Compassionate Use of Everolimus in a Patient With a Neuroendocrine Tumor: A Case Report and Discussion of the Literature

Abstract

Neuroendocrine tumors (NETs) represent a relatively rare form of neoplasias for which, in advanced unresectable stages, palliative treatment options remain limited largely to the use of somatostatin analogues or chemotherapy. Several newer targeted therapeutic options, alone or in combination with somatostatin analogues, are currently undergoing clinical evaluation for the treatment of NETs. This article reports the compassionate use of everolimus in combination with long-acting octreotide, in a 58-year old Italian female patient with a well-differentiated neuroendocrine gastric tumor who, since October 2004, has failed multiple previous therapies. Starting in October 2008, the patient has received intramuscular octreotide LAR 30 mg every 28 days plus everolimus 10 mg/day. The patient has reported benefits of symptoms (reduction of pain severity), objective response [improvement of liver function (reductions in LDH, ALP and total bilirubin) and chromogranin A], and radiological response (reduction in target lesions on CT). The patient has experienced an improved quality of life, increased life expectancy, and remains on this well-tolerated treatment regimen.