Treatment Outcomes in Patients with Metastatic Neuroendocrine Tumors: a Retrospective Analysis of a Community Oncology Database

J Gastrointest Cancer. 2019 Dec;50(4):816-823. doi: 10.1007/s12029-018-0160-x.


Purpose: Metastatic neuroendocrine tumors (mNETs) are rare, heterogeneous tumors that present diagnostic and treatment challenges, with limited data on the management of mNETs in clinical practice. The present study was designed to identify current diagnostic and treatment patterns in mNET patients treated in the US community oncology setting.

Methods: Patient-level data was collected from medical records of adults with mNETs from the Vector Oncology Data Warehouse, a comprehensive US community oncology network database.

Results: Of the 263 patients included (median follow-up, 22 months; range, 0.1-193.9), 30.4% (80/263) had intestinal tumors, 11.0% (29/263) had pancreatic, and 58.6% (154/263) had tumors of other or unknown location. Progression-free survival (PFS) from the start of first-line therapy differed significantly by tumor grade (log rank P = 0.0016) and location (P = 0.0044), as did overall survival (OS) (grade, P < 0.0001; location, P = 0.0068). Median PFS and OS for patients with undocumented tumor grade were shorter than for patients with G1/G2 tumors and longer than patients with G3 tumors. Median PFS and OS for patients with other or unknown tumors were shorter than for patients with intestinal tumors.

Conclusions: While potentially confounded by the high number of patients with other or unknown tumor locations, this retrospective study of patients in a US community oncology setting identified the importance of awareness of tumor grade and tumor location at diagnosis, as these were direct correlates of PFS and OS.

Keywords: Community oncology; Neuroendocrine tumor; Overall survival; Progression-free survival; Somatostatin analog.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Community Networks / statistics & numerical data*
  • Databases, Factual / statistics & numerical data
  • Drug Administration Schedule
  • Female
  • Follow-Up Studies
  • Humans
  • Intestinal Neoplasms / diagnosis
  • Intestinal Neoplasms / drug therapy*
  • Intestinal Neoplasms / mortality
  • Intestinal Neoplasms / pathology
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Neuroendocrine Tumors / diagnosis
  • Neuroendocrine Tumors / drug therapy*
  • Neuroendocrine Tumors / mortality
  • Neuroendocrine Tumors / pathology
  • Pancreatic Neoplasms / diagnosis
  • Pancreatic Neoplasms / drug therapy*
  • Pancreatic Neoplasms / mortality
  • Pancreatic Neoplasms / pathology
  • Positron Emission Tomography Computed Tomography / methods
  • Positron Emission Tomography Computed Tomography / statistics & numerical data
  • Practice Patterns, Physicians' / statistics & numerical data
  • Progression-Free Survival
  • Protein-Tyrosine Kinases / antagonists & inhibitors
  • Retrospective Studies
  • Somatostatin / analogs & derivatives
  • TOR Serine-Threonine Kinases / antagonists & inhibitors
  • United States / epidemiology
  • Young Adult


  • Somatostatin
  • MTOR protein, human
  • Protein-Tyrosine Kinases
  • TOR Serine-Threonine Kinases