Literature DB >> 27193465

Safety and QOL in Patients with Advanced NET in a Phase 3b Expanded Access Study of Everolimus.

Marianne Pavel1, Nicole Unger2, Ivan Borbath3, Sergio Ricci4, Tsann-Long Hwang5, Thomas Brechenmacher6, Jinhee Park7, Fabian Herbst8, Jennifer L Beaumont9, Oliver Bechter10.   

Abstract

BACKGROUND/AIMS: An open-label, multi-center, expanded access study was conducted in patients with advanced neuroendocrine tumors (NET) treated with everolimus (10 mg/day) to assess safety and health-related quality of life (HRQOL).
METHODS: Of the 246 patients enrolled, 126 have pancreatic NET (pNET) and 120 have non-pNET. Patients continued treatment until disease progression, unacceptable toxicity, death, until commercial availability of everolimus, or May 2012, whichever came first. Adverse events (AEs) were analyzed according to Common Terminology Criteria version 4.0. HRQOL was assessed at baseline, for three 28-day cycles, and then at every three cycles until end of treatment (EOT) with EQ-5D, EORTC QLQ-C30, and EORTC QLQ-GINET21 instruments.
RESULTS: The most common grade 3 or 4 AEs included hyperglycemia, infections, stomatitis, fatigue, and abdominal pain. In patients with pNET, mean (± SD) EQ VAS score remained stable at EOT (baseline, 68.8 ± 19.9 vs. EOT, 66.5 ± 20.6) without clinically significant change in QLQ-C30 global health status (change from baseline, - 3.9; n = 86). For patients with non-pNET, a reduction in EQ VAS score (63.9 ± 19.0 vs. 55.3 ± 23.0) with clinically significant changes in QLQ-C30 global health status (-13.0; n = 69) was seen by EOT. EQ-5D utility scores remained stable in patients with pNET and a moderate decrease was reported by patients with non-pNET.
CONCLUSIONS: The safety profile of everolimus was consistent with the previous studies without adversely affecting HRQOL in pNET. Lower baseline HRQOL scores and more frequent comorbidities might have contributed to the worse outcomes in non-pNET. TRIAL REGISTRATION: EudraCT no. 2010-023032-17.

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Year:  2016        PMID: 27193465     DOI: 10.1007/s11523-016-0440-y

Source DB:  PubMed          Journal:  Target Oncol        ISSN: 1776-2596            Impact factor:   4.493


  15 in total

Review 1.  EQ-5D: a measure of health status from the EuroQol Group.

Authors:  R Rabin; F de Charro
Journal:  Ann Med       Date:  2001-07       Impact factor: 4.709

2.  ENETS Consensus Guidelines for the management of patients with neuroendocrine neoplasms from the jejuno-ileum and the appendix including goblet cell carcinomas.

Authors:  Ulrich-Frank Pape; Aurel Perren; Bruno Niederle; David Gross; Thomas Gress; Frederico Costa; Rudolf Arnold; Timm Denecke; Ursula Plöckinger; Ramon Salazar; Ashley Grossman
Journal:  Neuroendocrinology       Date:  2012-02-15       Impact factor: 4.914

3.  ENETS Consensus Guidelines for the management of patients with liver and other distant metastases from neuroendocrine neoplasms of foregut, midgut, hindgut, and unknown primary.

Authors:  Marianne Pavel; Eric Baudin; Anne Couvelard; Eric Krenning; Kjell Öberg; Thomas Steinmüller; Martin Anlauf; Bertram Wiedenmann; Ramon Salazar
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4.  ENETS Consensus Guidelines for the management of patients with digestive neuroendocrine neoplasms of the digestive system: well-differentiated pancreatic non-functioning tumors.

Authors:  Massimo Falconi; Detlef Klaus Bartsch; Barbro Eriksson; Günter Klöppel; José M Lopes; Juan M O'Connor; Ramón Salazar; Babs G Taal; Marie Pierre Vullierme; Dermot O'Toole
Journal:  Neuroendocrinology       Date:  2012-02-15       Impact factor: 4.914

5.  NANETS consensus guidelines for the diagnosis of neuroendocrine tumor.

Authors:  Aaron I Vinik; Eugene A Woltering; Richard R P Warner; Martyn Caplin; Thomas M O'Dorisio; Gregory A Wiseman; Domenico Coppola; Vay Liang W Go
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6.  Development of a disease-specific Quality of Life questionnaire module for patients with gastrointestinal neuroendocrine tumours.

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Journal:  Eur J Cancer       Date:  2006-01-18       Impact factor: 9.162

7.  Elicitation of health state utilities in neuroendocrine tumours.

Authors:  P Swinburn; J Wang; D Chandiwana; W Mansoor; A Lloyd
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9.  The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology.

Authors:  N K Aaronson; S Ahmedzai; B Bergman; M Bullinger; A Cull; N J Duez; A Filiberti; H Flechtner; S B Fleishman; J C de Haes
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10.  Validation of the EORTC QLQ-GINET21 questionnaire for assessing quality of life of patients with gastrointestinal neuroendocrine tumours.

Authors:  G Yadegarfar; L Friend; L Jones; L M Plum; J Ardill; B Taal; G Larsson; K Jeziorski; D Kwekkeboom; J K Ramage
Journal:  Br J Cancer       Date:  2013-01-15       Impact factor: 7.640

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Review 2.  Health-related quality of life and treatment effects in patients with well-differentiated gastroenteropancreatic neuroendocrine neoplasms: A systematic review and meta-analysis.

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3.  Everolimus in the treatment of neuroendocrine tumors: efficacy, side-effects, resistance, and factors affecting its place in the treatment sequence.

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9.  Quality of life in patients with gastroenteropancreatic tumours: A systematic literature review.

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Review 10.  Spotlight on telotristat ethyl for the treatment of carcinoid syndrome diarrhea: patient selection and reported outcomes.

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