Effectiveness and Prognostic Factors of Everolimus in Patients with Pancreatic Neuroendocrine Neoplasms
Internal medicine (Tokyo, Japan)(2023)
Abstract
Objective The effectiveness of everolimus for the management of pancreatic neuroendocrine neoplasms (PNENs), including the G3/NEC types, remains unclear. We therefore investigated the effectiveness of the drug for the management of PNENs.Methods We analyzed the progression-free survival (PFS) and overall survival (OS) associated with ever-olimus and factors influencing the PFS and OS.Results One hundred patients were evaluated. The PFS associated with the G1/G2 types tended to be sig-nificantly longer than that associated with the G3/NEC types [hazard ratio (HR), 0.45; p=0.005]. A multivari-ate analysis showed that the significant factors influencing the PFS were age (<65 years old; HR, 0.44; p= 0.002), grade (G1/G2; HR, 0.42; p=0.006), everolimus treatment line (<= 2nd; HR, 0.55; p=0.031), and pres-ence of treatment with metformin (yes; HR, 0.29; p=0.044). The median OS was 63.8 months. In the multi-variate analysis, the significant factors influencing the OS were grade (G1/G2; HR, 0.21; p<0.001), volume of liver metastasis (<= 25%; HR, 0.27; p<0.001), everolimus treatment line (<= 2nd; HR, 0.27; p<0.001), and presence of primary tumor resection (yes; HR, 0.33; p=0.005).Conclusion The effectiveness of everolimus in the management of G3/NEC types and prognoses tended to be poorer than those associated with the G1/G2 types. Everolimus combined with metformin and early-line treatment with everolimus may be effective for managing advanced PNENs.
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Key words
pancreas,neuroendocrine neoplasms,everolimus,mTOR
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