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Review
. 2016 Sep;17(9):883-8.
doi: 10.1080/15384047.2016.1210735. Epub 2016 Jul 14.

Role of targeted agents in neuroendocrine tumors: Results from a meta-analysis

Giandomenico Roviello  1   2 , Laura Zanotti  2 , Sergio Venturini  3 , Alberto Bottini  2 , Daniele Generali  2   4
Affiliations
Review

Role of targeted agents in neuroendocrine tumors: Results from a meta-analysis

Giandomenico Roviello et al. Cancer Biol Ther. 2016 Sep.

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusion: Our analysis supports the routine use of targeted agents for treatment of neuroendocrine tumors with particular regards to the pancreatic neuroendocrine tumors.

Keywords: Everolimus; NET; bevacizumab; sunitinb.

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Figures

Figure 1.
Figure 1.
Trial selection flow chart.
Figure 2.
Figure 2.
Forest plots of hazard ratios (HRs) for overall survival (OS) comparing new target agents to control group. The Chi-squared test showed low heterogeneity between the trials. The fixed effects model was used.
Figure 3.
Figure 3.
Forest plots of hazard ratios (HRs) for progression-free survival (PFS) comparing new target agents to control group. The Chi-squared test showed high heterogeneity between the trials. The random effects model was used.
Figure 4.
Figure 4.
Forest plots of hazard ratios (HRs) for progression-free survival (PFS) comparing new target agents to control group in the subgroup of pancreatic NETs versus non pancreatic NETs. The Chi-squared test showed high heterogeneity between the trials. The random effects model was used.
See this image and copyright information in PMC

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