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Impact of everolimus on Japanese patients with advanced pancreatic neuroendocrine neoplasms
Author(s) -
Lee Lingaku,
Ito Tetsuhide,
Igarashi Hisato,
Ueda Keijiro,
Fujiyama Takashi,
Kawabe Ken,
Ogawa Yoshihiro
Publication year - 2017
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.418
Subject(s) - everolimus , medicine , neuroendocrine tumors , group b , gastroenterology , adverse effect , oncology , surgery
Background Although everolimus has become a key therapeutic agent in patients with advanced pancreatic neuroendocrine neoplasms ( PNEN ), its efficacy and safety in clinical practice remains unclear. Methods Forty‐seven patients with advanced PNEN treated with everolimus were reviewed retrospectively. To evaluate the safety of everolimus as a long‐term treatment, the patients were divided into two groups according to treatment duration: group A, ≤1 year ( n = 21); group B, >1 year ( n = 26). Results Among 42 patients with pancreatic neuroendocrine tumors ( PNET ), the median progression‐free survival, overall survival, and objective response rate were 27.5 months, 60.8 months, and 19.0%, respectively. Two patients with pancreatic neuroendocrine carcinomas ( PNEC ) with lower Ki‐67 index and well‐differentiated tumors showed favorable responses. More patients in group A discontinued everolimus owing to adverse drug reactions ( ADR s) than in group B. The median relative dose intensity was significantly lower in group B than group A ( P = 0.045), whereas the drug interruption rate was significantly higher in group B than group A ( P < 0.001). Conclusions Everolimus showed significant clinical benefit in Japanese patients with advanced PNEN . Prevention of severe ADR s by appropriate dose reduction and interruption is necessary for a long‐term continuation of everolimus.