Roviello Giandomenico, Zanotti Laura, Venturini Sergio, Bottini Alberto, Generali Daniele
a Department of Molecular and Translational Medicine, Section of Pharmacology and University Center DIFF-Drug Innovation Forward Future , University of Brescia , Brescia , Italy.
b Unit of Molecular Therapy and Pharmacogenomic , AO Azienda Istituti Ospitalieri di Cremona , Cremona , Italy.
Cancer Biol Ther. 2016 Sep;17(9):883-8. doi: 10.1080/15384047.2016.1210735. Epub 2016 Jul 14.
Several randomized phase III trials in neuroendocrine tumors (NETs) showed the clinical role of new targeted agents and their impact on tumor response and outcome of whose patients affected by advanced NET. In this study, we summarize the available clinical data related to clinical efficacy of targeted therapies in the treatment of advanced NETs.
A meta-analysis of randomized studies in accordance with the PRISMA guidelines was performed after searching the databases of PubMed, the Cochrane Library, and the ASCO University Meeting for relevant publications.
One thousand 9 hundred and 8 cases were included in the meta-analysis; among these, 1012 were in the experimental arm and 896 were in the control arm. The pooled analysis of the use of target agents in NETs revealed significantly increased of progression free survival compared to control group (hazard ratio = 0.59, 95% CI:0.42-0.84; P = 0.003). Subgroup analysis of patients according to tumor site showed a difference in favor of pancreatic neuroendocrine tumors. Moreover, targeted therapies improved the overall survival (hazard ratio = 0.79, 95%CI: 0.63-0.98; P = 0.03), and response rate (hazard ratio = 3.33, 95% CI 2.02-5.49; P < 0.00001) in all types of NETs.
Our analysis supports the routine use of targeted agents for treatment of neuroendocrine tumors with particular regards to the pancreatic neuroendocrine tumors.
多项神经内分泌肿瘤（NETs）的随机III期试验显示了新型靶向药物的临床作用及其对晚期NET患者肿瘤反应和预后的影响。在本研究中，我们总结了与靶向治疗在晚期NETs治疗中的临床疗效相关的现有临床数据。
按照PRISMA指南对随机研究进行荟萃分析，在检索PubMed、Cochrane图书馆和美国临床肿瘤学会大学会议的数据库以获取相关出版物后进行。
荟萃分析纳入了1908例病例；其中，1012例在试验组，896例在对照组。NETs中使用靶向药物的汇总分析显示，与对照组相比，无进展生存期显著延长（风险比=0.59，95%置信区间：0.42-0.84；P=0.003）。根据肿瘤部位对患者进行的亚组分析显示，胰腺神经内分泌肿瘤更具优势。此外，靶向治疗改善了所有类型NETs的总生存期（风险比=0.79，95%置信区间：0.63-0.98；P=0.03）和缓解率（风险比=3.33，95%置信区间2.02-5.49；P<0.00001）。
我们的分析支持常规使用靶向药物治疗神经内分泌肿瘤，尤其是胰腺神经内分泌肿瘤。
