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

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 clin...

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Detalles Bibliográficos
Autores: Capdevila, Jaume, Sevilla, Isabel, Alonso, Vicente, Anton Aparicio, Luis, Jimenez Fonseca, Paula, Grande, Enrique, Jose Reina, Juan, Luis Manzano, Jose, Alonso Lajara, Juan Domingo, Barriuso, Jorge, Castellano, Daniel, Medina, Javier, Lopez, Carlos, Segura, Angel, Carrera, Sergio, Crespo, Guillermo, Fuster Salva, Jose, Munarriz, Javier, Garcia Alfonso, Pilar
Tipo de recurso: artículo
Fecha de publicación:2015
País:España
Institución:Conselleria de Salut i Consum del Govern de les Illes Balears
Repositorio:Docusalut
Idioma:inglés
OAI Identifier:oai:docusalut.com:20.500.13003/12460
Acceso en línea:https://hdl.handle.net/20.500.13003/12460
Access Level:acceso abierto
Palabra clave:Young Adult
Adult
Humans
Adolescent
Antineoplastic Combined Chemotherapy Protocols
Antineoplastic Agents
Middle Aged
Cross-Sectional Studies
Male
Peptides, Cyclic
Retrospective Studies
Aged
Kaplan-Meier Estimate
Neuroendocrine Tumors
Aged, 80 and over
Female
Somatostatin
Adulto
Tumores Neuroendocrinos
Somatostatina
Femenino
Adolescente
Masculino
Estudios Transversales
Antineoplásicos
Humanos
Persona de Mediana Edad
Péptidos Cíclicos
Adulto Joven
Protocolos de Quimioterapia Combinada Antineoplásica
Estimación de Kaplan-Meier
Anciano
Anciano de 80 o más Años
Estudios Retrospectivos
Lanreotide
Neuroendocrine tumours
Sunitinib
Everolimus
Somatostatin analogues
Clinical practice
Cross-sectional analysis
Combination treatment
Descripción
Sumario: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.