KINETICS: secondary outcomes

Prof Dr Timon van Damme, a digestive oncologist at the University Hospital of Antwerp, presented the secondary outcomes of the KINETICS study, a retrospective analysis of 310 patients with GEP-NETs treated with LAN in the first-line setting. Patients were stratified into two equal groups according to their Ki-67 proliferation index: 155 patients with Ki-67 ≤10% and 155 with Ki-67 >10%. Progression-free survival outcomes from this cohort were previously reported at ESMO-GI; the current presentation focused on OS, time to treatment discontinuation or death (TTD), and time to next treatment (TTNT).

The study addresses a clinically relevant evidence gap. Although LAN is widely used in the management of GEP-NETs, data regarding its effectiveness in patients with tumors exhibiting Ki-67 >10% remain limited. The present cohort includes the patient population most frequently treated with this somatostatin analogue, thereby offering insight into real-world outcomes in both lower- and higher-grade disease.

In the full cohort, median OS reached 93 months, indicating favourable long-term survival under LAN-based management. Median OS was not reached in either Ki-67 subgroup; to differentiate outcomes further, the investigators examined the first quartile (Q1) OS, defined as the time point at which 25% of patients had died. In the overall cohort, Q1 OS was 50 months. When stratified, Q1 OS was 67 months for patients with Ki-67 ≤10% and 39 months for those with Ki-67 >10%. Although the higher Ki-67 group showed shorter survival, outcomes remained clinically meaningful, and LAN appeared to be well tolerated across both subgroups.

Subgroup analyses confirmed Ki-67 as a significant factor influencing survival, consistent with established prognostic understanding. Nevertheless, the data indicate that LAN remains a viable and safe treatment option even for patients with moderately elevated tumour proliferation indices. Findings from TTD and TTNT analyses further supported this conclusion, revealing patterns consistent with the OS results.