Published December 7, 2023
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Predictive Factors of Response to Streptozotocin in Neuroendocrine Pancreatic Neoplasms.

Creators

  • 1. Endocrine Oncology Program, Endocrine Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, University Hospital of Sassari, 07100 Sassari, Italy.
  • 2. National Center for Drug Research and Evaluation, National Institute of Health (ISS), 00161 Rome, Italy.
  • 3. Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari Aldo Moro, 70124 Bari, Italy.
  • 4. University of Bari
  • 5. Unit of Endocrinology, Andrology, Diabetology and Nutrition, Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy.
  • 6. Oncological Endocrinology Unit, Regina Elena National Cancer Institute IRCCS, 00144 Rome, Italy.
  • 7. Scientific Institute for Research, Hospitalization and Healthcare
  • 8. Department of Radiology, Oncology and Pathology, Sapienza University of Rome, 00161 Rome, Italy.
  • 9. Sapienza University of Rome
  • 10. Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy.
  • 11. UNESCO Chair, Education for Health and Sustainable Development, Federico II University, 80131 Naples, Italy.
  • 12. Endocrinology Unit, Department of Clinical and Molecular Medicine, The European Neuroendocrine Tumor Society (ENETS) Center of Excellence, Sant'Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy.

Description

Pancreatic neuroendocrine neoplasms (Pan-NENs) may exhibit a heterogeneous clinical course, ranging from indolent to progressive/metastatic behavior. In the latter scenario, streptozocin (STZ) is considered the cornerstone of systemic treatment; however, response to STZ-based chemotherapy may vary among individuals. In this narrative review, we aimed to identify the predictive factors of response to STZ in advanced Pan-NENs. We performed an extensive search in international online databases for published studies and ongoing clinical trials evaluating STZ in Pan-NENs. We found 11 pertinent studies evaluating 17 patient-, tumor-, or treatment-related factors. Age, CgA blood levels, tumor grade, Ki-67% index, anatomical location of the primary tumor, tumor stage, site of metastasis origin, liver tumor burden, extrahepatic spread, functional status, O6-methylguanine-methyltransferase (MGMT) status, line of therapy, and response to previous treatments were all statistically associated with radiological response and/or survival. The identified predictors may help clinicians make appropriate treatment decisions, in this way improving clinical outcomes in patients with advanced Pan-NENs.
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