Afinitor for panreatic cancer = rpo
This appears to be epithelial pancreatic cancer and not neuroendocrine, although a histology is nowhere stated in the record. As such, Afinitor is not medically necessary per current guidelines.
Afinitor has been studied in gemcitabine refractory and progressed patient and showed little activity. Although well-tolerated, administered as a single-agent it had minimal clinical activity in patients with gemcitabine-refractory, metastatic pancreatic cancer. Although Afinitor is FDA approved for neuroendcrine pancreatic cancer, the more common epithelial type is a completely different disease.
Brian M. Wolpin et al, Oral mTOR Inhibitor Everolimus in Patients With Gemcitabine-Refractory Metastatic Pancreatic Cancer. J Clin Oncol. 2009 Jan 10; 27(2): 193198.
Aleksandra Adamska, Alice Domenichini, and Marco Falasca, Pancreatic Ductal Adenocarcinoma: Current and Evolving Therapies. Int J Mol Sci. 2017 Jul; 18(7): 1338.
NCCN Pancreatic Cancer, 2017