Abstract 3581
Background
The incidence of infections is poorly studied in patients (pts) with neuroendocrine (NET) tumors treated with everolimus (eve) outside of clinical trials. We aimed to evaluate the incidence and risk factors for opportunistic infections (OpI) or any serious infection among eligible pts.
Methods
Retrospective multicenter Latin American cohort of consecutive pts with advanced NET who received at least one dose of eve. Duration of eve, comorbidities, organ dysfunctions, institution, type of prior treatment and concurrent immunosuppressive condition were tested for possible associations with serious (grade 3-5) infections in univariate and multivariable logistic regression models.
Results
111 pts from 5 centers were included: most were men (57.7%) and had pancreatic NET (49.5%). The median duration of eve treatment was 8.9 months and 30 (27%) pts required a dose reduction of eve due to any toxicity. The median overall survival of pts was 54.3 months. In a median follow-up of 32.9 months, 34 (30.6%) pts experienced infections of any grade, 24 (21.6%, 95% confidence interval [CI]: 12.9 – 28.5%) pts had a serious infection and 8 (7.2%, 95% CI: 2.6 – 12.6%) had at least one OpI. Among pts with OpI, the pathogens were Candida sp, Toxoplasma gondi, Pneumocystis sp and Cryptococcus sp; the most common serious infections were pneumonia and gastrointestinal infection. Eight pts (7.2%) died and all deaths were deemed as related to eve. The multivariable analysis identified eve duration (every 6-month increase; Odds Ratio [OR]: 1.26, 95%CI: 1.02-1.55; p = 0.04) and Charlson comorbidity score (OR: 1.47, 95% CI: 1.03-2.08; p = 0.03) as independent risk factors for serious infection.
Conclusions
Infections are more frequent in NET pts using eve than previously reported by clinical trials - 2% had serious infections in the RADIANT-3 trial. Pts on eve should be closely monitored for infections, especially those receiving eve for several months.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Rachel Riechelmann.
Funding
Has not received any funding.
Disclosure
J.M. O’Connor: Honoraria (self): Novartis. R.P. Riechelmann: Honoraria (self): Novartis. All other authors have declared no conflicts of interest.
Resources from the same session
3931 - Differences in multikinase inhibitors (MKI) toxicity profile according to gender. A pooled analysis of three phase II trials with lenvatinib, pazopanib and sorafenib in patients (pts) with advanced gastroenteropancreatic (GEP) neuroendocrine tumors (NETs).
Presenter: Jorge Hernando Cubero
Session: Poster Display session 2
Resources:
Abstract
5458 - Baseline characteristics from CLARINET FORTE: Evaluating lanreotide autogel (LAN) 120 mg every 14 days in patients with progressive pancreatic or midgut neuroendocrine tumours during a standard first-line LAN regimen.
Presenter: Philippe Ruszniewski
Session: Poster Display session 2
Resources:
Abstract
1234 - Analysis of PD-1/PD-L1 blockade biomarker and immune infiltrates in Gastroenteropancreatic neuroendocrine carcinoma
Presenter: Jia Zhang Xing
Session: Poster Display session 2
Resources:
Abstract
1517 - Diabetes Is Associated With Pancreatic Neuroendocrine Tumors Growth and Metastasis
Presenter: Zhiyao Fan
Session: Poster Display session 2
Resources:
Abstract
2145 - Investigation of the reclassification of G1/G2 pancreatic neuroendocrine neoplasms by WHO 2017 classification
Presenter: Takahiro Yokose
Session: Poster Display session 2
Resources:
Abstract
3134 - Treatment with somatostatin analogues after radiopeptide therapy
Presenter: Daria Handkiewicz Junak
Session: Poster Display session 2
Resources:
Abstract
2191 - Safety and Tolerability of Surufatinib in Western Patients with Solid Tumors
Presenter: Erika Hamilton
Session: Poster Display session 2
Resources:
Abstract
3253 - The impact of tumour absorbed dosimetry with survival outcomes after peptide receptor radionuclide therapy in metastatic neuroendocrine tumours.
Presenter: Rahul Ladwa
Session: Poster Display session 2
Resources:
Abstract
5374 - Establishment of Prognostic Nomogram Based on the Metastatic Lymph Nodes Ratio for Patients with Gastric Neuroendocrine Tumour
Presenter: yaobin lin
Session: Poster Display session 2
Resources:
Abstract
3951 - Neutrophil-lymphocyte ratio as an independent predictive factor in Neuroendocrine Neoplasms
Presenter: Sofia Ferreira
Session: Poster Display session 2
Resources:
Abstract