# RADIANT-4: everolimus for advanced non-functional neuroendocrine tumours of the lung or gastrointestinal tract

Source: https://onco.cc/key-papers/paper-radiant-4-everolimus-lancet-2016/  
OnCo record `paper-radiant-4-everolimus-lancet-2016` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Everolimus more than doubled the time to progression in advanced non-functioning neuroendocrine tumours of the lung and gut, the first drug with randomised evidence in lung carcinoids.

## Summary

Phase 3 placebo-controlled trial of 302 patients with advanced progressive, well-differentiated, non-functional neuroendocrine tumours of lung or gastrointestinal origin randomised 2:1 to everolimus 10 mg daily or placebo.

Median progression-free survival was 11.0 versus 3.9 months (hazard ratio 0.48), with consistent benefit in lung and gastrointestinal subgroups; stomatitis, diarrhoea and infections were the main toxicities.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: The Lancet
- Year: 2016
- DOI: 10.1016/S0140-6736(15)00817-X
- Authors: Yao JC, Fazio N, Singh S, et al.
- Findings: Median progression-free survival 11.0 vs 3.9 months; hazard ratio 0.48.; Lung subgroup: 9.2 vs 3.6 months.
- What it means: Everolimus is approved for progressive lung and gastrointestinal neuroendocrine tumours and is a standard option after somatostatin analogues, particularly in lung carcinoids where radioligand therapy is off label.
- Caveats: No overall survival benefit shown.; Response rates were low; benefit is disease stabilisation.

## Sources

- Lancet 2016: https://doi.org/10.1016/S0140-6736(15)00817-X
- PubMed: https://pubmed.ncbi.nlm.nih.gov/26703889/

## Connected records

- cancers: [Lung neuroendocrine tumours (typical and atypical carcinoid)](https://onco.cc/cancers/lung-net/), [Small intestinal neuroendocrine tumours](https://onco.cc/cancers/small-intestinal-net/)
- drugs: [Everolimus](https://onco.cc/drugs/everolimus/)
- journals: [The Lancet](https://onco.cc/journals/lancet/)

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