Quality-of-Life Outcomes of Radioligand Therapy Used in Combination with Systemic Therapies for Neuroendocrine Tumors: A Systematic Review
Author(s)
Cindy M. Chan, PharmD, MHI1, Raquel S. Erb, PharmD2, Mumbi E. Kimani, PhD, MA3, Cynthia C. Egbuemike, BSc4, Chanhyun Park, PhD, MPharm, MEd4;
1University of Pittsburgh, School of Pharmacy, Pittsburgh, PA, USA, 2Baylor Scott and White Health, Temple, TX, USA, 3Thomas Jefferson University, College of Population Health, Philadelphia, PA, USA, 4The University of Texas at Austin, College of Pharmacy, Austin, TX, USA
1University of Pittsburgh, School of Pharmacy, Pittsburgh, PA, USA, 2Baylor Scott and White Health, Temple, TX, USA, 3Thomas Jefferson University, College of Population Health, Philadelphia, PA, USA, 4The University of Texas at Austin, College of Pharmacy, Austin, TX, USA
Presentation Documents
OBJECTIVES: Neuroendocrine tumors (NETs) often present with symptoms that significantly impact patients' health-related quality of life (HRQoL) due to tumor burden and excessive hormone secretion. Currently, 177Lu-DOTATATE combined with long-acting octreotide is the only FDA-approved radioligand therapy (RLT) in NETs. As additional studies are investigating other combinations of RLT with systemic agents in NETs, this systematic review aimed to summarize HRQoL outcomes of these RLT combination treatment regimens.
METHODS: A systematic search of PubMed, Embase, and Cochrane Central Register of Controlled Trials was conducted from database inception to November 2024. Studies evaluating RLT combined with systemic drug therapies for NETs and reporting HRQoL outcomes were included. Extracted data included study design, patient population, tumor characteristics, HRQoL instruments, and HRQoL results. This review’s methods adhered to PRISMA guidelines. Risk of bias was assessed using Cochrane Risk of Bias 2 (RoB 2) for clinical trials, ROBINS-I for non-randomized studies, and the Newcastle-Ottawa Scale for cohort and case-control studies.
RESULTS: Of 1409 total records, 11 publications met inclusion criteria: three studies from randomized controlled trials, five single-arm prospective studies, and three retrospective observational studies. Treatments included combinations of RLT with radiosensitizing chemotherapy (n=6, using capecitabine +/- temozolomide), RLT with somatostatin analogues (n=3), and dual RLTs (n=2). Comprehensive HRQoL questionnaires were used in 5 studies, including EORTC QLQ-C30 (n=3), EORTC QLQ-H&N35 (n=2), and EORTC QLQ-GINET-21 (n=1). Additional HRQoL tools included Karnofsky Performance Scale or ECOG score (n=5), investigator-developed questionnaires (n=2), and symptom diaries (n=1). Despite heterogeneous study designs, HRQoL outcomes for combination RLT were comparable or favorable compared to baseline in single-arm studies and to comparators in controlled studies.
CONCLUSIONS: Limited studies reported HRQoL outcomes of RLT combination therapies in NETs, suggesting the need for additional HRQoL evidence to better understand patient experience in these novel treatment regimens.
METHODS: A systematic search of PubMed, Embase, and Cochrane Central Register of Controlled Trials was conducted from database inception to November 2024. Studies evaluating RLT combined with systemic drug therapies for NETs and reporting HRQoL outcomes were included. Extracted data included study design, patient population, tumor characteristics, HRQoL instruments, and HRQoL results. This review’s methods adhered to PRISMA guidelines. Risk of bias was assessed using Cochrane Risk of Bias 2 (RoB 2) for clinical trials, ROBINS-I for non-randomized studies, and the Newcastle-Ottawa Scale for cohort and case-control studies.
RESULTS: Of 1409 total records, 11 publications met inclusion criteria: three studies from randomized controlled trials, five single-arm prospective studies, and three retrospective observational studies. Treatments included combinations of RLT with radiosensitizing chemotherapy (n=6, using capecitabine +/- temozolomide), RLT with somatostatin analogues (n=3), and dual RLTs (n=2). Comprehensive HRQoL questionnaires were used in 5 studies, including EORTC QLQ-C30 (n=3), EORTC QLQ-H&N35 (n=2), and EORTC QLQ-GINET-21 (n=1). Additional HRQoL tools included Karnofsky Performance Scale or ECOG score (n=5), investigator-developed questionnaires (n=2), and symptom diaries (n=1). Despite heterogeneous study designs, HRQoL outcomes for combination RLT were comparable or favorable compared to baseline in single-arm studies and to comparators in controlled studies.
CONCLUSIONS: Limited studies reported HRQoL outcomes of RLT combination therapies in NETs, suggesting the need for additional HRQoL evidence to better understand patient experience in these novel treatment regimens.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
CO133
Topic
Clinical Outcomes
Disease
SDC: Gastrointestinal Disorders, SDC: Oncology, STA: Personalized & Precision Medicine