Long-Term Stable Disease with Everolimus in a Patient with Advanced Pancreatic Neuroendocrine Tumor Enrolled in RADIANT-1.

Introduction: The phase II open-label RADIANT-1 study evaluated the safety and efficacy of Everolimus (E, 10 mg/d) ± octreotide LAR (O) in patients (pts) with advanced pancreatic neuroendocrine tumors (pNET) after chemotherapy failure. Objective tumor response was 9.6% in the E group and 4.4% in the E+O group (all partial), and stable disease (SD) was 68% and 80%. Aim(s): We report long-term SD in a glucagonoma pt enrolled in RADIANT-1. Materials and methods: A man aged 46 was diagnosed with glucagonoma in 1990 with tumors in the pancreas (4 cm) and liver (5 cm): p-glucagon >1000 ng/L (ref, <140 ng/L), pancreatic polypeptide (PP)=170 pmol/L (ref, <100 pmol/L), Chromogranin A (CgA)=609 µg/L (ref, <350 µg/L). Pancreas, spleen, and liver metastases (met) were resected, and interferon-a 5x/wk was initiated. Recurrent disease was confirmed in Sept 1996 (CgA-/PP-/glucagon-positive liver tumor). Subsequent met were treated with surgery, radiofrequency ablation (RFA), and chemotherapy (streptozotocin+5-FU). In Feb 2007, multiple liver met not suitable for resection or RFA were identified; after 7 y, chemotherapy was stopped and the pt was enrolled in RADIANT-1 and received Everolimus alone. Results: While on Everolimus (since Feb 2007; 4 y, 9 mo), pt has had radiologically SD without side effects. At last visit, p-glucagon=319 pg/mL, and PP=826 pmol/L. Conclusion: A heavily pretreated patient with advanced metastatic pNET achieved SD lasting more than 4.5 y on Everolimus. Study supported by Novartis. [ABSTRACT FROM AUTHOR]