Patient-reported tolerance in treatments approved in neuroendocrine tumors: A national survey from the French Group of Endocrine Tumors

Background: Patients with advanced neuroendocrine tumors (NETs) benefit from an increasing number of treatments. The patient's preference could help physicians to choose among these options. Our patient-reported survey aims to compare the perceived tolerance of NETs treatments. Methods: Patients treated by at least three different therapeutic options have evaluated their perceived tolerance from one (very good) to five (very poor) for each single treatment. Referent physician confirmed the type and ranking over time of each treatment. Results: Two hundred and fourty two treatments have been evaluated by 54 patients. Among patients and NETs characteristics, only a female gender was associated with poor perceived tolerance. Median perceived tolerance increased from 1 (somatostatin analogs, peptide receptor radionuclide therapy (PRRT)), 2 (surgery, radiofrequency ablation and oral chemotherapy), 3 (interferon and everolimus), to 4 (liver embolization, sunitinib and intravenous chemotherapy). In taking somatostatin analogs as reference, the odd ratios for poor perceived tolerance were 1.7 [0.6–5.1] for oral chemotherapy, 2.2 [0.9–5.3] for surgery of the primary tumor, 2.4 [0.6–9.5] for radiofrequency ablation, 2.8 [1.1–7.3] for surgery of metastasis, 3.4 [1.4–7.9] for everolimus, 3.7 [1.6–8.5] for liver embolization, 4.9 [2.2–10.7] for intravenous chemotherapy and 5.9 [2.6–13.1] for sunitinib. Only PRRT had negative odd ratio. Conclusion: Our retrospective analysis suggests that perceived tolerance differ in between therapeutic options and may help physicians to sequence the therapeutic strategy.