Role of everolimus in the treatment of advanced neuroendocrine tumor: a meta-analysis of randomized trials

J BUON. 2019 Jan-Feb;24(1):368-373.

Abstract

Purpose: There are two fundamentally groups of neuroendocrine neoplasms: neuroendocrine tumors (NETs) and neuroendocrine carcinomas (NECs). Target therapy plays a quite important role in the treatment of NETs. However, whether everolimus (mTOR inhibitor) could improve the overall survival (OS) of NETs is contradictory and the efficacy of the agent in NETs from specific organ is lacking analysis. This meta-analysis enrolled the relevant published trials to see the results in a large sample size and further analyzed the efficacy of everolimus according to the tumor origin.

Methods: A systemic search was performed on four major medical databases and related studies were screened out of the result. All the works were done by two reviewers independently and then checked with each other.

Results: Finally, 5 articles and 4 conference abstracts from 3 trials were included. All of the trials indicated a statistically significant difference of progression free survival (PFS) in patients receiving everolimus. And the statistic difference remained significant when it came to the NETs from specific organ (overall HR=0.42, 95%CI 0.35, 0.51). As for OS, all the three trials showed no statistically significant difference between the experimental group (patients receiving everolimus) and control group (patients receiving placebo) and the pooled analysis also indicated no significant difference (HR=0.95, 95%CI 0.71,1.25, p=0.695).

Conclusion: Everolimus is effective in improving the PFS of NETs and the statistical difference remained significant when it came to the NETs from specific organs.

Publication types

  • Meta-Analysis

MeSH terms

  • Antineoplastic Agents / administration & dosage*
  • Everolimus / administration & dosage*
  • Female
  • Humans
  • Male
  • Neuroendocrine Tumors / drug therapy*
  • Neuroendocrine Tumors / mortality
  • Progression-Free Survival
  • Randomized Controlled Trials as Topic
  • Survival Analysis

Substances

  • Antineoplastic Agents
  • Everolimus