Tumori Journal Abstract Book - October 2020 - 132

132	
be an effective regimen for managing progressive TNETs.
Trial registration numbers: NCT02698410; EudraCT:
2014-005579-10.

Tumori Journal 106(2S)
with a reduced risk for progression (HR 0.28, 95%CI 0.110.74, p= 0.011).
Conclusions: Sequential SSA-PRRT therapy was associated with improved TSF in patients with pNET.

G03
Therapeutic sequences in
advanced grade 1-2 pancreatic
neuroendocrine tumors (pNET)
Maggio I.1, Panzuto F.2, Manuzzi L.1, Dall'Olio V.3, Rinzivillo M.2,
Campana D.4, Lamberti G.4
1
Sant'Orsola Malpighi University Hospital, Alma Mater Studiorum University
of Bologna, Bologna; 2Digestive Disease Unit, Sant'Andrea University
Hospital, ENETS Center of Excellence, Rome; 3Alma Mater Studiorum
University of Bologna, Bologna; 4NET Team Bologna, ENETS Center of
Excellence, Sant'Orsola Malpighi University Hospital, Alma Mater Studiorum
University of Bologna, Bologna

Background: There are several approved treatments in
well-differentiated pancreatic neuroendocrine tumors
(pNET) but there is no evidence about the best therapeutic
sequence for these patients (pts). The objective of this
study was to identify the optimal therapeutic sequence.
Methods: We retrospectively collected data about pts with
metastatic or locally advanced well-differentiated grade 1
or 2 pNET treated at 2 neuroendocrine neoplasia (NEN)dedicated Italian Centers who received at least two lines of
treatment for pNET. Radiological progressive disease
must have had occurred before switching to the second
line of treatment. Factors associated with progression-free
survival (PFS) and overall survival (OS), including treatment sequences, were analyzed.
Results: Of the 68 included pts, 34 (50%) were male.
Fifteen pts (22.1%) had a G1 pNET and 53 (77.9%) a G2
tumor, with median Ki67 of 6.9% (range 0.6-20). Four
(5.9%) pts presented localized disease, 55 (80.9%) hepatic
lesions, and 9 (13.2%) extrahepatic disease. Primary tumor
had been resected in 40 pts (58.8%). First-line therapy was
somatostatin analog (SSA) in 52,9%, SSA + peptide
receptor radionuclide therapy (SSA+PRRT) in 30.9%,
and everolimus (11.8%), chemotherapy (CHT) in 2,9%,
and other in 1.5%. Second-line therapy was SSA in 8.8%
of pts, high-dose SSA in 7.4%, SSA+PRRT in 9.1%, sunitinib in 11.8%, everolimus in 30.9%, CHT in 16.2%, and
other in 5.9%. Median PFS was 14 mo (95%CI 6.9-21.1)
for first line and 14.2 mo (95%CI 11.1-17.3) for second
line. To evaluate which was the best therapeutic sequence,
we compared outcome of 33 pts who received either firstline SSA+PRRT (concomitant) to first-line SSA followed
by SSA+PRRT at progression (sequential). In this cohort,
median time to strategy failure (TSF) was 46 mo (95%CI
35-56.9) and OS was 94.6 mo (95%CI 61.8-127.6). Median
TSF was longer with the sequential than with the concomitant strategy (74.4 vs 40 months, respectively; p= 0.007).
At multivariate analysis, sequential therapy was associated

G04
Efficacy of post-operative
radiation therapy in nonmetastatic Merkel Cell Carcinoma:
a registry-based analysis
Manuzzi L.1, Maggio I.1, Lamberti G.1, Siepe G.2, Campana D.3
1

DIMES - Università di Bologna, Bologna; 2Radioterapia "Morganti" Policlinico di Sant'Orsola, Bologna; 3DIMEC - Università di Bologna, Bologna

Background: Merkel cell carcinoma (MCC) is a rare
aggressive neuroendocrine tumor of the skin. The optimal
management of non-metastatic MCC is still unclear but it
is crucial to decrease relapse risk and improve survival.
We sought to assess the efficacy of radiation therapy (RT)
of MCC without distant metastases (M0 MCC) by analyzing data from the Surveillance, Epidemiology, and End
Results (SEER) registry.
Methods: We extracted from the SEER Registry data
about M0 MCC patients, identified by the 8247 ICD-03
code, irrespective of the site of origin. We collected data
about stage at diagnosis, site and size of primary, extent of
surgery, lymph node directed surgery, number of involved
lymph nodes, RT, and survival outcome. Primary endpoint
was overall survival (OS).
Results: Of 9773 MCC patients in the SEER registry,
2335 were M0 MCC (63% male, median age 77 years).
MCC originated from skin of the limbs in 994 (61.6%),
head and neck district in 386 (23.9%), and trunk in 234
(14.5%). Lymph nodes were negative in 1577 patients
(67.5%), while among the 687 (32.5%) MCC with nodal
involvement this was microscopic in 214, macroscopic in
233, not otherwise specified (NOS) in 240; 71 had intransit metastases. Post-operative RT was performed in
1212 (51.9%) patients. Overall, median OS of M0 MCC
patients was 56 months (95%CI: 50.7-61.3) and was
affected by age, site, tumor size, nodal involvement, type
of surgery of primary and RT (HR for RT: 0.65 [95%:
0.53-0.79]; p<0.001) at multivariate analysis. In the
1577 with negative lymph nodes, after correcting for
confounding factors, OS was affected by age, sex, site,
size of primary, extent of surgery and RT (HR for RT:
0.63 [95%: 0.47-0.82]; p<0.001). Among 687 patients
with positive lymph nodes (67% male, median age 74), at
multivariate analysis OS was affected by age, nodal
involvement, number of positive lymph nodes and RT
(HR for RT: 0.67 [95%CI: 0.49-0.92]; p=0.012).
Conclusions: RT was associated with a decreased risk for
death in M0 MCC, irrespective of nodal status.



Tumori Journal Abstract Book - October 2020

Table of Contents for the Digital Edition of Tumori Journal Abstract Book - October 2020

Contents
Tumori Journal Abstract Book - October 2020 - Cover1
Tumori Journal Abstract Book - October 2020 - Cover2
Tumori Journal Abstract Book - October 2020 - I
Tumori Journal Abstract Book - October 2020 - II
Tumori Journal Abstract Book - October 2020 - Contents
Tumori Journal Abstract Book - October 2020 - IV
Tumori Journal Abstract Book - October 2020 - V
Tumori Journal Abstract Book - October 2020 - 1
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