Everolimus Plus Lanreotide vs Everolimus Alone in Aggressive Gastroenteropancreatic Neuroendocrine Tumors

The phase III JCOG1901 (STARTER-NET) trial conducted in Japan evaluated the efficacy and safety of combined first-line treatment with the mTOR inhibitor everolimus and the somatostatin analog lanreotide in patients with aggressive gastroenteropancreatic neuroendocrine tumors, showing a significant improvement in median progression-free survival compared to everolimus alone, particularly in patients with poor prognostic factors. The combination therapy demonstrated promising outcomes, leading to better response rates and disease control. However, it was associated with a higher rate of adverse events, particularly grade ≥ 3 nonhematologic toxicities.