Capdevila Castillón, Jaume, Sevilla, Isabel, Alonso, Vicente, Antón Aparicio, Luís, Jiménez Fonseca, Paula, Grande, Enrique, Reina, Juan José, Manzano, José Luís, Alonso Lájara, Juan Domingo, Barriuso, Jorge, Castellano, Daniel, Medina, Javier, López, Carlos, Segura, Ángel, Carrera, Sergio, Crespo, Guillermo, Fuster, José, Munarriz, Javier, García Alfonso, Pilar, Universitat Autònoma de Barcelona, and [Capdevila,J] Medical Oncology Department, Vall d'Hebron University Hospital, Autonomous University of Barcelona, Spain. [Sevilla,I] Medical Oncology Department, Virgen de la Victoria University Hospital, Málaga, Spain. [Alonso,V] Medical Oncology Department, Miguel Servet University Hospital, Zaragoza, Spain. [Antón Aparicio,L] Medical Oncology Department, University Hospital Complex, As Xubias, A Coruña, Spain. [Jiménez Fonseca,P] Medical Oncology Department, Asturias Central University Hospital, Oviedo, Spain. [Grande,E] Medical Oncology Department, Ramón y Cajal University Hospita, Madrid, Spain. [Reina,JJ] Medical Oncology Department, Virgen Macarena University Hospital, Sevilla, Spain. [Manzano,JL] Medical Oncology Department, Catalan Oncology Institute (ICO-Badalona), Germans Trias i Pujol University Hospital, Barcelona, Spain. [Alonso Lájara,JD] Medical Oncology Department, Virgen de la Arrixaca University Hospital, Murcia, Spain. [Barriuso,J] Medical Oncology Department, La Paz University Hospital, Madrid, Spain. [Castellano,D] Medical Oncology Department, 12 de Octubre University Hospital, Madrid, Spain. [Medina,J] Medical Oncology Department, Toledo Hospital Complex, Toledo, Spain. [López,C] Medical Oncology Department, La Fe University Hospital, Valencia, Spain. [Carrera,S] Medical Oncology Department, Cruces University Hospital, Vizcaya, Spain. [Crespo,G] Medical Oncology Department, Burgos University Hospital, Burgos, Spain. [Fuster,J] Medical Oncology Department, Son Dureta University Hospital, Palma de Mallorca, Spain. [Munarriz,J] Medical Oncology Department, Castellón Provincial Hospital Consortium, Castellón de la Plana, Spain. [García Alfonso,P] Medical Oncology Department, Gregorio Marañon Hospital, Madrid, Spain.
Background: Based on the mechanism of action, combining somatostatin analogues (SSAs) with mTOR inhibitors or antiangiogenic agents may provide synergistic effects for the treatment of patients with neuroendocrine tumours (NETs). Herein, we investigate the use of these treatment combinations in clinical practice. Methods: This retrospective cross-sectional analysis of patients with NETs treated with the SSA lanreotide and targeted therapies at 35 Spanish hospitals evaluated the efficacy and safety of lanreotide treatment combinations in clinical practice. The data of 159 treatment combinations with lanreotide in 133 patients was retrospectively collected. Results: Of the 133 patients, with a median age of 59.4 (16-83) years, 70 (52.6 %) patients were male, 64 (48.1 %) had pancreatic NET, 23 (17.3 %) had ECOG PS >= 2, 41 (30.8 %) had functioning tumours, 63 (47.7 %) underwent surgery of the primary tumour, 45 (33.8 %) had received prior chemotherapy, and 115 (86.5 %) had received prior SSAs. 115 patients received 1 lanreotide treatment combination and 18 patients received between 2 and 5 combinations. Lanreotide was mainly administered in combination with everolimus (73 combinations) or sunitinib (61 combinations). The probability of being progression-free was 78.5 % (6 months), 68.6 % (12 months) and 57.0 % (18 months) for patients who only received everolimus plus lanreotide (n = 57) and 89.3 % (6 months), 73.0 % (12 months), and 67.4 % (18 months) for patients who only received sunitinib and lanreotide (n = 50). In patients who only received everolimus plus lanreotide the median time-to-progression from the initiation of lanreotide combination treatment was 25.8 months (95 % CI, 11.3, 40.3) and it had not yet been reached among the subgroup of patients only receiving sunitinib plus lanreotide. The safety profile of the combination treatment was comparable to that of the targeted agent alone. Conclusions: The combination of lanreotide and targeted therapies, mainly everolimus and sunitinib, is widely used in clinical practice without unexpected toxicities and suggests efficacy that should be explored in randomized prospective clinical trials., We thank the participating investigators: Veronica Calderero, Hospital de Barbastro (Huesca); Juana Cano, Hospital General de Ciudad Real; Nieves Diaz, Hospital Universitario (San Juan - Alicante); Emma Dotor, Hospital Parc Tauli (Sabadell) Barcelona; Maria Pilar Escudero, Hospital Clinico Universitario Lozano Blesa (Zaragoza); Jose Luis Firvida, Complexo Hospitalario Universitario de Ourense; Maria Jose Gomez, Hospital Puerta del Mar (Cadiz); Encarnacion Jimenez, Hospital de Jerez (Cadiz); Luis Leon, Hospital Clinico Universitario (Santiago de Compostela); Natalia Lupion, Hospital de Merida (Badajoz); David Marrupe, Hospital de Mostoles (Madrid); Miguel Navarro, Hospital Clinico Universitario (Salamanca); Miguel Ruiz Lopez de Tejada, Hospital Punta de Europa (Algeciras - Cadiz); Raquel Serrano, Hospital Reina Sofia (Cordoba); Diego Soto, Hospital Clinico Universitario (Valladolid); Alexandre Teule, Institut Catala d'Oncologia, Hospital Duran i Reynals (Barcelona); Francisca Vazquez, Hospital Clinico Universitario (Santiago de Compostela). We thank Ignasi Gich Saladich who provided support for the statistical analyses at the behest of the coordinating investigators and Aurora O'Brate who provided medical writing services subsequent to the initial draft of the manuscript, including requesting additional statistical analyses, collation of all author comments, formatting to adapt to publishing requirements, and help with submission. External commercial funding was not received for the retrospective analysis, but Ipsen Pharma, Spain provided funding for the medical writing services.