Chien-Ting Liu1, Ming-Huang Chen2, Jen-Shi Chen3, Li-Tzong Chen4,5,6, Yan-Shen Shan7, Chang-Hsien Lu8, Yu-Li Su1, Fan-Chen Ku9, Wen-Chi Chou3, Yen-Yang Chen1. 1. Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan. 2. Taipei Veterans General Hospital, Division of Hematology & Oncology- Department of Medicine, Taipei, Taiwan. 3. Division of Hematology-Oncology, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan. 4. National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan. 5. Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan. 6. Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. 7. Department of Surgery, National Cheng Kung University Hospital, Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan. 8. Chang Gung Memorial Hospital-Chiayi, Division of Hematology and Oncology- Department of Internal Medicine-, Chang Gung University College of Medicine, Chiayi, Taiwan. 9. Division of Hematology and Oncology, Department of Medicine, Changhua Show-Chwan Memorial Hospital, Changhua, Taiwan.
Abstract
AIM: Everolimus is an inhibitor of mTOR, approved for treatment of advanced pancreatic neuroendocrine tumors (NETs). The purpose of this observational study was to evaluate the efficacy and safety of everolimus in treatment of progressive, advanced gastroenteropancreatic neuroendocrine tumors (GEP-NETs) in Taiwan. METHODS: Fifty-three patients with progressive, advanced GEP-NETs who received everolimus treatment between January 2008 and August 2014 were selected. Patient characteristics, tumor features, safety profiles and treatment efficacy were retrospectively analyzed. RESULTS: Mean follow-up duration was 23.7 (1.2-70) months and 37 of 53 patients (69.8%) remained alive at the end of study. The one- and two-year overall survival rates were 90.5% and 75.4%, respectively. The median progression-free survival (PFS) was 18.9 (95% confidence interval; 10.9-26.8) months. Partial response was observed in 15 (28.3%) patients, 29 (54.7%) patients had stable disease and nine (17%) patients had progressive disease. Patients with World Health Organization (WHO) grade I NETs, nonfunctional tumors and liver metastasis burden <10% had significantly better PFS with everolimus treatment. Adverse events observed were stomatitis (35.8%), hyperglycemia (22.6%) and rash (18.8%). Seven (15.4%) patients experienced severe adverse events (grade 3 or more), including hyperglycemia (4.4%), anemia (4.4%), fatigue (2.2%) and elevated liver function (2.2%). One (2.2%) patient died from grade 5 interstitial pneumonitis. CONCLUSION: Everolimus was an effective treatment for Taiwanese patients with progressive advanced GEP-NETs. Patients with nonfunctional NETs had a trend toward longer PFS, whereas patients with liver metastases burden <10% had a trend toward longer overall survival time receiving everolimus treatment.
AIM: Everolimus is an inhibitor of mTOR, approved for treatment of advanced pancreatic neuroendocrine tumors (NETs). The purpose of this observational study was to evaluate the efficacy and safety of everolimus in treatment of progressive, advanced gastroenteropancreatic neuroendocrine tumors (GEP-NETs) in Taiwan. METHODS: Fifty-three patients with progressive, advanced GEP-NETs who received everolimus treatment between January 2008 and August 2014 were selected. Patient characteristics, tumor features, safety profiles and treatment efficacy were retrospectively analyzed. RESULTS: Mean follow-up duration was 23.7 (1.2-70) months and 37 of 53 patients (69.8%) remained alive at the end of study. The one- and two-year overall survival rates were 90.5% and 75.4%, respectively. The median progression-free survival (PFS) was 18.9 (95% confidence interval; 10.9-26.8) months. Partial response was observed in 15 (28.3%) patients, 29 (54.7%) patients had stable disease and nine (17%) patients had progressive disease. Patients with World Health Organization (WHO) grade I NETs, nonfunctional tumors and liver metastasis burden <10% had significantly better PFS with everolimus treatment. Adverse events observed were stomatitis (35.8%), hyperglycemia (22.6%) and rash (18.8%). Seven (15.4%) patients experienced severe adverse events (grade 3 or more), including hyperglycemia (4.4%), anemia (4.4%), fatigue (2.2%) and elevated liver function (2.2%). One (2.2%) patient died from grade 5 interstitial pneumonitis. CONCLUSION:Everolimus was an effective treatment for Taiwanese patients with progressive advanced GEP-NETs. Patients with nonfunctional NETs had a trend toward longer PFS, whereas patients with liver metastases burden <10% had a trend toward longer overall survival time receiving everolimus treatment.
Authors: Sarah Skeoch; Nicholas Weatherley; Andrew J Swift; Alexander Oldroyd; Christopher Johns; Conal Hayton; Alessandro Giollo; James M Wild; John C Waterton; Maya Buch; Kim Linton; Ian N Bruce; Colm Leonard; Stephen Bianchi; Nazia Chaudhuri Journal: J Clin Med Date: 2018-10-15 Impact factor: 4.241
Authors: Emily A Armstrong; Eliza W Beal; Manisha Shah; Bhavana Konda; Sherif Abdel-Misih; Aslam Ejaz; Mary E Dillhoff; Timothy M Pawlik; Jordan M Cloyd Journal: Hepatobiliary Surg Nutr Date: 2020-02 Impact factor: 7.293