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ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Neuroendocrine Science
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1526470
This article is part of the Research Topic Diagnosis, Treatment and Prognosis of Neuroendocrine Neoplasms with a focus on peptide receptor radionuclide therapy (PRRT) View all 3 articles
Impact of Functionality and Grading on Survival in Pancreatic Neuroendocrine Tumor Patients Receiving Peptide Receptor Radionuclide Therapy
Provisionally accepted- Essen University Hospital, Essen, Germany
Background: Peptide receptor radionuclide therapy (PRRT) is a well-established treatment option for neuroendocrine tumors (NET), yet randomized controlled trials have not provided data on its impact on overall survival. The real-world efficacy of PRRT and its association with tumor functionality and grading in pancreatic neuroendocrine tumors (PanNET) remains underexplored.Methods: A retrospective analysis of 166 patients with histologically confirmed metastatic PanNET was performed. Subgroup analyses examined progression-free survival (PFS) and overall survival (OS) following PRRT cycles, stratified by tumor grading, tumor functionality and bone metastases.Results: Of 166 patients, 100 (60.2%) received PRRT with a median of four cycles.In the PRRT cohort, 68% of patients had deceased. PFS after four and eight consecutive cycles was 20 and 18 months, respectively (p=0.4). OS for the entire cohort was 79 months, with patients receiving 4+ cycles of PRRT having an OS of 87 months and those receiving 5+ cycles achieving an OS of 100 months. Patients with grade 1 or 2 tumors had a significantly longer median OS of 97 months compared to 74.5 months for grade 3 tumors (p = 0.0055). There was no significant difference in OS between functioning and non-functioning tumors after PRRT. Patients with bone metastases who received PRRT had a significantly shorter OS than those without (74 vs. 89 months, p = 0.013). In 19% of patients who received PRRT, therapy was discontinued due to progressive disease, toxicity or death.Patients receiving extended cycles of PRRT showed improved survival outcomes in metastatic PanNET, particularly in patients with lower tumor grades and without bone metastases. No survival difference was seen between functioning and non-functioning PanNET, while patients with grade 3 tumors and bone metastases had significantly shorter survival despite PRRT.
Keywords: Pancreas, Survival, PRRT, neuroendocrine tumor, PanNET
Received: 11 Nov 2024; Accepted: 19 Mar 2025.
Copyright: © 2025 Mathew, Kersting, Fendler, Brägelmann, Führer and Lahner. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Harald Lahner, Essen University Hospital, Essen, Germany
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