420P - Sequential use of everolimus and sunitinib in treating WHO grade 1 and 2 pancreatic neuroendocrine tumors–retrospective multi-center study in Taiwan

Date 17 December 2016
Event ESMO Asia 2016 Congress
Session Poster lunch
Topics Anticancer Agents
Neuroendocrine Tumours
Presenter Chien-Ting Liu
Citation Annals of Oncology (2016) 27 (suppl_9): ix130-ix131. 10.1093/annonc/mdw590
Authors C. Liu1, L. Chen2, Y. Chen3, J. Chen4, Y. Su1, W. Chou5, C. Lu6, F. Ku7, M. Chen8, Y. Shan9
  • 1Hematology And Oncology, Chang Gung Memorial Hospital-Kaohsiung, 83303 - Kaohsiung/TW
  • 2National Institute Of Cancer Research, National Health Research Institutes, 704 - Tainan/TW
  • 3Department Of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung, 83301 - Kaohsiung/TW
  • 4Division Of Hematology-oncology, Chang Gung Memorial Hospital-Linkou, 333 - Taoyuan/TW
  • 5Department Of Medical Oncology, Chang Gung Memorial Hospital-Linkou, 333 - Taoyuan/TW
  • 6Department Of Medical Oncology, Chang Gung Memorial Hospital, Chiayi, 613 - Chiayi/TW
  • 7Internal Medicine, Hematology-oncology, Show-Chwan Memorial Hospital, 500 - Changhua City/TW
  • 8Division Of Hematology & Oncology- Department Of Medicine, Taipei Veterans General Hospital, 11217 - Taipei/TW
  • 9Institute Of Clinical Medicine, NCKU, Tainan/TW



There are at least four different systemic treatments for grade 1 and 2 advanced pancreatic neuroendocrine tumors (pNETS), including chemotherapy, somatostatin analogues, sunitinib and everolimus. Sequential sunitinib and everolimus in renal cell carcinoma have led to an improvement in overall survival. Theoretically, this is believed to occur in pNETS but not been proved, yet. The purpose of this retrospective study was to compare outcomes for patients with pNETS receiving two targeted therapies, everolimus and sunitinib, sequentially.


This is a retrospective multi-center registration study. The primary objective was to assess progression-free survival (PFS) of front-line everolimus compared with front-line sunitinib. Secondary objectives was safety profile of both agents.


From Feb. 1st. 2008 to Oct. 31th. 2014, twenty-four patients were included in seven medical centers in Taiwan. Overall median age was 52.6 years, and most patients were women (58.3%). Median PFS was 14.2 months with front line everolimus, 4.9 months with front line sunitinib (hazard ratio [HR], 0.34; 95% confidence interval (CI), 0.13 to 0.90, p = 0.08). After discontinuing from front line targeted therapy, median PFS was 13.0 months with everolimus in later line, 7.2 months with sunitinib in later line (HR, 1.79; 95% CI, 0.65 to 4.94, p = 0.64). There is 36.5% of patients discontinued sunitinib due to adverse events, no matter front or later line, compared to 6.7% patients while receiving everolimus.


Sequential use of everolimus and sunitinib in treating patient with advanced pNETS may be an option, but prospective and randomized trials that seek for the sequence of targeted therapies are highly needed.

Clinical trial indentification

Legal entity responsible for the study





L-T. Chen: Dr L-T. Chen reports support for travel to meetings for the study or other purposes, consultancy, grants/grants pending, and payment for lectures including service on speakers’ bureaus for Novartis. No other disclosures were reported. J-S. Chen: Consultant/Advisory Role: Joint Advisory meeting for Novartis Taiwan; and Honoraria. Received: Speakers for Novartis Taiwan. All other authors have declared no conflicts of interest.