1165P - Efficacy and safety of somatuline autogel in combination with molecular targeted therapies (MTT) in neuroendocrine tumors (NETs)

Date 29 September 2012
Event ESMO Congress 2012
Session Poster presentation I
Topics Anti-Cancer Agents & Biologic Therapy
Neuroendocrine Cancers
Presenter Jaume Capdevila
Authors J. Capdevila1, I. Sevilla2, V. Alonso3, L. Anton-Aparicio4, P. Jimenez Fonseca5, E. Grande6, J.J. Reina7, J.L. Manzano8, J. Alonso-Jara9, P. García Alfonso10
  • 1Medical Oncology, Vall d'Hebron University Hospital, 08035 - Barcelona/ES
  • 2Medical Oncology, Virgen de la Victoria University Hospital, Malaga/ES
  • 3Medical Oncology, Miguel Servet University Hospital, Zaragoza/ES
  • 4Medical Oncology, Complejo Hospitalario A Coruña, A Coruña/ES
  • 5Servicio De Oncologia Medica, Hospital Universitario Central de Asturias, 33006 - Oviedo/ES
  • 6Ramon y Cajal University Hospital, Madrid/ES
  • 7Medical Oncology, Virgen de la Macarena University Hospital, Sevilla/ES
  • 8Medical Oncology, ICO Hospital Germans Trias i Pujol, Barcelona/ES
  • 9Medical Oncology, Virgen de la Arrixaca University Hospital, Murcia/ES
  • 10Medical Oncology, Gregorio Marañón University Hospital, 28007 - Madrid/ES

Abstract

Background

Analysis of the mechanisms of action of somatostatin analogs (SSAs) and mTOR inhibitors or multiple tyrosine kinase inhibitors have suggested that they may provide synergistic effects when used in combination for the treatment of patients with NETs.

Methods

This is a Spanish Multicenter cohort of patients (pts) with NETs treated with the SSAs lanreotide (LAN) and MTTs at 35 Spanish Medical Oncology Departments. The data of 159 combined treatments (133 pts) was retrospectively collected in order to evaluate the efficacy and safety of such combinations out of trials.

Results

133 pts (52,6% Male) with a mean age of 59,4 years; ECOG 0/1/2/3: 34%/49%/16%/1%; Lung/Pancreas/Gastrointestinal//Unknown(UK)origin: 9%/48% /32%/11%; G1/G2/G3/UK: 41%/32%/1%/26%; Non Functioning/ Functioning (69%/31%) received treatment with MTT + LAN for synergistic antiproliferative purpose in 85% of the cases, hormonal control (13,5%) or both objectives (1,5%). 115 pts received just one and 18 pts received between 2 (12 pts) and 5 (1 pt) combination treatments. LAN was administrated in combination with everolimus (46%), sunitinib (38%), bevazucimab (6%), sorafenib (5%) and pazopanib (5%). The reported toxicity was determined by the MTT profile with no significant additional severe adverse events related to the combination with LAN. The median progression-free survival (mPFS) for the two main groups was 31.9 months for those pts who received LAN and sunitinib (n = 50) and 21.9 months for those pts who received LAN and everolimus (n = 56).

Conclusions

The combination of LAN and MTT treatments, mainly everolimus and sunitinib, is widely used in clinical practice without unexpected toxicities. Although studies are not directly comparable mPFS observed in the two main groups were higher than data showed by phase III studies with sunitinib, everolimus or SSAs alone raising the hypothesis of enhanced antitumor efficacy combining SSAs and MTT that should be confirmed in randomized prospective clinical trials.

Tumor Response (%)
PD SD PR CR Not evaluated
61 Sunit +LAN 4.9 68.9 14.8 1.6 9.8
73 Evero +LAN 12.3 67.0 15.1 0 5.5
9 Bevac +LAN 0 88.9 11.1 0 0
8 Soraf +LAN 0 100.0 0 0 0
8 Pazop +LAN 12.5 75.0 12.5 0 0

Disclosure

All authors have declared no conflicts of interest.