Therapy for Gastroenteropancreatic Neuroendocrine Tumors: drug evaluation reports review in Spain.


  Vol. 39 (8) 2019 Neuro endocrinology letters Journal Article   2019; 39(8): 537-543 PubMed PMID:  30927758    Citation

OBJECTIVES: In Spain it is necessary to conduct additional studies to determine place in therapy and cost-effectiveness of a drug. The main objective of this study is to identify all drug assessments and health technology assessment reports of the drugs for gastroenteropancreatic (GEP) neuroendocrine tumors (NET) at a national, regional and hospital level and to summarize the efficacy in terms of outcome measures, adverse events, economic impact and final recommendations. METHODS: A search was made on the GENESIS website for drug evaluation reports regarding GEP NET, including gastrointestinal and bronchopulmonary, to identify the drug assessments at a regional and hospital level. 8 reviews at regional and hospital level were considered. Two clinical guidelines have been reviewed to determine the current management and available treatments. RESULTS: Surgery is the main treatment for NETs in different phases of their evolution. If there is recurrence there are other possible treatments as chemotherapy, somatostatin analogues and new biological agents, also called \"targeted treatments\", that currently have a palliative and symptom control role, since they rarely achieve the elimination of the disease themselves. CONCLUSIONS: Everolimus and sunitinib are new drugs available for the treatment of GEP NET patients reported to have promising effects in advanced diseases. However, the reports are limited and thus new clinical studies on the impact of these drugs on clinical outcome, prognosis, financial burden and feasibility are necessary to support further recommendations.