Pancreatic Neuroendocrine Tumors: Role of Novel Agents
Abstract
Neuroendocrine tumors of pancreas (PNET) are very rare, consisting of heterogeneous histological subtypes with a variable natural history and different clinical manifestations. Although the vast majority of these neoplasms are sporadic, it is possible to be part of a genetic syndrome such as multiple endocrine neoplasia 1 (MEN-1) or tuberous sclerosis (TSC). When systemic treatment is required the options are limited and management strategy is generally based on experts’ consensus or clinical experience. The prognosis is usually better than in pancreatic adenocarcinoma, though poorly differentiated PNET behave aggressively and survival is shortened. Since last year, there has been a significant advance in the management of PNET, after reported data confirmed the efficacy of everolimus, an mTOR inhibitor, in patients with advanced disease. At the 2011 American Society of Clinical Oncology (ASCO) Gastrointestinal Symposium, updated results of the phase III trial (RADIANT-3) regarding the efficacy of everolimus in PNET (Abstract #158) were reported, along with the results of a subgroup analysis of the Japanese patients enrolled in this study (Abstract #289). Another agent with promising activity in PNET which will be discussed in this review is sunitinib, a biological agent with multikinase inhibitor properties (Abstract #244).
Image: Sotiria General Hospital. Athens, Greece.
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References
Ehehalt F, Saeger HD, Schmidt CM, Grutzmann R. Neuroendocrine tumors of the pancreas. Oncologist 2009; 14:456-67. [PMID 19411317]
Yao J, Shah M, Ito T, Lombard-Bohas C, Wolin E, Van Cutsem E, et al. A randomized, double-blind, placebo-controlled, multicenter phase III trial of everolimus in patients with advanced pancreatic neuroendocrine tumors (PNET) (RADIANT-3). Ann Oncol 2010; 21(Suppl 8):viii4-5.
Valle J, Faivre S, Raoul J, Bang Y, Patyna S, Lu D, et al. Phase III trial of sunitinib (SU) versus placebo (PLO) for treatment of pancreatic neuroendocrine tumors (NET): impact of somatostatin analogue (SSA) treatment on progression-free survival (PFS). Ann Oncol 2010; 21(Suppl 8):viii264.
Castellano D, Capdevilla J, Salazar R, Sastre J, Alonso V, Llanos M, et al. Sorafenib and bevacizumab combination targeted therapy in advanced neuroendocrine tumor: a phase II study of Spanish neuroendocrine tumor group (GETNE-0801). Ann Oncol 2010; 21(Suppl 8):viii265.
Shah MH, Ito T, Lombard-Bohas C, Wolin EM, Van Cutsem E, Sachs C, et al. Everolimus in patients with advanced pancreatic neuroendocrine tumors (pNET): Updated results of a randomized, double-blind, placebo-controlled, multicenter phase III trial (RADIANT-3). J Clin Oncol 2011; 29(Suppl. 4):Abstract 158.
Ito T, Okusaka T, Ikeda M, Tajima T, Kasuga A, Fujita Y, Furuse Y. Everolimus versus placebo in Japanese patients with advanced pancreatic neuroendocrine tumors (pNET): Japanese subgroup analysis of RADIANT-3. J Clin Oncol 2011; 29(Suppl. 4):Abstract 289.
Strosberg JR, Cheema A, Campos T, Valone T, Kvols LK. Phase II study of sunitinib malate following hepatic artery embolization for metastatic neuroendocrine tumors. J Clin Oncol 2011; 29(Suppl. 4):Abstract 244.
Strimpakos AS, Karapanagiotou EM, Saif MW, Syrigos KN. The role of mTOR in the management of solid tumors: an overview. Cancer Treat Rev 2009; 35: 148-59. [PMID 19013721]
Copyright (c) 2011 Alexios S Strimpakos, Kostas N Syrigos, Muhammad Wasif Saif
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