title: Real-world treatment patterns in advanced pancreatic neuroendocrine tumors in the era of targeted therapy: perspectives from an academic tertiary center and community oncology practices.
abstract: Pancreatic neuroendocrine tumors (pNETs) are rare, slow-growing cancers. Optimal treatment of advanced pNETs is unclear. The aim of this study was to examine treatment patterns and preferences among an academic tertiary medical center and community-based oncology practices. Retrospective chart review was performed for patients with newly diagnosed locally advanced, metastatic, or unresectable pNET diagnosed between January 2010 and December 2013 at an academic tertiary cancer center [University of California, San Francisco (UCSF)] or a large network of community oncology practices [Altos Solutions' OncoEMR database (ALTOS)]. Fifty-four eligible patients (NUCSF= 23; NALTOS= 31) were identified. Median time to treatment initiation was 1.1 months; median follow-up time was 22.9 months. UCSF patients underwent more lines of therapy than ALTOS patients despite similar follow-up times. UCSF tended toward more invasive treatment than ALTOS. The median time to treatment discontinuation was statistically significantly shorter for patients on chemotherapy than on targeted therapy in the combined UCSF and ALTOS groups (chemotherapy = 2.1 months vs. targeted = 18.6 months, p < 0.001). Treatment patterns and duration for newly diagnosed advanced pNETs vary widely both within and between different practice settings. Further studies are warranted to investigate the significant difference in duration of targeted therapy compared to chemotherapy.
authors.affiliation: UCSF Helen Diller Family Comprehensive Cancer Center, 550 16th St., Box 3211, San Francisco, CA, 94143, USA.
authors.forename: Maurice
authors.initials: M
authors.lastname: Herring
authors.affiliation: Analysis Group Inc., Boston, MA, USA.
authors.forename: Lynn
authors.initials: L
authors.lastname: Huynh
authors.affiliation: Analysis Group Inc., Boston, MA, USA.
authors.forename: Mei Sheng
authors.initials: MS
authors.lastname: Duh
authors.affiliation: Analysis Group Inc., Boston, MA, USA.
authors.forename: Francis
authors.initials: F
authors.lastname: Vekeman
authors.affiliation: Analysis Group Inc., Boston, MA, USA.
authors.forename: Audrey
authors.initials: A
authors.lastname: Tiew
authors.affiliation: Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA.
authors.forename: Maureen
authors.initials: M
authors.lastname: Neary
authors.affiliation: UCSF Helen Diller Family Comprehensive Cancer Center, 550 16th St., Box 3211, San Francisco, CA, 94143, USA. Emily.Bergsland@ucsf.edu.
authors.forename: Emily
authors.identifier: http://orcid.org/0000-0001-7754-6552
authors.initials: E
authors.lastname: Bergsland
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002173:Cancer Care Facilities / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058990:Molecular Targeted Therapy; D018358:Neuroendocrine Tumors / Q000628:therapy*; D010190:Pancreatic Neoplasms / Q000628:therapy*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012189:Retrospective Studies; D062606:Tertiary Care Centers / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Advanced pancreatic neuroendocrine tumors; Low-grade neuroendocrine tumor; Targeted therapy; Treatment pattern