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Effectiveness and Prognostic Factors of Everolimus in Patients with Pancreatic Neuroendocrine Neoplasms

Abstract

Objective The effectiveness of everolimus for the management of pancreatic neuroendocrine neoplasms (PNENs), including the G3/NEC types, remains unclear. We therefore investigated the effectiveness of the drug for the management of PNENs. Methods We analyzed the progression-free survival (PFS) and overall survival (OS) associated with everolimus and factors influencing the PFS and OS. Results One hundred patients were evaluated. The PFS associated with the G1/G2 types tended to be significantly longer than that associated with the G3/NEC types [hazard ratio (HR), 0.45; p=0.005]. A multivariate analysis showed that the significant factors influencing the PFS were age (<65 years old; HR, 0.44; p=0.002), grade (G1/G2; HR, 0.42; p=0.006), everolimus treatment line (≤2nd; HR, 0.55; p=0.031), and presence of treatment with metformin (yes; HR, 0.29; p=0.044). The median OS was 63.8 months. In the multivariate analysis, the significant factors influencing the OS were grade (G1/G2; HR, 0.21; p<0.001), volume of liver metastasis (≤25%; HR, 0.27; p<0.001), everolimus treatment line (≤2nd; HR, 0.27; p<0.001), and presence of primary tumor resection (yes; HR, 0.33; p=0.005). Conclusion The effectiveness of everolimus in the management of G3/NEC types and prognoses tended to be poorer than those associated with the G1/G2 types. Everolimus combined with metformin and early-line treatment with everolimus may be effective for managing advanced PNENs.

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References
1.
Rinke A, Wittenberg M, Schade-Brittinger C, Aminossadati B, Ronicke E, Gress T . Placebo-Controlled, Double-Blind, Prospective, Randomized Study on the Effect of Octreotide LAR in the Control of Tumor Growth in Patients with Metastatic Neuroendocrine Midgut Tumors (PROMID): Results of Long-Term Survival. Neuroendocrinology. 2016; 104(1):26-32. DOI: 10.1159/000443612. View

2.
Yao J, Shah M, Ito T, Bohas C, Wolin E, Van Cutsem E . Everolimus for advanced pancreatic neuroendocrine tumors. N Engl J Med. 2011; 364(6):514-23. PMC: 4208619. DOI: 10.1056/NEJMoa1009290. View

3.
Cavalcoli F, Rausa E, Conte D, Nicolini A, Massironi S . Is there still a role for the hepatic locoregional treatment of metastatic neuroendocrine tumors in the era of systemic targeted therapies?. World J Gastroenterol. 2017; 23(15):2640-2650. PMC: 5403743. DOI: 10.3748/wjg.v23.i15.2640. View

4.
Panzuto F, Boninsegna L, Fazio N, Campana D, Brizzi M, Capurso G . Metastatic and locally advanced pancreatic endocrine carcinomas: analysis of factors associated with disease progression. J Clin Oncol. 2011; 29(17):2372-7. DOI: 10.1200/JCO.2010.33.0688. View

5.
Libby G, Donnelly L, Donnan P, Alessi D, Morris A, Evans J . New users of metformin are at low risk of incident cancer: a cohort study among people with type 2 diabetes. Diabetes Care. 2009; 32(9):1620-5. PMC: 2732153. DOI: 10.2337/dc08-2175. View