An international study led by the head of the Medical Oncology Service of the Catalan Institute of Oncology (ICO) in L’Hospitalet and researcher at the Bellvitge Biomedical Research Institute (IDIBELL) Ramon Salazar, with the support of the Spanish Group of Neuroendocrine and Endocrine Tumors (GETNE), and which has had the collaboration of health centres from eight European countries, has compared for the first time two treatment strategies for pancreatic neuroendocrine tumours (panNET), a type of cancer that is rare but increasing. The study, which has been recently published in the scientific journal ESMO Open, is of important relevance as it is an academic study in a rare type of tumor such as pancreas.
The Phase III clinical trial called SEQTOR, which has included 141 patients from different European centers, has analyzed the effectiveness of two common treatments: on the one hand the everolimus drug, aimed at impairing tumor growth by inhibiting the MTOR metabolic pathway, and the treatment of streptozotocin+5-fluorouracil (STZ/5FU), a combination of chemotherapy used for decades.
The results of the study indicate that both options are equally effective in controlling the disease, with a progression-free survival after 12 months of more than 60% in both treatments and reinforces the importance of adapting the treatment to the characteristics of each patient in this type of tumor.
Similar efficacy but higher responses in chemotherapy
Until now, there was no trial that directly compared the best treatment sequence for pancreatic neuroendocrine tumours. At this point, though the results are very similar, they show that chemotherapy with STZ/5-FU achieved a more intense anti-tumour response that translates into a more noticeable reduction in the size of tumours in patients. This makes it a particularly useful option when the tumor volume needs to be reduced quickly. On the other hand, the everolimus drug showed different side effects, with more cases with mucositis and skin alterations, while STZ/5-FU generated more nausea and some mild renal affectation.
The head of Medical Oncology at ICO l’Hospitalet, principal investigator and senior author of the study, Ramon Salazar, highlights that “the data obtained in this study confirm that there is no optimal sequence for all patients and that, therefore, the decision to perform one treatment or another must take into account the characteristics of the disease, comorbidities and tolerability of each person.” And he adds “it is important to note that, after many years, this is the first large-scale and well-controlled study that shows that chemotherapy works and is well tolerated when compared to a common treatment such as everolimus.”
With these results, Dr. Salazar’s team, and in which the medical oncologist from the Vall d’Hebron University Hospital and VHIO researcher, Jaume Capdevila, has also participated, reinforces the role of the CCC Bellvitge Health Campus in international research in oncology and in the continuous improvement of patient care.
An uncommon but steadily increasing cancer
Pancreatic neuroendocrine tumours are rare, representing only 2% of pancreatic tumours, but their incidence is growing steadily in recent years. These are tumours that often evolve slowly and therefore require prolonged treatments that are both effective and well tolerated. At this point, the results of the SEQTOR clinical trial take on a relevant importance since they offer robust data for the first time on how to sequence the available therapies and help clinical teams to customize the approach of each patient to the maximum.
According to Ramon Salazar, this trial has been a great challenge because it has been carried out in a totally academic environment, without commercial interests, and with patients who had advanced tumours and few treatment options available. It also stands out that it has been demonstrated, through a Phase III study, that a classic chemotherapy treatment can be effective and well tolerated within a complex treatment strategy that combines different phases. In addition, he explains that these results allow us to better understand how to use and combine the different treatment options, and value therapeutic alternatives that already exist, are accessible and are well established.
Thus, the contribution of the data from this study, carried out in collaboration with professionals from eight European centres, reinforces scientific knowledge in a field where studies are scarce but essential to improve the quality of life and prognosis of patients affected by pancreatic neuroendocrine tumors.
About the Bellvitge Health Campus Comprehensive Cancer Center
The Comprehensive Cancer Centre (CCC) of the Bellvitge Health Campus is the only one in Spain and Catalonia where four independent public institutions (the Catalan Institute of Oncology, the Bellvitge Hospital and IDIBELL, with the support of the University of Barcelona) take part in a coordinated and networked approach to cancer with a team of more than 1,500 professionals who lead from research to prevention to comprehensive care. The accreditation of the Bellvitge Health Campus as a CCC has a direct impact on about 2 million people in the Southern Metropolitan and Penedès regions, as well as patients with certain pathologies in the Camp de Tarragona and Terres de l’Ebre. It includes 12 functional units that offer comprehensive and multidisciplinary care and has 7 state accreditations (CSUR) in complex cancers. It carries out more than 5,000 complex surgeries per year, more than 1,200 robotic surgeries, nearly 600 active clinical trials in cancer, and more than 640 scientific publications on oncology.
About IDIBELL
The Bellvitge Biomedical Research Institute (IDIBELL) is a research center created in 2004 and specialized in cancer, neuroscience, translational medicine and regenerative medicine. It has a team of more than 1,500 professionals who, from 73 research groups, publish more than 1,400 scientific articles per year. IDIBELL is participated by the Bellvitge University Hospital and the Viladecans Hospital of the Catalan Institute of Health, the Catalan Institute of Oncology, the University of Barcelona and the City Council of L Hospitalet de Llobregat.
IDIBELL is a member of the Campus of International Excellence of the University of Barcelona HUBc and is part of the CERCA institution of the Generalitat de Catalunya. In 2009 it became one of the first five Spanish research centres accredited as a health research institute by the Carlos III Health Institute. In addition, it is part of the HR Excellence in Research program of the European Union and is a member of EATRIS and REGIC. Since 2018, IDIBELL is an Accredited Center of the AECC Scientific Foundation (FCAECC).