Open-label, phase IIIb, multicenter, expanded access study of everolimus in patients with advanced neuroendocrine tumors (NET).

Authors

null

Oliver Edgar Bechter

Universitz Hospital Leuven, Leuven Cancer Institute, Leuven, Belgium

Oliver Edgar Bechter , Nicole Unger , Ivan Borbath , Sergio Ricci , Tsann-Long Hwang , Young Suk Park , Jiri Tomasek , Hussein Raef , Sudsawat Laohavinij , Lisa JeanLouis , Ashok Panneerselvam , Stephen Saletan , Sotirios G. Stergiopoulos , Marianne E. Pavel

Organizations

Universitz Hospital Leuven, Leuven Cancer Institute, Leuven, Belgium, University of Duisburg-Essen, Essen, Germany, Cliniques Universitaires Saint-Luc; Universite Catholique de Louvain, Brussels, Belgium, Presidio Ospedaliero Santa Chiara, Pisa, Italy, Chang Gung Memorial Hospital/Chang Gung University, Lin-Kou, Taiwan, Samsung Medical Center, Seoul, South Korea, Masaryk Memorial Cancer Institute, Brno, Czech Republic, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia, Oncology Unit, Department of Medicine, Rajavithi Hospital, Bangkok, Thailand, Novartis Pharmaceuticals Corp, Florham Park, NJ, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Berlin, Germany

Research Funding

Pharmaceutical/Biotech Company

Background: Everolimus (EVE) antitumor efficacy in patients (pts) with advanced NET was demonstrated in 2 double-blind, placebo (P)–controlled, phase III trials (RADIANT-2 and RADIANT-3). Median PFS in pancreatic (pNET) pts was 11.0 months (EVE) vs. 4.6 months (P) (HR 0.35, 95% CI 0.27-0.45, P <0.001) in RADIANT-3. Median EVE exposure in RADIANT-3 was 38 wks. EVE was approved for advanced pNET in the US and Europe in 2011. An expanded access protocol was launched to gather additional safety data and provide access to EVE for pts with advanced NET while awaiting regulatory approval. Methods: Pts aged ≥18 years with biopsy-proven NET; WHO performance status 0-2; and adequate bone, hepatic, and renal function were enrolled. Main exclusion criteria were poorly differentiated NET and cytotoxic therapy within 4 wks of enrollment. EVE (10 mg/d) was administered until disease progression, unacceptable toxicity, discontinuation, death, commercial availability of EVE, or until May 30, 2012. Pts were enrolled from April 21, 2011 to April 20, 2012. Primary objective was grade 3/4 and serious adverse events (AEs). Secondary objectives included investigator-assessed best overall response rate and PFS. Results: The full analysis set included 246 pts (pNET, n=126; non-pNET, n=120); the safety set included 240 pts (pNET, n=123; non-pNET, n=117). Median age was 61 and 66 years; 54% and 49% were male. Main primary tumor sites in non-pNET pts included small intestine (40%) and lung (22%). Median duration of EVE exposure was 12.1 wks and 24 wks in pNET and non-pNET. At data cutoff, there were 21 and 32 PFS events; 105 and 88 pts were censored. Grade 3/4 AEs were reported in 42.3% and 69.2% of pNET and non-pNET; those reported in ≥10% of pts in pNET and non-pNET included hyperglycemia (12.2% and 5.1%), diarrhea (10.6% and 31.6%), stomatitis (9.8% and 11.1%), nausea (8.1% and 10.3%), and anemia (5.7% and 11.1%). Median investigator-assessed PFS was 7.6 (95% CI 5.52-7.62) months and 10.8 (8.77-Not Estimable) months in pNET and non-pNET. Conclusions: EVE was well tolerated in pts with advanced NET. AEs were similar to those previously reported. Protocol-specified early termination of pts limits the interpretation of PFS medians. Clinical trial information: EudraCT Number: 2010-023032-17.

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Abstract Details

Meeting

2013 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Gastrointestinal (Noncolorectal) Cancer

Track

Gastrointestinal Cancer—Gastroesophageal, Pancreatic, and Hepatobiliary

Sub Track

Neuroendocrine/Carcinoid

Clinical Trial Registration Number

EudraCT Number: 2010-023032-17

Citation

J Clin Oncol 31, 2013 (suppl; abstr 4138)

DOI

10.1200/jco.2013.31.15_suppl.4138

Abstract #

4138

Poster Bd #

30H

Abstract Disclosures

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