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Capdevila J, Sevilla I, Alonso V, Antón Aparicio L, Jiménez Fonseca P, Grande E, Reina JJ, Manzano JL, Alonso Lájara JD, Barriuso J, Castellano D, Medina J, López C, Segura Á, Carrera S, Crespo G, Fuster J, Munarriz J, García Alfonso P. 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. BMC Cancer 2015; 15:495. [PMID: 26138480 PMCID: PMC4490650 DOI: 10.1186/s12885-015-1512-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Accepted: 06/23/2015] [Indexed: 02/07/2023] Open
Abstract
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.
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Affiliation(s)
- Jaume Capdevila
- Medical Oncology Department, Vall d'Hebron University Hospital, Autonomous University of Barcelona, P. Vall d'Hebron 119-129, 08035, Barcelona, Spain.
| | - Isabel Sevilla
- Medical Oncology Department, Virgen de la Victoria University Hospital , Campus Universitario Teatinos, 29010, Málaga, Spain.
| | - Vicente Alonso
- Medical Oncology Department, Miguel Servet University Hospital, Paseo Isabel la Católica, 1-3, 50009, Zaragoza, Spain.
| | - Luís Antón Aparicio
- Medical Oncology Department, University Hospital Complex, As Xubias, 84, 15006, A Coruña, Spain.
| | - Paula Jiménez Fonseca
- Medical Oncology Department, Asturias Central University Hospital, Calle Celestino Villamil, 33006, Oviedo, Spain.
| | - Enrique Grande
- Medical Oncology Department, Ramón y Cajal University Hospital, Ctra. de Colmenar Viejo, km. 9100, 28034, Madrid, Spain.
| | - Juan José Reina
- Medical Oncology Department, Virgen Macarena University Hospital, Avda Dr Fedriani, 3 41009, Sevilla, Spain.
| | - José Luís Manzano
- Medical Oncology Department, Catalan Oncology Institute (ICO-Badalona), Germans Trias i Pujol University Hospital, Carretera Canyet s/n, Badalona, 08016, Barcelona, Spain.
| | - Juan Domingo Alonso Lájara
- Medical Oncology Department, Virgen de la Arrixaca University Hospital, Ctra. Madrid Cartagena, 30120, Murcia, Spain.
| | - Jorge Barriuso
- Medical Oncology Department, La Paz University Hospital, Paseo de la Castellana 261, 28046, Madrid, Spain.
| | - Daniel Castellano
- Medical Oncology Department, 12 de Octubre University Hospital, Avda. de Córdoba, 28041, Madrid, Spain.
| | - Javier Medina
- Medical Oncology Department, Toledo Hospital Complex, Av de Barber 30, 45071, Toledo, Spain.
| | - Carlos López
- Medical Oncology Department, Marqués de Valdecilla University Hospital, Av Valdecilla, 39008, Santander, Spain.
| | - Ángel Segura
- Medical Oncology Department, La Fe University Hospital, Avinguda de Campanar 21, 46026, Valencia, Spain.
| | - Sergio Carrera
- Medical Oncology Department, Cruces University Hospital, Plaza Cruces, 48903, Barakaldo, Vizcaya, Spain.
| | - Guillermo Crespo
- Medical Oncology Department, Burgos University Hospital, Avda. Islas Baleares 3, 09006, Burgos, Spain.
| | - José Fuster
- Medical Oncology Department, Son Dureta University Hospital, C/ Andrea Doria 55, 07014, Palma de Mallorca, Spain.
| | - Javier Munarriz
- Medical Oncology Department, Castellón Provincial Hospital Consortium, Av Doctor Clara 19, 12002, Castellón de la Plana, Spain.
| | - Pilar García Alfonso
- Medical Oncology Department, Gregorio Marañon Hospital, Calle Doctor Esquerdo 46, 28007, Madrid, Spain.
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