Cancer Chemotherapy and Pharmacology

, Volume 80, Issue 4, pp 799–805 | Cite as

Clinical outcomes of everolimus in patients with advanced, nonfunctioning pancreatic neuroendocrine tumors: a multicenter study in Korea

  • Kyong Joo Lee
  • Jae Hee Cho
  • Sang Hyub Lee
  • Si Young Song
  • Kwang Hyuk Lee
  • Seok Jeong
  • Ji Kon Ryu
  • Sang Myung Woo
  • Seungmin Bang
  • Jong Kyun Lee
  • Tae Hoon Lee
  • Woo Hyun Paik
  • Yong Tae KimEmail author
  • Woo Jin LeeEmail author
Original Article



Everolimus is a standard treatment option for advanced pancreatic neuroendocrine tumors (pNETs). This multicenter study evaluated the efficacy and safety of everolimus in low and intermediate grade advanced pNETs.


Tumors were graded according to the World Health Organization 2010 classification system. Patients with low or intermediate grade pNETs who received everolimus as first- or second-line chemotherapy between 2002 and 2014 were included.


A total of 40 patients with metastatic or recurrent pNETs were included in this study. The median age was 54.5 years (range 19–83 years). Twelve patients (30%) experienced recurrence. There were 11 patients (27.5%) with low grade pNETs and 29 (72.5%) with intermediate. Everolimus was administered as first-line therapy in 30 patients (75%) and as second-line therapy in 10 patients (25%). The median progression-free survival (PFS) of patients with low and intermediate grade pNETs was significantly different (median not reached vs. 11 months, P = 0.015). On multivariate analysis, tumor grade (intermediate grade; HR 6.52, 95% CI 1.31–32.27, P = 0.022) was the only independent prognostic factor for PFS in pNETs. The most common adverse events were stomatitis, skin rash, and anemia.


World Health Organization 2010 grade is the most important determinant for PFS in patients undergoing everolimus treatment for pNETs with an acceptable incidence of adverse events.


Everolimus Pancreatic neuroendocrine tumor World Health Organization classification Tumor grade Prognosis 



This study was conducted as a part of the Korean Gastroenteropancreatic Neuroendocrine Tumor Registry research project of the Korean Society of Gastrointestinal Cancer (KSGC).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.


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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Kyong Joo Lee
    • 1
  • Jae Hee Cho
    • 2
  • Sang Hyub Lee
    • 3
  • Si Young Song
    • 4
  • Kwang Hyuk Lee
    • 5
  • Seok Jeong
    • 6
  • Ji Kon Ryu
    • 3
  • Sang Myung Woo
    • 7
  • Seungmin Bang
    • 4
  • Jong Kyun Lee
    • 5
  • Tae Hoon Lee
    • 8
  • Woo Hyun Paik
    • 3
  • Yong Tae Kim
    • 3
    Email author
  • Woo Jin Lee
    • 7
    Email author
  1. 1.Department of Internal MedicineYonsei University Wonju College of MedicineWonjuSouth Korea
  2. 2.Department of Internal MedicineGachon University, Gil Medical CenterIncheonSouth Korea
  3. 3.Department of Internal Medicine and Liver Research InstituteSeoul National University College of MedicineSeoulSouth Korea
  4. 4.Department of Internal MedicineYonsei University College of MedicineSeoulSouth Korea
  5. 5.Department of Internal MedicineSamsung Medical Center, Sungkyunkwan University School of MedicineSeoulSouth Korea
  6. 6.Department of Internal MedicineInha University College of MedicineIncheonSouth Korea
  7. 7.Center for Liver CancerNational Cancer CenterGoyangSouth Korea
  8. 8.Department of Internal MedicineSoon Chun Hyang University Cheonan Hospital, Soon Chun Hyang University College of MedicineCheonanSouth Korea

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