dc.contributor
Institut Català de la Salut
dc.contributor
[Capdevila J] Servei d’Oncologia Mèdica, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Neuroendocrine and Endocrine Tumor Translational Research Program (NET-VHIO), Vall Hebron Institute of Oncology (VHIO), Barcelona, Spain. [Tafuto S] Sarcomas and Rare Tumors Unit, Istituto Nazionale Tumori IRCCS, Fondazione ‘G.Pascale’, Naples, Italy. [Krogh M] Medical Oncology Department, Odense University Hospital, Odense, Denmark. [Teulé A] Medical Oncology Department, Oncobell Program, IDIBELL, Institut Català d’Oncologia (ICO) Hospital Duran i Reynals, Barcelona, Spain. Clinical Sciences Department, Bellvitge Campus, University of Barcelona, CIBERONC, Barcelona, Spain. [Garcia-Carbonero R] Medical Oncology Department, Hospital Universitario 12 de Octubre, Imas12, UCM, Madrid, Spain. [Klümpen HJ] Medical Oncology Department, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
dc.contributor
Vall d'Hebron Barcelona Hospital Campus
dc.contributor.author
tafuto, salvatore
dc.contributor.author
Krogh, Merete
dc.contributor.author
Klümpen, Heinz-Josef
dc.contributor.author
Capdevila Castillon, Jaume
dc.contributor.author
Teule, Alex
dc.contributor.author
Garcia-Carbonero, Rocio
dc.date.accessioned
2026-03-21T06:09:16Z
dc.date.available
2026-03-21T06:09:16Z
dc.date.issued
2026-03-20T11:55:43Z
dc.date.issued
2026-03-20T11:55:43Z
dc.identifier
Capdevila J, Tafuto S, Krogh M, Teulé A, Garcia-Carbonero R, Klümpen HJ, et al. Streptozotocin plus 5-fluorouracil followed by everolimus or the reverse sequence in patients with advanced pancreatic neuroendocrine tumors (SEQTOR-GETNE phase III study): a randomized clinical trial. ESMO Open. 2025 Dec;10(12):105922.
dc.identifier
http://hdl.handle.net/11351/14377
dc.identifier
10.1016/j.esmoop.2025.105922
dc.identifier
001635238900001
dc.identifier.uri
https://hdl.handle.net/11351/14377
dc.description.abstract
5-fluorouracil; Advanced pancreatic neuroendocrine neoplasm; Everolimu
dc.description.abstract
5-fluorouracil; Neoplasia neuroendocrina pancreàtica avançada; Everolimus
dc.description.abstract
5-fluorouracilo; Neoplasia neuroendocrina pancreática avanzada; Everolimus
dc.description.abstract
Background: Everolimus or streptozotocin plus 5-fluorouracil (STZ/5-FU) are approved treatments for patients with pancreatic neuroendocrine tumors (panNETs). The SEQTOR trial aimed to assess the optimal treatment sequence.
Patients and methods: SEQTOR was an international, open-label, randomized, crossover, phase III trial that recruited adults with unresectable or metastatic, advanced, well-differentiated panNET. Patients received 10 mg/day of everolimus followed upon progression by STZ/5-FU; or the reverse sequence. The primary endpoint was the 35-month progression-free survival (PFS) rate after first- and second-line treatment; however, due to slow accrual and longer survival, it was changed to the 12-month PFS rate following first-line treatment (12-mPFS1).
Results: Patients were randomized to everolimus (n = 72) or STZ/5-FU (n = 69) first. The 12-mPFS1 was 71.4% [95% confidence interval (CI) 59.4% to 81.6%] and 61.8% (95% CI 49.2% to 73.3%) (odds ratio 0.65, 95% CI 0.32-1.32) with a median PFS1 of 19.4 versus 22.7 months for everolimus and STZ/5-FU, respectively. STZ/5-FU achieved a significantly higher overall response rate in first-line (11.6% versus 30.3%, P = 0.012) and second-line (30.6% versus 9.1%, P = 0.072) treatments. No differences were shown in overall survival (median 61.7 versus 50.6 months in everolimus first and STZ/5-FU first, respectively; hazard ratio 1.43, 95% CI 0.86-2.37). Discontinuations of everolimus were more frequent.
Conclusion: STZ/5-FU and everolimus were not statistically different in PFS rates, but STZ/5-FU achieved higher response rates.
dc.description.abstract
This work was supported by the Grupo Español de Tumores Neuroendocrinos y Endocrinos (GETNE). Novartis awarded a grant to GETNE to pay the costs of the study. The funder did not have a role in designing or conducting the study.
dc.format
application/pdf
dc.relation
ESMO Open;10(12)
dc.relation
https://doi.org/10.1016/j.esmoop.2025.105922
dc.rights
Attribution-NonCommercial-NoDerivatives 4.0 International
dc.rights
http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights
info:eu-repo/semantics/openAccess
dc.subject
Quimioteràpia combinada
dc.subject
Pàncrees - Càncer - Quimioteràpia
dc.subject
Tumors neuroendocrins - Quimioteràpia
dc.subject
ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Therapeutics::Drug Therapy::Antineoplastic Protocols::Therapeutics::Drug Therapy::Antineoplastic Combined Chemotherapy Protocols
dc.subject
DISEASES::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Pancreatic Neoplasms
dc.subject
Other subheadings::Other subheadings::Other subheadings::/drug therapy
dc.subject
DISEASES::Neoplasms::Neoplasms by Histologic Type::Neoplasms, Germ Cell and Embryonal::Neuroectodermal Tumors::Neuroendocrine Tumors
dc.subject
TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::terapéutica::farmacoterapia::protocolos antineoplásicos::terapéutica::farmacoterapia::protocolos de quimioterapia antineoplásica combinada
dc.subject
ENFERMEDADES::neoplasias::neoplasias por localización::neoplasias del sistema digestivo::neoplasias pancreáticas
dc.subject
Otros calificadores::Otros calificadores::Otros calificadores::/farmacoterapia
dc.subject
ENFERMEDADES::neoplasias::neoplasias por tipo histológico::neoplasias de células germinales y embrionarias::tumores neuroectodérmicos::tumores neuroendocrinos
dc.title
Streptozotocin plus 5-fluorouracil followed by everolimus or the reverse sequence in patients with advanced pancreatic neuroendocrine tumors (SEQTOR-GETNE phase III study): a randomized clinical trial
dc.type
info:eu-repo/semantics/article
dc.type
info:eu-repo/semantics/publishedVersion
