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BMC Cancer. 2015 Jul 4;15:495. doi: 10.1186/s12885-015-1512-6.

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.

Author information

1
Medical Oncology Department, Vall d'Hebron University Hospital, Autonomous University of Barcelona, P. Vall d'Hebron 119-129, 08035, Barcelona, Spain. jacapdevila@vhebron.net.
2
Medical Oncology Department, Virgen de la Victoria University Hospital , Campus Universitario Teatinos, 29010, Málaga, Spain. isevilla02@yahoo.es.
3
Medical Oncology Department, Miguel Servet University Hospital, Paseo Isabel la Católica, 1-3, 50009, Zaragoza, Spain. alonord@gmail.com.
4
Medical Oncology Department, University Hospital Complex, As Xubias, 84, 15006, A Coruña, Spain. luis.anton.aparicio@sergas.es.
5
Medical Oncology Department, Asturias Central University Hospital, Calle Celestino Villamil, 33006, Oviedo, Spain. palucaji@hotmail.com.
6
Medical Oncology Department, Ramón y Cajal University Hospital, Ctra. de Colmenar Viejo, km. 9100, 28034, Madrid, Spain. egrande@oncologiahrc.com.
7
Medical Oncology Department, Virgen Macarena University Hospital, Avda Dr Fedriani, 3 41009, Sevilla, Spain. juanjoreinaz@yahoo.es.
8
Medical Oncology Department, Catalan Oncology Institute (ICO-Badalona), Germans Trias i Pujol University Hospital, Carretera Canyet s/n, Badalona, 08016, Barcelona, Spain. jmanzano@iconcologia.net.
9
Medical Oncology Department, Virgen de la Arrixaca University Hospital, Ctra. Madrid Cartagena, 30120, Murcia, Spain. juand.alonso@carm.es.
10
Medical Oncology Department, La Paz University Hospital, Paseo de la Castellana 261, 28046, Madrid, Spain. jorge.barriuso@salud.madrid.org.
11
Medical Oncology Department, 12 de Octubre University Hospital, Avda. de Córdoba, 28041, Madrid, Spain. cdanicas@hotmail.com.
12
Medical Oncology Department, Toledo Hospital Complex, Av de Barber 30, 45071, Toledo, Spain. boladiez39@yahoo.es.
13
Medical Oncology Department, Marqués de Valdecilla University Hospital, Av Valdecilla, 39008, Santander, Spain. clopez@humv.es.
14
Medical Oncology Department, La Fe University Hospital, Avinguda de Campanar 21, 46026, Valencia, Spain. segura_ang@gva.es.
15
Medical Oncology Department, Cruces University Hospital, Plaza Cruces, 48903, Barakaldo, Vizcaya, Spain. sergio.carrerarevilla@osakidetza.net.
16
Medical Oncology Department, Burgos University Hospital, Avda. Islas Baleares 3, 09006, Burgos, Spain. gcrespoherrero@hotmail.com.
17
Medical Oncology Department, Son Dureta University Hospital, C/ Andrea Doria 55, 07014, Palma de Mallorca, Spain. jose.fuster@ssib.es.
18
Medical Oncology Department, Castellón Provincial Hospital Consortium, Av Doctor Clara 19, 12002, Castellón de la Plana, Spain. jmunarriz@comcas.es.
19
Medical Oncology Department, Gregorio Marañon Hospital, Calle Doctor Esquerdo 46, 28007, Madrid, Spain. pgarcaalfonso@gmail.com.

Abstract

BACKGROUND:

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.

METHODS:

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.

RESULTS:

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.

CONCLUSIONS:

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.

PMID:
26138480
PMCID:
PMC4490650
DOI:
10.1186/s12885-015-1512-6
[Indexed for MEDLINE]
Free PMC Article

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