Long-term disease stabilization in a patient with advanced pancreatic neuroendocrine tumor treated with combined everolimus and octreotide LAR after prior failure of cytotoxic therapy
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Introduction: Targeting of multiple pathways has become an important strategy for improved tumor control in metastatic neuroendocrine tumors (NETs). Among these targets is the mammalian target of rapamycin (mTOR), a central regulator of cell growth, proliferation, and apoptosis, which is blocked by everolimus, an oral inhibitor of mTOR that has shown efficacy in patients with metastatic pancreatic NETs. Recent evidence has suggested that suppression of insulin-like growth factor-1 receptor (IGF-1R) secretion with octreotide therapy, along with concurrent inhibition of mTOR by everolimus, may improve tumor control synergistically by preventing feedback activation of the PI3K/Akt/mTOR pathway.
Aim(s): We report the case of a pancreatic NET patient who, after failure of multiple surgical interventions, single agent octreotide, and systemic cytotoxic therapy, achieved long-term stable disease when treated with a combination of the mTOR inhibitor everolimus and octreotide long-acting release (LAR).
Materials and methods: A 45-year-old man in otherwise good health was diagnosed with a non-functioning, well-differentiated pancreatic NET 2 cm in diameter and multiple focal hepatic lesions. He underwent surgery of the primary tumor, biopsy of hepatic lesions, and splenectomy.
Conference: 7th Annual ENETSConcerence (2010)
Presenting Author:
Authors: Teulé Vega A, Ochoa M, Villabona C, Cuadra C, Salazar Soler R,
Keywords: pancreatic neuroendocrine tumor, everolimus, octreotide LAR, case study,
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