Brunner, Philippe; Jörg, Ann-Catherine; Glatz, Katharina; Bubendorf, Lukas; Radojewski, Piotr; Umlauft, Maria; Marincek, Nicolas; Spanjol, Petar Marko; Krause, Thomas Michael; Dumont, Rebecca A; Maecke, Helmut R; Müller-Brand, Jan; Briel, Matthias; Schmitt, Anja; Perren, Aurel; Walter, Martin Alexander (2017). The prognostic and predictive value of sstr2-immunohistochemistry and sstr2-targeted imaging in neuroendocrine tumors. European journal of nuclear medicine and molecular imaging, 44(3), pp. 468-475. Springer 10.1007/s00259-016-3486-2
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art%3A10.1007%2Fs00259-016-3486-2.pdf - Published Version Available under License Publisher holds Copyright. Download (1MB) | Preview |
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EJNM-D-16-00297 - Revised Manuscript - The prognostic and predictive value of sstr2-immunohistochemistry and sstr2-targeted imaging in neuroendocrine tumors.pdf - Accepted Version Available under License Publisher holds Copyright. Download (7MB) | Preview |
PURPOSE
Our aim was to assess the prognostic and predictive value of somatostatin receptor 2 (sstr2) in neuroendocrine tumors (NETs).
METHODS
We established a tissue microarray and imaging database from NET patients that received sstr2-targeted radiopeptide therapy with yttrium-90-DOTATOC, lutetium-177-DOTATOC or alternative treatment. We used univariate and multivariate analyses to identify prognostic and predictive markers for overall survival, including sstr2-imaging and sstr2-immunohistochemistry.
RESULTS
We included a total of 279 patients. In these patients, sstr2-immunohistochemistry was an independent prognostic marker for overall survival (HR: 0.82, 95 % CI: 0.67 - 0.99, n = 279, p = 0.037). In DOTATOC patients, sstr2-expression on immunohistochemistry correlated with tumor uptake on sstr2-imaging (n = 170, p < 0.001); however, sstr2-imaging showed a higher prognostic accuracy (positive predictive value: +27 %, 95 % CI: 3 - 56 %, p = 0.025). Sstr2-expression did not predict a benefit of DOTATOC over alternative treatment (p = 0.93).
CONCLUSIONS
Our results suggest sstr2 as an independent prognostic marker in NETs. Sstr2-immunohistochemistry correlates with sstr2-imaging; however, sstr2-imaging is more accurate for determining the individual prognosis.
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