Metastatic Pancreatic Neuroendocrine Tumors with Ectopic Cushing Syndrome: Could Everolimus Be a Safe Therapeutic Option?

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Introduction: Everolimus(E) has proved effective in prolonging PFS in advanced P-NETs. As E is a substrate of CYP3A4 co-administration with ketoconazole (k), a strong inhibitor of CYP3A4 used to control hypercortisolism, should be avoided.

Aim(s): We present two pts affected by ectopic Cushing syndrome (ECS) due to metastatic P-NETs that have been treated with E after bilateral adrenalectomy (AD)

Materials and methods: A 61-year-old male underwent left pancreaectomy and AD for a P-NET (Ki-67 25%) associated with bilateral liver metastases and ECS. He was treated with k resulting in partial control of the ECS. Because of a high Ki-67 and the absence of SSTR at GaDOTATOC–PET, he was given three lines of chemotherapy (CHT), which resulted in disease progression. He subsequently underwent right AD to definitively relieve the ECS. A subsequent GaPET-DOTATOC showed the presence of SSTR and the pt started lanreotide treatment with E, resulting in SD documented at CT after 10 months.

Conference: 11th Annual ENETSConcerence (2014)

Presenting Author: davi' m

Authors: Davì M, Cingarlini S, Butturini G, Capelli P, Scarpa A,

Keywords: Everolimus, pancreatic NET, ectopic Cushing syndrome,