ESMO Sarcoma and Rare Cancers | Key trials to determine treatment of advanced pancreatic NETs

Rocio Garcia-Carbonero, MD, PhD, University Hospital 12 De Octubre, Madrid, Spain, gives an overview of the current standard of care for neuroendocrine tumors (NETs), breaking down recent promising Phase II and III trials in pancreatic NETs. The first study analysed is the Phase III SEQTOR trial (NCT02246127), which investigated the sequencing of everolimus and chemotherapy plus streptozocin for patients with pancreatic NETs with advanced disease following first- and second-line therapy. Patients were randomized to either receive everolimus first then, after progression, chemotherapy plus streptozocin or to receive these treatments in inverse order. Due to recruitment difficulties, progression-free survival (PFS) after one line of therapy was the chosen primary endpoint. Preliminary results show chemotherapy plus streptozocin significantly increased objective response rate (ORR) compared to everolimus but there were no significant differences in PFS. The other study presented is the Phase II OCLURANDOM trial (NCT02230176) comparing sunitinib and the peptide receptor radionuclide therapy (PRRT), lu-DOTA-TATE. Dr Garcia-Carbonero highlights promising PFS data of lu-DOTA-TATE at 20 months, which is significantly higher than that of sunitinib, but notes that the trial is not big enough to prove PRRT agents are superior to sunitinib. Dr Garcia-Carbonero also discusses other factors behind the decision to choose treatments. This interview took place at the ESMO Sarcoma and Rare Cancers Congress 2023 in Lugano, Switzerland.

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