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Everolimus as first line therapy for pancreatic neuroendocrine tumours: current knowledge and future perspectives

Marco Gallo1, Pasqualino Malandrino2, Giuseppe Fanciulli3

  • 1Oncological Endocrinology Unit, Department of Medical Sciences, University of Turin, AOU Città della Salute e della Scienza di Torino, Via Genova 3, 10126, Turin, Italy. mgallo4@cittadellasalute.to.it.

Journal of Cancer Research and Clinical Oncology
|April 14, 2017
PubMed
Abstract

Insights

Everolimus shows promise for advanced pancreatic neuroendocrine tumors (pNETs), but its first-line therapy role requires more high-quality data. Current evidence supports its use for symptomatic, unresectable insulin-secreting pNETs to manage endocrine syndromes.

Area of Science:

  • Oncology
  • Endocrinology
  • Pharmacology

Background:

  • Pancreatic neuroendocrine tumors (pNETs) are rare neoplasms.
  • Everolimus is an mTOR inhibitor with demonstrated efficacy in advanced pNETs.
  • The optimal therapeutic positioning of everolimus in pNETs remains under investigation.

Purpose of the Study:

  • To critically review the current evidence for everolimus in advanced pNETs.
  • To evaluate the role of everolimus as a first-line therapy for pNETs.
  • To identify ongoing clinical trials investigating everolimus in pNETs.

Main Methods:

  • Systematic literature review of retrospective and prospective studies.
  • Analysis of international treatment guidelines for pNETs.
  • Comprehensive search of global clinical trial registries.

Main Results:

  • Eight retrospective and two prospective studies were identified.
  • Five ongoing clinical trials and four international guidelines were analyzed.
  • Limited high-quality data exists for first-line everolimus therapy in general pNETs.

Conclusions:

  • High-quality evidence is lacking to support everolimus as a universal first-line therapy for pNETs.
  • Ongoing trials are expected to clarify its future role.
  • Everolimus is recommended as a first-line therapy for symptomatic, unresectable, insulin-secreting pNETs to manage hormonal symptoms.
Keywords:
EverolimusNeuroendocrine tumoursTherapymTOR inhibitors

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