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Anti-tumour activit...
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Daskalakis, KosmasUppsala universitet,Endokrinkirurgi,Univ Athens, Laiko Hosp, Endocrine Unit, Dept Propaupaed Internal Med 1, Athens, Greece
(author)
Anti-tumour activity of everolimus and sunitinib in neuroendocrine neoplasms
- Article/chapterEnglish2019
Publisher, publication year, extent ...
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Bioscientifica,2019
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electronicrdacarrier
Numbers
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LIBRIS-ID:oai:DiVA.org:uu-390599
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-390599URI
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https://doi.org/10.1530/EC-19-0134DOI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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Comparisons between everolimus and sunitinib regarding their efficacy and safety in neuroendocrine neoplasms (NENs) are scarce. We retrospectively analysed the clinicopathological characteristics and outcomes in 92 patients with well-differentiated (WD) NEN of different origin (57 pancreatic NENs (PanNENs)), treated with molecular targeted therapy (MTT) with everolimus or sunitinib, first- (73: 19) or second-line (sequential; 12: 22) for progressive disease. Disease control rates (DCR: partial response or stable disease) at first-line were higher in all patients treated with everolimus than sunitinib (64/73 vs 12/19, P = 0.012). In PanNENs, DCR at first-line everolimus was 36/42 versus 9/15 with sunitinib (P = 0.062). Progression-free survival (PFS) at first-line everolimus was longer than sunitinib (31 months (95% CI: 23.1-38.9) vs 9 months (95% CI: 0-18.5); log-rank P < 0.0001) in the whole cohort and the subset of PanNENs (log-rank P < 0.0001). Median PFS at second-line MTT was 12 months with everolimus (95% CI: 4.1-19.9) vs 13 months with sunitinib (95% CI: 9.3-16.7; log-rank P = 0.951). Treatment with sunitinib (HR: 3.47; 95% CI: 1.5-8.3; P value: 0.005), KI67 > 20% (HR: 6.38; 95% CI: 1.3-31.3; P = 0.022) and prior chemotherapy (HR: 2.71; 95% CI: 1.2-6.3; P = 0.021) were negative predictors for PFS at first line in multivariable and also confirmed at multi-state modelling analyses. Side effect (SE) analysis indicated events of serious toxicities (Grades 3 and 4: n = 13/85 for everolimus and n = 4/41 for sunitinib). Discontinuation rate due to SEs was 20/85 for everolimus versus 4/41 for sunitinib (P = 0.065). No additive toxicity of second-line MTT was confirmed. Based on these findings, and until reliable predictors of response become available, everolimus may be preferable to sunitinib when initiating MTT in progressive NENs.
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Tsoli, MarinaUniv Athens, Laiko Hosp, Endocrine Unit, Dept Propaupaed Internal Med 1, Athens, Greece
(author)
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Angelousi, AnnaUniv Athens, Laiko Hosp, Endocrine Unit, Dept Propaupaed Internal Med 1, Athens, Greece
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Kassi, EvanthiaUniv Athens, Laiko Hosp, Endocrine Unit, Dept Propaupaed Internal Med 1, Athens, Greece;Univ Athens, Med Sch, Dept Biol Chem, Athens, Greece
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Alexandraki, Krystallenia, IUniv Athens, Laiko Hosp, Endocrine Unit, Dept Propaupaed Internal Med 1, Athens, Greece
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Kolomodi, DeniseUniv Athens, Laiko Hosp, Endocrine Unit, Dept Propaupaed Internal Med 1, Athens, Greece
(author)
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Kaltsas, GregoryUniv Athens, Laiko Hosp, Endocrine Unit, Dept Propaupaed Internal Med 1, Athens, Greece;Univ Warwick, Univ Hosp, Warwick Med Sch, Clin Sci Res Labs, Coventry, W Midlands, England;Coventry Univ, Fac Hlth & Life Sci, Ctr Appl Biol & Exercise Sci, Coventry, W Midlands, England
(author)
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Koumarianou, AnnaUniv Athens, Haematol Oncol Unit, Dept Internal Med 4, Attikon Univ Gen Hosp, Athens, Greece
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Uppsala universitetEndokrinkirurgi
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Related titles
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In:Endocrine Connections: Bioscientifica8:6, s. 641-6532049-3614
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