RADIANT-3 and RADIANT-4
The two trials that made everolimus a standard pill for pancreatic, lung and gut neuroendocrine tumours.
Overview
RADIANT-3 and RADIANT-4, led by trial NCT00510068 and sponsored by Novartis, are the two trials, reported from 2011, that made everolimus a standard tablet for pancreatic, lung and gastrointestinal neuroendocrine tumours. RADIANT-3 randomised 410 patients with progressive pancreatic neuroendocrine tumours and RADIANT-4 302 patients with lung or gastrointestinal tumours to everolimus or placebo, and both met their primary progression-free survival endpoints with large effects, while overall survival was not significantly improved because of crossover. Nuclide links them to neuroendocrine tumours, everolimus and James C. Yao. Whether everolimus should come before or after radioligand therapy, which COMPETE has now tested directly, is the open question.
- Median 11 vs 4.6 months with Everolimus compared with Placebo; about 6.4 months longer for half the group.
- A median is a midpoint: half the people did better than this and half did worse, so it is not a prediction for any one person.
- Put another way, the treated group had about 65 percent lower chance of the event at any given time (hazard ratio 0.35, likely range 0.27 to 0.45).
- Median 11 vs 3.9 months with Everolimus compared with Placebo; about 7.1 months longer for half the group.
- A median is a midpoint: half the people did better than this and half did worse, so it is not a prediction for any one person.
- Put another way, the treated group had about 52 percent lower chance of the event at any given time (hazard ratio 0.48, likely range 0.35 to 0.67).
- This is a surrogate endpoint: it measures the cancer being controlled or absent on scans and tests, which often, but not always, translates into living longer.
- These results apply to the people the trial enrolled: Progressive pancreatic NETs (RADIANT-3, n=410) and lung/GI NETs (RADIANT-4, n=302): everolimus vs placebo. People in a different situation may not see the same effect.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
712 enrolled.
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