALY for the cost-effectiveness threshold, based on list prices, only sunitinib could be deemed "good value for money in England and Wales. Funding for the National Institute for Health Research Health Technology Assessment program (NICE).
Source link: https://doi.org/10.3310/hta22490
The primary aim of this research was to investigate incidentally detected meningiomas in metastatic NET patients referred to peptide receptor radionuclide therapy. This was a retrospective review of 500 metastatic/advanced NET patients who had undergone 68Ga-DOTATE PET/CT and 18F-FDG PET/CT before PRRT testing. On 68Ga-DOTATATE PET/CT, twelve NET patients were retrospectively diagnosed with abnormal focal brain uptake. The conversion ratios ranged from 140 to 42. 0 and 1. 02–1. 07, respectively, for lesion-to-normal brain parenchyma SUVmax, which ranged from 7. 0 to 22. 0 and 13. 70, respectively. According to six patients with incidentally diagnosed meningiomas, one patient died within a month, and five patients were awarded 177Lu-DOTATATE PRRT, ranging from two to six cycles with cumulative therapeutic doses ranging from 13. 28 to 29. 97GBq. In any of these patients, no significant hematological or renal impairment was reported. Following PRRT, the estimated mean PFS of the meningioma lesions was 26. 25 months. To summarize, 68Ga-DOTATATE PET/CT imaging is an effective tool for the incidental detection of meningioma in NET patients. Given the limited therapeutic options in advanced or metastatic NET patients and morbidity related to the medical procedures, RT may be a promising targeted therapeutic option for such cases of incidentally identified meningiomas, which can also aid in stabilizing the disease process without any significant toxicities.
Source link: https://doi.org/10.4103/wjnm.wjnm_39_18
Gallium-68 DOTA-Tyr3-octreotate positron emission tomography in the detection of neuroendocrine tumors has increased dramatically over the past decade, and is becoming more popular. We introduce the case of a male with no known metastatic NET who underwent 68Ga DOTATE PET/CT for restaging, while still exhibiting rapid risetake of the prostate with a maximum uptake value of 17. 4. Chronic prostatitis is a common disorder in adult males and is often asymptomatic.
Source link: https://doi.org/10.4103/wjnm.WJNM_11_19
This retrospective review and divided into three groups was determined as FDG uptake at baseline, SUVmax 5-10, and Group 3 consisted of patients with low-grade FDG uptake at baseline, defined as SUVmax > 10. These patients also had improved PFS and OS, as well as the lowest hazard ratio in comparison to patients in Group 3. Patients of low- to moderately NET metabolism with poor biochemical and anatomical disease control were found to have prolonged PFS and OS in comparison to those with high-grade baseline tumor FDG metabolism.
Source link: https://doi.org/10.4103/wjnm.WJNM_62_18
This knowledge has resulted in the testing of mTOR inhibitors as a treatment for metastatic NETs. Everolimus' efficacy in improving progression-free survival for metastatic NET of pancreatic, lung, and digestive origins, according to the U. S. Food and Drug Administration, which led to the FDA's acceptance of the drug in tumor control in those settings. Although cessation rates are low, many patients may require dose adjustment to safely continue therapy. The combination of everolimus with somatostatin analogues or other potentially harmful drugs such as bevacizumab hasn't resulted in any incremental improvement, and dual biologic therapy is not widely used. Ongoing trials are looking at everolimus, optimal sequencing of therapy, and the combination of everolimus with radiotherapy. Future research should concentrate on the identification of predictive biomarkers for benefiting from mTOR therapy, as well as the inclusion of quality of life as a measure.
Source link: https://doi.org/10.1177/1756283X16674660
0 - no uptake; tracer uptake in somatostatin receptor-positive bone marrow lesions were divided into four categories in comparison to liver uptake; II - equal to liver uptake; and III - higher than liver uptake; and III - higher than liver uptake. Following a progressive disease and death at 18 months' biochemical, three patients demonstrated remarkable symptomatic palliation and improved quality of life with improvement of Karnofsky/Lansky's results; one patient had an increase in the serum chromogranin level, but three others had good health and longevity; one patient had a stable disease and death in the first six months; one patient had sustained symptomatic response in the first six months; one patient had stable disease and one patient had symptomad Except for two patients, there was no apparent FDG uptake in the bone marrow metastatic lesions demonstrated no apparent FDG interest in visual assessment. In the first six months after the first dose of PRRT, the single patient with a progressive disease had a prompt symptomatic response in the first six months.
Source link: https://doi.org/10.4103/1450-1147.165353
The systematic review of metastatic NEN patient trials could help reduce the potential bias of single phase II trials. Methods' systematic review focuses on the effectiveness and safety of pazopanib in patients with metastatic and locally advanced NEN. Methods: A systematic search of the major databases Medline/PubMed, Cochrane, and Embase, as well as additional literature from renowned international Meetings to find papers on pazopanib for the treatment of neuroendocrine neoplasia. In all of the trials, pazopanib was orally administered at a dose of 800 mg daily for a 28-day cycle. Results: One trial was ruled out because the subject was Von-Hippel Landau disease, and one abstract was rejected due to a lack of information on meeting procedures. The prevalence of stable disease was 79. 6% with a disease control rate of 90. 3%.
Source link: https://doi.org/10.3389/fonc.2020.00414
Internal radioembolization with yttrium-90 is a promising treatment strategy, particularly for liver tumors. Following transarterial yttrium-90 therapy for a metastatic neuroendocrine tumor in a 58-year-old man, we present a case of gastric outlet obstruction due to antropyloric stenosis with ulceration, edema, and inflammation. After stent removal, GOO's improved after stenting and recovery of oral intake was permanent.
Source link: https://doi.org/10.5946/ce.2015.149
On cross-sectional imaging at presentation, liver metastases from neuroendocrine tumors are often seen. In those instances, curative surgical resection is usually not feasible, given that the majority of patients have bilobar disease. We present a rare case of hepatic necrosis after TAE in a 61-year-old woman with a metastatic NET. The occurrence of portal vein thrombosis after TAE could be attributed to the presence of occult arterioportal anastomoses. These allow for the transport of the embolizing agents into the portal vein branches that supply the treated segments and subsequent thrombosis.
Source link: https://doi.org/10.12890/2020_001530
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