Real world outcomes for patients with high grade neuroendocrine neoplasms at Guy

Jasmine Handford; Yamin Shwe Yee Soe; Charlotte Moss; Camilla Carr-Smith; Francesca Curran; Wendy Martin; Elmie Cananea; Justin Mencel; Kiruthikah Thillai; Paul Ross; Sarah Brown; Dominique Clement; Yoh Zen; Rajaventhan Srirajaskanthan; Mieke Van Hemelrijck; Debashis Sarker; Saoirse Dolly

doi:10.1530/endoabs.114.P19

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Endocrine Abstracts (2025) 114 P19 | DOI: 10.1530/endoabs.114.P19

UKINETS2025 23rd National Conference of the UK and Ireland Neuroendocrine Tumour Society 2025 Poster Presentations (33 abstracts)

Real world outcomes for patients with high grade neuroendocrine neoplasms at Guy’s Cancer Centre

Jasmine Handford ¹ , Yamin Shwe Yee Soe ² , Charlotte Moss ³ , Camilla Carr-Smith ⁴ , Francesca Curran ⁴ , Wendy Martin ⁵ , Elmie Cananea ⁵ , Justin Mencel ⁴ , Kiruthikah Thillai ⁴ , Paul Ross ⁴ , Sarah Brown ⁵ , Dominique Clement ⁵ , Yoh Zen ⁵ , Rajaventhan Srirajaskanthan ⁵ , Mieke Van Hemelrijck ³ , Debashis Sarker ⁴ & Saoirse Dolly ⁴

Author affiliations

¹Transforming Cancer Outcomes through Research, King’s College London, London, United Kingdom; ²University Hospitals Sussex NHS Foundation Trust, Sussex, United Kingdom; ³King’s College London, London, United Kingdom; ⁴Guy’s and St Thomas' NHS Foundation Trust, London, United Kingdom; ⁵King’s College Hospital, London, United Kingdom

Background: High grade neuroendocrine neoplasms (NENs) are a heterogenous group, including G3 neuroendocrine tumours (NETs), neuroendocrine carcinomas (NECs), and mixed neuroendocrine and non-neuroendocrine neoplasms (MiNENs). There is currently limited evidence for the optimal management of high grade NENs, particularly for MiNENs. This study aims to describe the real-world management and outcomes for patients with high grade NENs at a large NHS cancer centre in London (UK).

Methods: Adults with high grade NENs seen at Guy’s Cancer Centre between 2017-2023 were included. Data was collected using the Research Electronic Data Capture (REDCap) platform. The study received ethical approval from Guy’s Cancer Cohort (Ref 23/NW/0105).

Results: Seventy-six patients were included; comprising 23 G3 NETs, 43 NECs (18 small cell, 10 large cell, 15 not specified), and 10 MiNENs. Gastrointestinal (GI) NENs were most common (72.4%) and most presented with metastatic disease (69.7%). The mean age was 60, the majority male (51.3%), of White ethnicity (64.5%), and performance status 0-1 (60.6%). Amongst G3 NETs (n = 23), the majority were observed in GI sites (73.9%) with Ki67 <55% (82.6%). Palliative chemotherapy was most common in the first line (39.1%), followed by curative surgery (30.4%), and somatostatin analogues (8.7%). Best supportive care (BSC) was received by 13.0%. Median overall survival (mOS) for the G3 NET cohort was 33.4 months (95CI 6.7-65.8). Of the NECs (n = 43), 67.4% affected GI sites. The most frequent first-line treatment was palliative chemotherapy (44.2%), of which most received platinum-etoposide (P-E), and curative surgery (16.3%). BSC occurred in 16.3% of patients. The mOS for the NEC cohort was 8.4 months (95CI 5.2-14.0). Of the MiNENs (n = 10), almost all were GI (90%). All received treatment; 40% receiving palliative chemotherapy (20% P-E, 10% CAPTEM, 10% Other) in the first line. Prognosis was lowest amongst the MiNEN cohort, with mOS of 4.4 months (95CI 1.6-15.3). Finally, molecular profiling data has been collected within this real-world database, with ongoing analyses exploring associations with treatment patterns and outcomes.

Conclusion: This real-world study showed poor survival for NECs and MiNENs compared to G3 NENs. Precise histological categorisation is essential to inform optimal treatment and maximise outcomes.