Himil Mahadevia

What is the prevalence and risk of skeletal-related events (SREs) in patients with NETs and bone metastases? We all realize that the prevalence of bone mets is much higher in the PET era than it was thought to be in the Octreoscan era owing to the much better sensitivity of SSTR PETs. What is not as well known is the clinical relevance of bone mets. This study adds to that literature and provides a novel risk score for predicting SREs. A few key findings below: -- 400 patients, most were asymptomatic (64%), had sclerotic lesions (77%), Krenning 4 (71%), and had >3 sites (69%) of osseous disease -- A high proportion of patients had osseous metastases at sites with high risk for fracture, including vertebra (82%), pelvis (63%), and peri-trochanteric femur (34%). -- 13% in the entire cohort suffered a fracture -- Fracture prevalence was significantly lower in small bowel neuroendocrine tumors (NETs, 7%) and Grades 1 and 2 disease (8% and 9%, respectively), with higher prevalence in pancreatic NETs, paragangliomas/pheochromocytomas, lung carcinoid, and Grade 3 disease (≥20% for each; p-values <.05) -- Prevalence of osseous metastatic disease approximates 20% in well-differentiated NENs A different question, yet to be addressed well, is the activity of bone-protecting agents in this population but if we are designing a trial, this risk score sure could be applied. Excellent work led by Jason Starr at Mayo Clinic Florida. @sonbol_bassam @PatrickMcGarrah @Meddoc77 @TubaKendi @TuckerCoston onlinelibrary.wiley.com/doi/…