文章：

接受肽受体放射性核素治疗的神经内分泌肿瘤患者血浆标志物用于治疗反应监测的研究

Plasma Markers for Therapy Response Monitoring in Patients with Neuroendocrine Tumors Undergoing Peptide Receptor Radionuclide Therapy

原文发布日期：6 December 2023

DOI: 10.3390/cancers15245717

类型: Article

开放获取: 是

英文摘要：

Background: Pretherapeutic chromogranin A, alkaline phosphatase (ALP), or De Ritis ratio (aspartate aminotransferase/alanine aminotransferase) are prognostic factors in patients with metastatic neuroendocrine tumors (NET) undergoing peptide receptor radionuclide therapy (PRRT). However, their value for intratherapeutic monitoring remains unclear. We evaluated if changes in plasma markers during PRRT can help identify patients with unfavorable outcomes. Methods: A monocentric retrospective analysis of 141 patients with NET undergoing PRRT with [177Lu]Lu-DOTATOC was conducted. Changes in laboratory parameters were calculated by dividing the values determined immediately before each cycle of PRRT by the pretherapeutic value. Patients with low vs. high PFS were compared with the Wilcoxon rank-sum test. Results: Progression, relapse, or death after PRRT was observed in 103/141 patients. Patients with low PFS showed a significant relative ALP increase before the third (p= 0.014) and fourth (p= 0.039) cycles of PRRT. Kaplan–Meier analysis revealed a median PFS of 24.3 months (95% CI, 20.7–27.8 months) in patients with decreasing ALP values (Δ > 10%) during treatment, 12.5 months (95% CI, 9.2–15.8 months) in patients with increasing ALP values (Δ > 10%), and 17.7 months (95% CI, 13.6–21.8 months) with stable ALP values (Δ ± 10%). Conclusions: Based on these exploratory data, a rise in plasma ALP might indicate disease progression and should be interpreted cautiously during therapy.

摘要翻译： 

背景：治疗前嗜铬粒蛋白A、碱性磷酸酶（ALP）或De Ritis比值（天冬氨酸氨基转移酶/丙氨酸氨基转移酶）是接受肽受体放射性核素治疗（PRRT）的转移性神经内分泌肿瘤（NET）患者的预后因素。然而，这些指标在治疗过程中的监测价值尚不明确。本研究评估了PRRT期间血浆标志物的变化是否有助于识别预后不良的患者。方法：对141例接受[177Lu]Lu-DOTATOC PRRT治疗的NET患者进行单中心回顾性分析。通过将每个PRRT周期开始前即刻测定的实验室参数值除以治疗前基线值，计算各指标的变化率。采用Wilcoxon秩和检验比较无进展生存期（PFS）较短与较长患者间的差异。结果：141例患者中有103例在PRRT后出现疾病进展、复发或死亡。PFS较短的患者在第三周期（p=0.014）和第四周期（p=0.039）PRRT前均呈现显著的ALP相对升高。Kaplan-Meier分析显示：治疗期间ALP下降（Δ>10%）患者的中位PFS为24.3个月（95% CI：20.7-27.8个月），ALP升高（Δ>10%）患者为12.5个月（95% CI：9.2-15.8个月），ALP稳定（Δ±10%）患者为17.7个月（95% CI：13.6-21.8个月）。结论：基于这些探索性数据，血浆ALP升高可能提示疾病进展，在治疗过程中应谨慎解读该指标变化。

原文链接：

Plasma Markers for Therapy Response Monitoring in Patients with Neuroendocrine Tumors Undergoing Peptide Receptor Radionuclide Therapy