In two separate Phase III clinical trials, the targeted drugs Sutent® (sunitinib) and Afinitor® (everolimus) delayed the progression of advanced pancreatic neuroendocrine tumors. These results were published in the New England Journal of Medicine.
Pancreatic neuroendocrine tumors are a relatively uncommon type of cancer that develops in the hormone-producing cells of the pancreas.
Sutent is an oral targeted agent that works by inhibiting multiple biologic pathways involved in the growth, replication, and spread of cancer cells. It has been shown to be effective in the treatment of selected patients with kidney cancer or gastrointestinal stromal tumors, and is also being evaluated in the treatment of other types of cancer.
To evaluate Sutent for the treatment of advanced pancreatic neuroendocrine tumors, researchers conducted a Phase III clinical trial among 171 patients who had experienced cancer progression. Half the patients were treated with Sutent, and half were treated with a placebo.
- Progression-free survival was 11.4 months among patients treated with Sutent and 5.5 months among patients treated with placebo.
- Patients treated with Sutent also experienced better overall survival than patients treated with placebo.
- The most common serious side effect of Sutent was neutropenia (a low white blood cell count), which affected 12% of patients.
A second clinical trial evaluated Afinitor for the treatment of advanced pancreatic neuroendocrine tumors. Afinitor is an oral targeted therapy that works by inhibiting a protein known as the mammalian target of rapamycin (mTOR). The mTOR protein plays an important role in regulating cancer cell division and blood vessel growth. Afinitor is used in the treatment of selected patients with kidney cancer or subependymal giant cell astrocytoma (SEGA), and is also being evaluated for the treatment of other types of cancer.
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The study of Afinitor enrolled 410 patients with advanced, low-grade or intermediate-grade pancreatic neuroendocrine tumors. Half the patients were treated with Afinitor and half were treated with a placebo.
- Progression-free survival was 11 months among patients treated with Afinitor and 4.6 months among patients treated with placebo.
- 34% of patients treated with Afinitor were alive and free of cancer progression at 18 months, compared with 9% of patients treated with placebo.
- Serious side effects of Afinitor included anemia and high blood sugar.
The results of these studies suggest that Sutent and Afinitor may improve outcomes among patients with advanced pancreatic neuroendocrine tumors.
Raymond E, Dahan L, Raoul J-L et al. Sunitinib malate for the treatment of pancreatic neuroendocrine tumors. New England Journal of Medicine. 2011;364:501-513.
Yao JC, Shah MH, Ito T et al. Everolimus for advanced pancreatic neuroendocrine tumors. New England Journal of Medicine. 2011;364:514-523.
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