TY - JOUR
T1 - Association between somatostatin analogues and diabetes mellitus in gastroenteropancreatic neuroendocrine tumor patients
T2 - A Surveillance, Epidemiology, and End Results-Medicare analysis of 5235 patients
AU - Ni, Katherine
AU - Yang, Jeong Yun
AU - Baeg, Kiwoon
AU - Leiter, Amanda C.
AU - Mhango, Grace
AU - Gallagher, Emily J.
AU - Wisnivesky, Juan P.
AU - Kim, Michelle K.
N1 - Funding Information:
This study used the linked SEER-Medicare database. The interpretation and reporting of these data are the sole responsibility of the authors. The authors acknowledge the efforts of the National Cancer Institute; the Office of Research, Development and Information, CMS; Information Management Services (IMS), Inc.; and the Surveillance, Epidemiology, and End Results (SEER) Program tumor registries in the creation of the SEER-Medicare database.
Funding Information:
Author J.W. received consulting honorarium from Sanofi, Banook, and GSK, and a research grant from Sanofi. Author E.G. has an advisory role for Novartis and consulting role for Seattle Genetics. The other authors declare no potential conflicts of interest.
Publisher Copyright:
© 2021 The Authors. Cancer Reports published by Wiley Periodicals LLC.
PY - 2021/10
Y1 - 2021/10
N2 - Background: Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are increasingly common malignancies and tend to have favorable long-term prognoses. Somatostatin analogues (SSA) are a first-line treatment for many NETs. Short-term experiments suggest an association between SSAs and hyperglycemia. However, it is unknown whether there is a relationship between SSAs and clinically significant hyperglycemia causing development of diabetes mellitus (DM), a chronic condition with significant morbidity and mortality. Aim: In this study, we aimed to compare risk of developing DM in patients treated with SSA vs no SSA treatment. Methods and Results: Using the Surveillance, Epidemiology, and End Results (SEER) database and linked Medicare claims (1991-2016), we identified patients age 65+ with no prior DM diagnosis and a GEP-NET in the stomach, small intestine, appendix, colon, rectum, or pancreas. We used χ2 tests to compare SSA-treated and SSA-untreated patients and multivariable Cox regression to assess risk factors for developing DM. Among 8464 GEP-NET patients, 5235 patients had no prior DM and were included for analysis. Of these, 784 (15%) patients received SSAs. In multivariable analysis, the hazard ratio of developing DM with SSA treatment was 1.19, which was not statistically significant (95% CI 0.95-1.49). Significant risk factors for DM included black race, Hispanic ethnicity, prior pancreatic surgery, prior chemotherapy, tumor size >2 cm, pancreas tumors, and higher Charlson scores. Conclusion: DM was very common in GEP-NET patients, affecting 53% of our cohort. Despite prior studies suggesting an association between SSAs and hyperglycemia, our analysis found similar risk of DM in SSA-treated and SSA-untreated GEP-NET patients. Further studies are needed to better understand this relationship. As NET patients have increasingly prolonged survival, it is crucial to identify chronic conditions such as DM that these patients may be at elevated risk for.
AB - Background: Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are increasingly common malignancies and tend to have favorable long-term prognoses. Somatostatin analogues (SSA) are a first-line treatment for many NETs. Short-term experiments suggest an association between SSAs and hyperglycemia. However, it is unknown whether there is a relationship between SSAs and clinically significant hyperglycemia causing development of diabetes mellitus (DM), a chronic condition with significant morbidity and mortality. Aim: In this study, we aimed to compare risk of developing DM in patients treated with SSA vs no SSA treatment. Methods and Results: Using the Surveillance, Epidemiology, and End Results (SEER) database and linked Medicare claims (1991-2016), we identified patients age 65+ with no prior DM diagnosis and a GEP-NET in the stomach, small intestine, appendix, colon, rectum, or pancreas. We used χ2 tests to compare SSA-treated and SSA-untreated patients and multivariable Cox regression to assess risk factors for developing DM. Among 8464 GEP-NET patients, 5235 patients had no prior DM and were included for analysis. Of these, 784 (15%) patients received SSAs. In multivariable analysis, the hazard ratio of developing DM with SSA treatment was 1.19, which was not statistically significant (95% CI 0.95-1.49). Significant risk factors for DM included black race, Hispanic ethnicity, prior pancreatic surgery, prior chemotherapy, tumor size >2 cm, pancreas tumors, and higher Charlson scores. Conclusion: DM was very common in GEP-NET patients, affecting 53% of our cohort. Despite prior studies suggesting an association between SSAs and hyperglycemia, our analysis found similar risk of DM in SSA-treated and SSA-untreated GEP-NET patients. Further studies are needed to better understand this relationship. As NET patients have increasingly prolonged survival, it is crucial to identify chronic conditions such as DM that these patients may be at elevated risk for.
KW - SEER
KW - cancer survivorship
KW - digestive cancer
KW - epidemiology
KW - neuroendocrine tumor
KW - somatostatin analogue
UR - http://www.scopus.com/inward/record.url?scp=85104076645&partnerID=8YFLogxK
U2 - 10.1002/cnr2.1387
DO - 10.1002/cnr2.1387
M3 - Article
C2 - 33835729
AN - SCOPUS:85104076645
VL - 4
JO - Cancer Reports
JF - Cancer Reports
SN - 2573-8348
IS - 5
M1 - e1387
ER -