Panzuto Francesco, Rinzivillo Maria, Spada Francesca, Antonuzzo Lorenzo, Ibrahim Toni, Campana Davide, Fazio Nicola, Delle Fave Gianfranco
From the *Digestive and Liver Diseases, Sant'Andrea Hospital-Sapienza University of Roma, Rome; †Unit of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology, Milan; ‡Medical Oncology, Azienda Ospedaliero-Universitaria Careggi, Florence, and Department of Medical Biotechnologies, University of Siena, Siena; §Osteoncology and Rare Tumors Center, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Meldola (FC); and ∥Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Pancreas. 2017 Mar;46(3):302-305. doi: 10.1097/MPA.0000000000000762.
The aim of this study was to investigate everolimus efficacy in well-moderately differentiated pancreatic NEC (pNEC) G3.
This was a retrospective analysis of patients with pNEC G3 and Ki67 20% to 55% treated with everolimus.
Fifteen patients with median Ki67 30% and Eastern Cooperative Oncology Group performance status 0 to 1 were evaluated. Of these, 4 patients received everolimus as first-line treatment, whereas 11 had been pretreated with chemotherapy or peptide receptor radionuclide therapy. Median progression-free survival was 6 months, and median overall survival was 28 months. Eleven patients achieved disease stabilization (DS) at 3 month follow-up. Six patients (40%) maintained DS for at least 12 months. Three of 4 patients who received everolimus as first-line therapy had sustained DS (progression-free survival, 12, 17, and 22 months). The safety profile was consistent with that previously reported, with adverse events occurring in 9 patients (66.7%).
This study suggests that everolimus is active in pNEC G3 with well-moderately differentiated morphology and Ki67 less than 55%, in which more toxic systemic chemotherapy is, to date, the only available treatment.
本研究旨在调查依维莫司在中高分化胰腺神经内分泌癌（pNEC）G3中的疗效。
这是一项对接受依维莫司治疗的中高分化pNEC G3且Ki67为20%至55%的患者的回顾性分析。
评估了15例中位Ki67为30%且东部肿瘤协作组体能状态为0至1的患者。其中，4例患者接受依维莫司作为一线治疗，而11例患者曾接受过化疗或肽受体放射性核素治疗。中位无进展生存期为6个月，中位总生存期为28个月。11例患者在3个月随访时病情稳定（DS）。6例患者（40%）维持DS至少12个月。4例接受依维莫司作为一线治疗的患者中有3例持续病情稳定（无进展生存期分别为12、17和22个月）。安全性与先前报道一致，9例患者（66.7%）出现不良事件。
本研究表明，依维莫司在形态学中高分化且Ki67小于55%的pNEC G3中具有活性，而迄今为止，毒性更强的全身化疗是唯一可用的治疗方法。
