Evaluation of the efficacy and safety of lanreotide in combination with targeted therapies in patients with neuroendocrine tumours in clinical practice: a retrospective cross-sectional analysis

BMC Cancer

Research Article

Daniel Castellano¹  Paula Jiménez Fonseca²  Guillermo Crespo³  Javier Munarriz⁴  José Luís Manzano⁵  Sergio Carrera⁶  Pilar García Alfonso⁷  Ángel Segura⁸  Jorge Barriuso⁹  Carlos López^1,10  Vicente Alonso^1,11  Enrique Grande^1,12  José Fuster^1,13  Javier Medina^1,14  Luís Antón Aparicio^1,15  Jaume Capdevila^1,16  Juan José Reina^1,17  Juan Domingo Alonso Lájara^1,18  Isabel Sevilla^1,19 

[1] Medical Oncology Department, 12 de Octubre University Hospital, Avda. de Córdoba, 28041, Madrid, Spain;Medical Oncology Department, Asturias Central University Hospital, Calle Celestino Villamil, 33006, Oviedo, Spain;Medical Oncology Department, Burgos University Hospital, Avda. Islas Baleares 3, 09006, Burgos, Spain;Medical Oncology Department, Castellón Provincial Hospital Consortium, Av Doctor Clara 19, 12002, Castellón de la Plana, Spain;Medical Oncology Department, Catalan Oncology Institute (ICO-Badalona), Germans Trias i Pujol University Hospital, Carretera Canyet s/n, 08016, Badalona, Barcelona, Spain;Medical Oncology Department, Cruces University Hospital, Plaza Cruces, 48903, Barakaldo, Vizcaya, Spain;Medical Oncology Department, Gregorio Marañon Hospital, Calle Doctor Esquerdo 46, 28007, Madrid, Spain;Medical Oncology Department, La Fe University Hospital, Avinguda de Campanar 21, 46026, Valencia, Spain;Medical Oncology Department, La Paz University Hospital, Paseo de la Castellana 261, 28046, Madrid, Spain;Medical Oncology Department, Marqués de Valdecilla University Hospital, Av Valdecilla, 39008, Santander, Spain;Medical Oncology Department, Miguel Servet University Hospital, Paseo Isabel la Católica, 1-3, 50009, Zaragoza, Spain;Medical Oncology Department, Ramón y Cajal University Hospital, Ctra. de Colmenar Viejo, km. 9100, 28034, Madrid, Spain;Medical Oncology Department, Son Dureta University Hospital, C/ Andrea Doria 55, 07014, Palma de Mallorca, Spain;Medical Oncology Department, Toledo Hospital Complex, Av de Barber 30, 45071, Toledo, Spain;Medical Oncology Department, University Hospital Complex, As Xubias, 84, 15006, A Coruña, Spain;Medical Oncology Department, Vall d’Hebron University Hospital, Autonomous University of Barcelona, P. Vall d’Hebron 119-129, 08035, Barcelona, Spain;Medical Oncology Department, Virgen Macarena University Hospital, Avda Dr Fedriani, 3 41009, Sevilla, Spain;Medical Oncology Department, Virgen de la Arrixaca University Hospital, Ctra. Madrid Cartagena, 30120, Murcia, Spain;Medical Oncology Department, Virgen de la Victoria University Hospital, Campus Universitario Teatinos, 29010, Málaga, Spain;

关键词: Lanreotide;    Neuroendocrine tumours;    Sunitinib;    Everolimus;    Somatostatin analogues;    Clinical practice;    Cross-sectional analysis;    Combination treatment;   

DOI  :  10.1186/s12885-015-1512-6

 received in 2014-05-04, accepted in 2015-06-23,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundBased on the mechanism of action, combining somatostatin analogues (SSAs) with mTOR inhibitors or antiangiogenic agents may provide synergistic effects for the treatment of patients with neuroendocrine tumours (NETs). Herein, we investigate the use of these treatment combinations in clinical practice.MethodsThis retrospective cross-sectional analysis of patients with NETs treated with the SSA lanreotide and targeted therapies at 35 Spanish hospitals evaluated the efficacy and safety of lanreotide treatment combinations in clinical practice. The data of 159 treatment combinations with lanreotide in 133 patients was retrospectively collected.ResultsOf the 133 patients, with a median age of 59.4 (16–83) years, 70 (52.6 %) patients were male, 64 (48.1 %) had pancreatic NET, 23 (17.3 %) had ECOG PS ≥2, 41 (30.8 %) had functioning tumours, 63 (47.7 %) underwent surgery of the primary tumour, 45 (33.8 %) had received prior chemotherapy, and 115 (86.5 %) had received prior SSAs. 115 patients received 1 lanreotide treatment combination and 18 patients received between 2 and 5 combinations. Lanreotide was mainly administered in combination with everolimus (73 combinations) or sunitinib (61 combinations). The probability of being progression-free was 78.5 % (6 months), 68.6 % (12 months) and 57.0 % (18 months) for patients who only received everolimus plus lanreotide (n = 57) and 89.3 % (6 months), 73.0 % (12 months), and 67.4 % (18 months) for patients who only received sunitinib and lanreotide (n = 50). In patients who only received everolimus plus lanreotide the median time-to-progression from the initiation of lanreotide combination treatment was 25.8 months (95 % CI, 11.3, 40.3) and it had not yet been reached among the subgroup of patients only receiving sunitinib plus lanreotide. The safety profile of the combination treatment was comparable to that of the targeted agent alone.ConclusionsThe combination of lanreotide and targeted therapies, mainly everolimus and sunitinib, is widely used in clinical practice without unexpected toxicities and suggests efficacy that should be explored in randomized prospective clinical trials.

【 授权许可】

CC BY   
© Capdevila et al. 2015