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Real-world treatment patterns in advanced pancreatic neuroendocrine tumors in the era of targeted therapy: perspectives from an academic tertiary center and community oncology practices

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Abstract

Pancreatic neuroendocrine tumors (pNETs) are rare, slow-growing cancers. Optimal treatment of advanced pNETs is unclear. The aim of this study was to examine treatment patterns and preferences among an academic tertiary medical center and community-based oncology practices. Retrospective chart review was performed for patients with newly diagnosed locally advanced, metastatic, or unresectable pNET diagnosed between January 2010 and December 2013 at an academic tertiary cancer center [University of California, San Francisco (UCSF)] or a large network of community oncology practices [Altos Solutions’ OncoEMR database (ALTOS)]. Fifty-four eligible patients (N UCSF = 23; N ALTOS = 31) were identified. Median time to treatment initiation was 1.1 months; median follow-up time was 22.9 months. UCSF patients underwent more lines of therapy than ALTOS patients despite similar follow-up times. UCSF tended toward more invasive treatment than ALTOS. The median time to treatment discontinuation was statistically significantly shorter for patients on chemotherapy than on targeted therapy in the combined UCSF and ALTOS groups (chemotherapy = 2.1 months vs. targeted = 18.6 months, p < 0.001). Treatment patterns and duration for newly diagnosed advanced pNETs vary widely both within and between different practice settings. Further studies are warranted to investigate the significant difference in duration of targeted therapy compared to chemotherapy.

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Acknowledgements

This study was supported by Novartis Pharmaceutical Corporations, East Hanover, New Jersey, USA. LH, MSD, and FV are employees of Analysis Group, Inc., a consulting company that has received research funding from Novartis. AT is a former employee of Analysis Group, Inc. EB is an employee of the University of California, San Francisco (UCSF) Helen Diller Family (HDF) Comprehensive Cancer Center (CCC) which received research funding from Novartis to support this work. EB has served as a consultant for Novartis, Lexicon, and Ipsen (uncompensated). MH is a former employee of UCSF HDF CCC. MN is an employee of Novartis.

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Authors and Affiliations

  1. UCSF Helen Diller Family Comprehensive Cancer Center, 550 16th St., Box 3211, San Francisco, CA, 94143, USA

    Maurice Herring & Emily Bergsland

  2. Analysis Group Inc., Boston, MA, USA

    Lynn Huynh, Mei Sheng Duh, Francis Vekeman & Audrey Tiew

  3. Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA

    Maureen Neary

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  1. Maurice Herring
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  2. Lynn Huynh
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  3. Mei Sheng Duh
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  4. Francis Vekeman
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  5. Audrey Tiew
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  6. Maureen Neary
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  7. Emily Bergsland
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Corresponding author

Correspondence to Emily Bergsland.

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Ethical approval

Approval was obtained from the ethics committee (institutional review board) at the University of California, San Francisco (UCSF). All procedures were performed in accordance with the ethical standards of the UCSF Institutional Review Board and the 1964 Helsinki declaration and its later amendments. No prospective studies with human participants or animals were performed by any of the authors for this article.

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Informed consent was waived for individual participants included in the study given the retrospective nature of this work and in accordance with UCSF Institutional Review Board standards.

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Herring, M., Huynh, L., Duh, M.S. et al. Real-world treatment patterns in advanced pancreatic neuroendocrine tumors in the era of targeted therapy: perspectives from an academic tertiary center and community oncology practices. Med Oncol 34, 88 (2017). https://doi.org/10.1007/s12032-017-0927-0

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  • DOI: https://doi.org/10.1007/s12032-017-0927-0

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