QOL preserved during everolimus treatment of neuroendocrine tumors

Last Updated: 2017-09-13

By Will Boggs MD

NEW YORK (Reuters Health) - Health-related quality of life (HRQOL) is maintained during everolimus treatment of gastrointestinal and lung neuroendocrine tumors (NETs), even with the usual toxic effects related to cancer treatment, according to secondary results from RADIANT-4.

"I think this gives strength to everolimus as a treatment option, as it improves clinical outcomes while maintaining HRQOL," Dr. Simron Singh from Sunnybrook Odette Cancer Center, Toronto, Canada, told Reuters Health. "This is another important option in the arsenal in the treatment of NETs. In fact, this is the first approved treatment for lung NETs ever."

Everolimus was approved in 2016 by the U.S. Food and Drug Administration and the European Medicines Agency for the treatment of advanced, progressive, nonfunctional, well-differentiated NETs of gastrointestinal or lung origin.

In RADIANT-4, Dr. Singh and colleagues compared 205 NET patients randomly assigned to everolimus and 97 to placebo. HRQOL was assessed with the Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire and World Health Organization (WHO) performance status.

Roughly 40% of both groups experienced at least a 7-point decrease in the FACT-G total score, and the groups also did not differ significantly in median time to definitive deterioration, according to the August 21 Lancet Oncology online report.

The percentage of patients who had a decrease in WHO performance status of at least 1 category was statistically similar with everolimus and placebo (34% vs. 25%); the time to definitive deterioration in WHO performance status did not differ between the groups.

The proportion of patients who reported that they were "not at all" or "a little bit" bothered by side effects ranged from 58% at week 8 to 68% at week 48 in the everolimus group and from 81% at week 8 to 100% at week 48 in the placebo group.

Disease progression was accompanied by an average decline of 4.91 in FACT-G total scores.

"NET patients can have long treatment times, so the advantage of a treatment that is oral is that it can have less disruption on patients' lives," Dr. Singh said by email. "The fact that it maintains HRQOL strengthens this argument."

"New, simple methods to assess HRQOL, which take into account the specificities of this disease, are needed, but in the mean time a longer-term assessment of HRQOL of patients with NETs might provide some important insight into the effectiveness of treatment," writes Dr. Thomas Walter from Hospices Civils de Lyon, Hopital Edouard Herriot, Lyon, France, in a related editorial.

Novartis Pharmaceuticals sponsored the study, employed 3 of the 24 authors, and had various relationships with 15 other authors.

SOURCES: http://bit.ly/2xUtrtC and http://bit.ly/2jbbnrK

Lancet Oncol 2017.