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Prognostic impact of the cumulative dose and dose intensity of everolimus in patients with pancreatic neuroendocrine tumors (PNETs)

Date

08 Oct 2016

Session

Poster Display

Presenters

Rossana Berardi

Citation

Annals of Oncology (2016) 27 (6): 136-148. 10.1093/annonc/mdw369

Authors

R. Berardi1, M. Torniai1, S. Pusceddu2, F. Spada3, T. Ibrahim4, C. Zichi5, L. Antonuzzo6, P. Ferolla7, M. Rinzivillo8, N. Silvestris9, S. Partelli10, B. Ferretti11, A. Bongiovanni4, L. Giustini12, F. Di Costanzo13, G. Delle Fave14, N. Fazio15, F.G.M. De Braud16, M. Falconi10, S. Cascinu17

Author affiliations

  • 1 Oncology, AOU Ospedali Riuniti Ancona Università Politecnica delle Marche, 60126 - Ancona/IT
  • 2 Medical Oncology Department, Fondazione IRCCS - Istituto Nazionale dei Tumori, 20133 - Milano/IT
  • 3 Medical Oncology, Istituto Europeo di Oncologia, Milano/IT
  • 4 Osteoncology And Rare Tumors Center, Istituto Tumori della Romagna I.R.S.T., 47014 - Meldola/IT
  • 5 Medical Oncology, Azienda Ospedaliero-Universitaria ASOU San Luigi Gonzaga, Orbassano/IT
  • 6 Oncology, Azienda Ospedaliera Careggi U.O. Medical Oncology, 50134 - Firenze/IT
  • 7 Dept. Of Medical Oncology, Multidisciplinary NET Group, Umbria Regional Cancer Network and University of Perugia, 06126 - Perugia/IT
  • 8 Digestive And Liver Disease Unit, Sapienza University of Rome, 00189 - Rome/IT
  • 9 Medical Oncology, Istituto Tumori Giovanni Paolo II, 47121 - Bari/IT
  • 10 Pancreatic Surgery, Ospedale San Raffaele IRCCS, 20132 - Milan/IT
  • 11 U.o.oncologia Medica, Ospedale Bartolomeo Eustachio, 62027 - San Severino Marche/IT
  • 12 Uoc Oncologia Medica, Ospedale Augusto Murri, 63023 - Fermo/IT
  • 13 Dipartimento Di Oncologia, Azienda Ospedaliera Careggi U.O. Medical Oncology, 50134 - Firenze/IT
  • 14 Digestive And Liver Disease Unit, Sapienza University of Rome, Sant'Andrea Hospital, 00189 - Rome/IT
  • 15 Gastrointestinal And Net Unit, Istituto Europeo di Oncologia, 20141 - Milano/IT
  • 16 Division Of Oncology, Fondazione IRCCS - Istituto Nazionale dei Tumori, 20133 - Milano/IT
  • 17 Medical Oncology, Azienda Ospedaliero - Universitaria Policlinico di Modena, 47121 - Modena/IT
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Resources

Abstract 2684

Background

Pancreatic neuroendocrine tumors (PNETs) are still considered a rare disease, which accounts for approximately 10% of all cases of pancreatic cancer. The oral mTOR inhibitor everolimus has become an established recommended standard therapy for patients with advanced PNETs. Aim of the study is to assess if cumulative dose (CD) and dose intensity (DI) of everolimus may affect survival of advanced PNETs patients.

Methods

One hundred and sixteen patients (62 males and 54 females, median age 55 years) with advanced PNETs were treated with everolimus for ≥ 3 months. According to a ROC analysis, patients were stratified into two groups, with CD ≤ 3000 mg (Group A; n = 68) and CD > 3000 mg (Group B; n = 48).

Results

The response rate and toxicity were comparable in the two groups. However, patients in group A experienced more dose modifications than patients in group B. Median OS was 24 months in Group A whilst in Group B it was not reached (HR: 26.9; 95% CI: 11.0-76.7; p 

Conclusions

Overall, our study results showed that both CD and DI of everolimus play a prognostic role for patients with advanced PNETs treated with everolimus. This should prompt efforts to continue everolimus administration in responsive patients up to at least 3000 mg despite delays or temporary interruptions.

Clinical trial identification

Legal entity responsible for the study

Clinica di Oncologia Medica - Unversità Politecnica delle Marche - Ospedali Riuniti di Ancona

Funding

Università Politecnica delle Marche

Disclosure

All authors have declared no conflicts of interest.

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