title: Role of targeted agents in neuroendocrine tumors: Results from a meta-analysis.
abstract: 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.
  
  
  
  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.
  
  
  
  One thousand 9 hundred and 8 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 tumor site showed a difference in favor 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.
  
  
  
  Our analysis supports the routine use of targeted agents for treatment of neuroendocrine tumors with particular regards to the pancreatic neuroendocrine tumors.
authors.affiliation: a Department of Molecular and Translational Medicine, Section of Pharmacology and University Center DIFF-Drug Innovation Forward Future , University of Brescia , Brescia , Italy.|b Unit of Molecular Therapy and Pharmacogenomic , AO Azienda Istituti Ospitalieri di Cremona , Cremona , Italy.
authors.forename: Giandomenico
authors.initials: G
authors.lastname: Roviello
authors.affiliation: b Unit of Molecular Therapy and Pharmacogenomic , AO Azienda Istituti Ospitalieri di Cremona , Cremona , Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Zanotti
authors.affiliation: c Centre for Research on Health and Social Care Management (CeRGAS) , Bocconi University , Milan , Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Venturini
authors.affiliation: b Unit of Molecular Therapy and Pharmacogenomic , AO Azienda Istituti Ospitalieri di Cremona , Cremona , Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Bottini
authors.affiliation: b Unit of Molecular Therapy and Pharmacogenomic , AO Azienda Istituti Ospitalieri di Cremona , Cremona , Italy.|d Department of Medical , Surgery and Health Sciences, University of Trieste , Trieste , Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Generali
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D006801:Humans; D058990:Molecular Targeted Therapy; D018358:Neuroendocrine Tumors / Q000188:drug therapy*
chemical_list: D000970:Antineoplastic Agents
keywords: Everolimus; NET; bevacizumab; sunitinb