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

Based 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 practic...

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Published in:BMC cancer 2015-07, Vol.15 (1), p.495, Article 495
Main Authors: Capdevila, Jaume, Sevilla, Isabel, Alonso, Vicente, Antón Aparicio, Luís, Jiménez Fonseca, Paula, Grande, Enrique, Reina, Juan José, Manzano, José Luís, Alonso Lájara, Juan Domingo, Barriuso, Jorge, Castellano, Daniel, Medina, Javier, López, Carlos, Segura, Ángel, Carrera, Sergio, Crespo, Guillermo, Fuster, José, Munarriz, Javier, García Alfonso, Pilar
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Antineoplastic Agents - administration & dosage
Antineoplastic Agents - adverse effects
Antineoplastic Agents - therapeutic use
Antineoplastic Combined Chemotherapy Protocols
Clinical medicine
Cross-Sectional Studies
Female
Health aspects
Hospitals
Humans
Kaplan-Meier Estimate
Male
Metastasis
Middle Aged
Neuroendocrine tumors
Neuroendocrine Tumors - drug therapy
Neuroendocrine Tumors - mortality
Oncology
Patients
Peptides, Cyclic - administration & dosage
Peptides, Cyclic - adverse effects
Peptides, Cyclic - therapeutic use
Retrospective Studies
Somatostatin - administration & dosage
Somatostatin - adverse effects
Somatostatin - analogs & derivatives
Somatostatin - therapeutic use
Spain
Young Adult
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Summary:Based 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. This 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. Of 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. The 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.
ISSN:1471-2407
1471-2407
DOI:10.1186/s12885-015-1512-6