Depot octreotide plus interferon alfa-2b (IFN-α-2b) and bevacizumab demonstrated similar efficacy among patients with advanced carcinoid tumors, according to a study published in the Journal of Clinical Oncology.1
Though lanreotide delays neuroendocrine tumor (NET) progression, additional treatment options are needed for nonpancreatic tumors. This study evaluated the efficacy of the addition of IFN-α-2b or bevacizumab to depot octreotide in NETs.
The phase 3 SWOG S0518 trial randomly assigned 427 patients with advanced grades 1-2 NETs with progressive disease or poor prognostic features to receive octreotide plus IFN-α-2b or bevacizumab. The primary endpoint was progression-free survival (PFS).
At baseline, the median age was 61, 83% had well differentiated disease, 57% received prior octreotide therapy within the past 2 months, 32.5% received radiation, and 26.5% received chemotherapy.
There was no significant difference in median PFS by central review between the trial arms. Median PFS was 16.6 months (95% CI, 12.9-19.6 months) and 15.4 months (95% CI, 9.6-18.6 months) in the bevacizumab and IFN-α-2b arms, respectively (hazard ratio [HR], 0.93; 95% CI, 0.73-1.18; P = .55).
Time to treatment failure (HR, 0.72; 95% CI, 0.58-0.89; P = .003) and response rates (12% vs 4%, respectively) were, however, higher with bevacizumab compared with IFN-α-2b.
Common adverse events observed in the bevacizumab group included hypertension (32%), proteinuria (9%), and fatigue (7%), whereas the IFN-α-2b group most frequently experienced fatigue (27%), neutropenia (12%), and nausea (6%).
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According to the authors, the results of this study indicate that though there was no improvement in PFS, “bevacizumab was associated with a higher response rate, a longer time to treatment failure, and lower rate of fatigue than interferon.”
- Yao JC, Guthrie KA, Moran C, et al. Phase III prospective randomized comparison trial of depot octreotide plus interferon alfa-2b versus depot octreotide plus bevacizumab in patients with advanced carcinoid tumors: SWOG S0518. J Clin Oncol. 2017 April 6. doi: 10.1200/JCO.2016.70.4072 [Epub ahead of print]