Everolimus in a Patient with Metastatic Neuroendocrine Tumor of the Rectum

At that time, five years after initial diagnosis, the patient first presented at our endocrine department for further treatment. 68Ga-DOTANOC-PET/CT revealed progressive, systemic disease with hepatic, lymphatic, and pulmonal metastases, without relevant tracer uptake. The patient was not willing to undergo systemic chemotherapy. We therefore discussed an off-label use of everolimus 10mg daily with the patient who agreed on this option. In the first assessment of treatment efficacy after three months of treatment, we saw a stable disease with a marked necrosis of the largest as well as some other metastases (Figure 1). The patient reported a relief of right upper abdominal pain that she had complained about constantly before. Unfortunately, she kept on experiencing several adverse effects of the medication, so we had to taper and finally withdraw everolimus after about 4.5 months. The re-assessment of the tumor burdon, about 3 months after the previous MRI scan, showed progressive disease again (Figure 1). Volume 5 Issue 7 2016