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Pancreas. 2017 Mar;46(3):302-305. doi: 10.1097/MPA.0000000000000762.

Everolimus in Pancreatic Neuroendocrine Carcinomas G3.

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From the *Digestive and Liver Diseases, Sant'Andrea Hospital-Sapienza University of Roma, Rome; †Unit of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology, Milan; ‡Medical Oncology, Azienda Ospedaliero-Universitaria Careggi, Florence, and Department of Medical Biotechnologies, University of Siena, Siena; §Osteoncology and Rare Tumors Center, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Meldola (FC); and ∥Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.



The aim of this study was to investigate everolimus efficacy in well-moderately differentiated pancreatic NEC (pNEC) G3.


This was a retrospective analysis of patients with pNEC G3 and Ki67 20% to 55% treated with everolimus.


Fifteen patients with median Ki67 30% and Eastern Cooperative Oncology Group performance status 0 to 1 were evaluated. Of these, 4 patients received everolimus as first-line treatment, whereas 11 had been pretreated with chemotherapy or peptide receptor radionuclide therapy. Median progression-free survival was 6 months, and median overall survival was 28 months. Eleven patients achieved disease stabilization (DS) at 3 month follow-up. Six patients (40%) maintained DS for at least 12 months. Three of 4 patients who received everolimus as first-line therapy had sustained DS (progression-free survival, 12, 17, and 22 months). The safety profile was consistent with that previously reported, with adverse events occurring in 9 patients (66.7%).


This study suggests that everolimus is active in pNEC G3 with well-moderately differentiated morphology and Ki67 less than 55%, in which more toxic systemic chemotherapy is, to date, the only available treatment.

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