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Efficacy and safety of everolimus and sunitinib in patients with gastroenteropancreatic neuroendocrine tumor

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Abstract

Purpose

Efficacy of targeted agents, such as everolimus and sunitinib, has been demonstrated in prospective trials on patients with gastroenteropancreatic neuroendocrine tumors (GEP-NETs). Considering the heterogeneous clinicopathological characteristics of neuroendocrine tumors (NETs), evaluation of treatment outcomes in a real-world setting is necessary.

Methods

Clinical records of 44 patients with GEP-NET who were treated with everolimus or sunitinib between March 2007 and October 2014 were retrospectively reviewed. Considering the distinct characteristics of pancreatic NETs (pNETs) and non-pancreatic gastrointestinal NETs (GI-NETs), efficacy analysis was performed separately.

Results

Pancreas was the most common primary site (n = 28, 64%), followed by rectum (n = 10, 23%) and stomach (n = 3, 7%). Sunitinib and everolimus were administered in 27 (61%) and 17 (39%) patients, respectively. In patients with pNET, median progression-free survival (PFS) with everolimus and sunitinib was 16.6 months (95% CI 8.0–25.1) and 8.0 months (95% CI 0.0–17.4), respectively (p = 0.51). Among non-pancreatic GI-NET patients, median PFS with everolimus and sunitinib was 14.7 months (95% CI 2.4–27.0) and 1.7 months (95% CI 0.5–3.0), respectively (p = 0.001). Compared to patients treated with everolimus, tumor grade 3 (30 vs. 0%) and history of prior cytotoxic chemotherapy (70 vs. 50%) were more common in patients treated with sunitinib.

Conclusions

Both everolimus and sunitinib were effective in GEP-NET patients. Outcomes of everolimus therapy in GEP-NETs were consistent with those reported elsewhere. Poor efficacy of sunitinib in non-pancreatic GI-NETs may be attributable to the baseline characteristics associated with poor clinical outcomes.

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Acknowledgements

This study was supported by a Grant (2015-0753) from the Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea.

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    Authors and Affiliations

    1. Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, South Korea

      Changhoon Yoo, Hyungwoo Cho, Kyu-pyo Kim, Heung-Moon Chang, Heejung Chae, Tae Won Kim, Yong Sang Hong, Min-Hee Ryu, Yoon-Koo Kang & Baek-Yeol Ryoo

    2. Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, South Korea

      Min Jeong Song & Seung-Mo Hong

    3. Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, South Korea

      Song Cheol Kim

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    1. Changhoon Yoo
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    Correspondence to Baek-Yeol Ryoo.

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    The authors declare that they have no conflict of interest.

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    Changhoon Yoo and Hyungwoo Cho have equally contributed to this work and should be considered as co-first author.

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    Yoo, C., Cho, H., Song, M.J. et al. Efficacy and safety of everolimus and sunitinib in patients with gastroenteropancreatic neuroendocrine tumor. Cancer Chemother Pharmacol 79, 139–146 (2017). https://doi.org/10.1007/s00280-016-3215-3

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    • DOI: https://doi.org/10.1007/s00280-016-3215-3

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