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Anti-tumour activity of everolimus and sunitinib in neuroendocrine neoplasms.

08:00 EDT 1st April 2019 | BioPortfolio

Summary of "Anti-tumour activity of everolimus and sunitinib in neuroendocrine neoplasms."

Comparisons between everolimus and sunitinib, regarding their efficacy and safety in neuroendocrine neoplasms (NENs) are scarce. We retrospectively analysed clinicopathological characteristics and outcomes in 92 patients with well-differentiated (WD) NEN of different origin (57 pancreatic NENs (PanNENs)), treated with molecular targeted therapy (MTT) with everolimus or sunitinib, first- (73:19) or second-line (sequential;12:22) for progressive disease. Disease control rates (
DCR:
partial response or stable disease) at first-line were higher in all patients treated with everolimus than sunitinib (64/73 vs. 12/19, P=0.012). In panNENs, DCR at first-line everolimus was 36/42 versus 9/15 with sunitinib (P=0.062). Progression-free survival (PFS) at first-line everolimus was longer than sunitinib (31 months (95%
CI:
23.1-38.9) vs. 9 months (95%
CI:
0-18.5); log-rank P<0.0001) in the whole cohort and the subset of PanNENs (log-rank P<0.0001). Median PFS at second-line MTT was 12 months with everolimus (95%
CI:
4.1-19.9) vs. 13 months with sunitinib (95%
CI:
9.3-16.7; log-rank P=0.951). Treatment with sunitinib (
HR:
3.47; 95%
CI:
1.5-8.3; P=0.005), Ki67>20% (HR 6.38; 95%CI 1.3-31.3; P=0.022) and prior chemotherapy (HR 2.71; 95%CI 1.2-6.3; P=0.021) were negative predictors for PFS at first-line in multivariable- and also confirmed at multi-state modelling analyses. Side-effects (SE) analysis indicated events of serious toxicities (Grades 3 and 4; n=13/85 for everolimus and n=4/41 for sunitinib). Discontinuation rate due to SE was 19% (23.5% for everolimus vs. 10% for sunitinib, P=0.065). No additive toxicity of second-line MTT was confirmed. Based on these findings, and until reliable predictors of response become available, everolimus may be preferable to sunitinib when initiating molecular targeted therapies in progressive NENs.

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Journal Details

This article was published in the following journal.

Name: Endocrine connections
ISSN: 2049-3614
Pages:

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