Role of targeted agents in neuroendocrine tumours: results from a meta-analysis

Background: Several randomized phase III trials in neuroendocrine tumors (NETs) showed the clinical role of new targeted agents and their impact on tumor response and outcome of whose patients affected by advanced NET. In this study, we summarize the available clinical data related to clinical efficacy of targeted therapies in the treatment of advanced NETs. Methods: A meta-analysis of randomized studies in accordance with the PRISMA guidelines was performed after searching the databases of PubMed, the Cochrane Library, and the ASCO University Meeting for relevant publications. Results: One thousand nine hundred and eight cases were included in the meta-analysis; among these, 1012 were in the experimental arm and 896 were in the control arm. The pooled analysis of the use of target agents in NETs revealed significantly increased of progression free survival compared to control group (hazard ratio=0.59, 95% CI:0.42-0.84; P=0.003). Subgroup analysis of patients according to tumour site showed a difference in favour of pancreatic neuroendocrine tumors. Moreover, targeted therapies improved the overall survival (hazard ratio=0.79, 95%CI: 0.63-0.98; P=0.03), and response rate (hazard ratio=3.33, 95% CI 2.02-5.49; P<0.00001) in all types of NETs. Conclusion: Our analysis supports the routine use of targeted agents for treatment of neuroendocrine tumors with particular regards to the pancreatic neuroendocrine tumors.