A pilot study of everolimus and radiation for neuroendocrine liver metastases

依维莫司 医学 神经内分泌肿瘤 耐受性 放射治疗 肿瘤科 内科学 无进展生存期 实体瘤疗效评价标准 泌尿科 临床研究阶段 毒性 化疗 不利影响
作者
Sten Myrehaug,David L. Chan,Víctor Rodríguez-Freixinós,Hans Chung,Julie Hallet,Calvin Law,Chirag B. Patel,Laurent Milot,John M. Hudson,Hanbo Chen,Simron Singh
出处
期刊:Endocrine-related Cancer [Bioscientifica]
卷期号:28 (8): 541-548 被引量:6
标识
DOI:10.1530/erc-21-0030
摘要

Liver metastases are common in patients with neuroendocrine tumours. For patients, management must balance disease control with consideration of toxicity, given limited treatment options. Everolimus has demonstrated effectiveness in neuroendocrine neoplasms. Given emerging data of a synergistic effect with radiation therapy, we evaluated combined everolimus and radiation for neuroendocrine liver metastases. This single-arm, single-centre prospective pilot study evaluated the safety and efficacy of combined everolimus and radiotherapy for well-differentiated neuroendocrine liver metastases. Patients with unresectable liver metastases received everolimus for 30 days, followed by concurrent everolimus and liver radiotherapy, then a further 14 days of everolimus. Tolerability was evaluated using the CTCAE v.4.03. Individual metastasis response rate and local control were measured by RECIST v1.1. Overall survival, progression-free survival and freedom from a change in systemic therapy were estimated by the Kaplan-Meier method. Forty metastases were treated in 14 patients. No grade 3 or higher toxicities were identified in the concurrent treatment phase; one patient developed grade 3 toxicity in the post-radiation phase. Overall response rate was 38%. One- and 2-year local control were 97% and 71%. Median progression-free survival was 12 months. One- and 2-year overall survival were 100% and 92%. In conclusion, combined everolimus and radiation are well-tolerated for neuroendocrine liver metastases and are associated with excellent local control. The approach of selective local ablation of oligometastatic or oligoprogressive disease warrants further evaluation in this patient population.

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