May 28, 2016
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Neuroendocrine tumor presence increases B-lymphocyte stimulator levels

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ORLANDO, Fla. — Patients with neuroendocrine tumors are more likely to have increased B-lymphocyte stimulator levels compared with healthy controls, and these elevated levels may be associated with more severe disease during follow-up.

“B-lymphocyte stimulator levels may be an important biomarker of disease progression in patients with neuroendocrine tumors,” Franco Grimaldi, MD, of the endocrinology and metabolism unit at the University Hospital of Udine in Italy, said during his presentation.

Grimaldi and colleagues evaluated 115 consecutive unselected patients (48.4% men; mean age, 63.4 years) with a neuroendocrine tumor (disease duration, 5.9 years) to assess the potential role of the cytokine B-lymphocyte stimulator (BLyS) during follow-up.

The types of neuroendocrine tumors were as follows: 36 with lung tumors, 47 with gastrointestinal tumors and 32 with nonfunctioning pancreatic lesions.

During follow-up (within 1 to 4 years from first evaluation), 23 participants had BLyS repeatedly assessed, and Response Evaluation Criteria in Solid Tumors definitions were used to monitor the disease for progression, stabilization of remission.

Seventy-seven healthy blood donors were matched for age and sex as controls for comparison. ELISA was used to analyze serum levels of BLyS and chromogranin A (CgA).

Compared with controls, participants with neuroendocrine tumors had higher levels of serum BLyS (666.5 pg/mL vs. 1,274 pg/mL; P < .001). There was no relationship between BLyS and CgA.

BLyS was gradually reduced in patients with neuroendocrine tumors who had sustained remission after surgery (1,478 pg/mL within 6 months vs. 1,043 pg/mL after 6 months; P = .08). Compared with participants without metastases, participants with metastases tended to have higher levels of BLyS (P = .052). Compared with participants with progressing disease (1,521 pg/mL), participants with stable disease had lower levels of BLyS (1,177 pg/mL; P = .046). Progressing disease during follow-up was not predicted by more elevated BLyS levels at baseline.

“Increased levels of BLyS are significantly associated with the presence of [neuroendocrine tumors],” Grimaldi said. “They do not seem to have prognostic value at baseline, but they may identify a more severe disease in the follow-up, which is progressing despite treatment.” – by Amber Cox

Reference:

Grimaldi, F, et al. Abstract #844. Presented at: AACE Annual Scientific and Clinical Congress; May 25-29, 2016; Orlando, Fla.

Disclosure: Grimaldi reports no relevant financial disclosures.