{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T02:45:03Z","timestamp":1778813103694,"version":"3.51.4"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:00:00Z","timestamp":1769126400000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Neuroendocrine neoplasms (NEN) are a heterogeneous disease and chemotherapy (CT) represents the standard first-line treatment for those with a Ki-67 index &amp;gt;20%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>MAVERIC is a randomized, multicenter, non-comparative phase II study including patients with metastatic gastroenteropancreatic (GEP-NEN) or large-cell neuroendocrine carcinoma (LCNEC) (Ki-67 20%-55%) according to the 2010 WHO grading system and at least stable disease after first-line CT. Patients were randomized (2:1) to everolimus 10\u2009mg\/day or observation until progression or treatment intolerance. The primary endpoint was progression-free survival (PFS); secondary endpoints included overall survival (OS) and safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Between November 2015 and June 2022, 30 patients were enrolled across 5 Italian centers, with 20 assigned to everolimus and 10 to observation. The analysis included 29 patients (52% GEP-NEN, 48% LCNEC). Median (m)PFS was 11.8\u2009months in the everolimus arm and 1.8\u2009months in the control arm. MOS was similar between arms (38.3 and 38.2\u2009months). The subgroup of 11 patients with GEP-neuroendocrine tumor (NET) grade 3 treated with everolimus showed an mPFS of 19.9\u2009months and mOS of 48.1\u2009months. Most common adverse events (AEs) were mucositis (80%), dyslipidemia (55%), fatigue (45%), pneumonitis (40%), and peripheral edema (35%). Grade 3 AEs occurred in 70% of patients; no grade 4 AEs were observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The MAVERIC trial demonstrated encouraging clinical benefit of everolimus in metastatic GEP-NEN and LCNEC (Ki-67 20%-55%) following first-line CT. Toxicity was consistent with the known safety profile of everolimus. This strategy was particularly effective in GEP-NEN patients and warrants further investigation. ClinicalTrials.gov identifier: NCT02687958 (https:\/\/clinicaltrials.gov\/study\/NCT02687958).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/oncolo\/oyaf432","type":"journal-article","created":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T12:44:35Z","timestamp":1767098675000},"source":"Crossref","is-referenced-by-count":1,"title":["Everolimus as maintenance therapy in advanced neuroendocrine neoplasms: results from the MAVERIC phase II trial"],"prefix":"10.1093","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3349-5604","authenticated-orcid":false,"given":"Lorenzo","family":"Antonuzzo","sequence":"first","affiliation":[{"name":"Oncology Unit, Careggi University Hospital , Florence 50134,","place":["Italy"]},{"name":"Department of Experimental Clinical Medicine, University of Florence , Florence 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