Outcomes of patients treated with capecitabine and temozolamide for advanced pancreatic neuroendocrine tumors (PNETs) and non-PNETs
Open Access
- 1 August 2014
- journal article
- Vol. 5 (4), 247-252
- https://doi.org/10.3978/j.issn.2078-6891.2014.019
Abstract
Retrospective studies have demonstrated high response rates among patients with advanced pancreatic neuroendocrine tumors (PNETs) treated with capecitabine and temozolamide (CapTem), while responses are infrequently seen among non-PNETs. The objective of the study was to describe progression free survival (PFS) among neuroendocrine tumor (NET) patients treated with CapTem, and to identify factors associated with better activity. Patients who were referred to one of five provincial cancer treatment centers between 2009 and 2013 for advanced NETs and initiated CapTem were included. Patients received Cap 1,500 mg/m2 on days 1-14 and TMZ 200 mg/m2 on days 10-14 every 28 days. Their characteristics and outcomes were retrospectively analyzed. In our cohort, 29 patients (16 males) with a median age of 59 (range 26-76) received palliative CapTem, 15 of them as first-line chemotherapy. Primary tumors included pancreas (48.3%), small bowel (20.7%), lung (10.3%), unknown (10.3%), rectum (6.9%) and appendix (3.4%). Median number of cycles was three. Fifteen patients (51.7%) received CapTem as first-line chemotherapy and 14 (48.3%) as subsequent lines. Median PFS for the entire cohort was 4.7 months. PNETs had a median PFS of 4.9 months compared to 2.8 months for non-PNETs (P=0.178). Patients with PNETs who received CapTem in the first-line setting had a median PFS of 15.9 months as compared to only 3.1 months for the remainder [P=0.047, hazard ratios (HR) 0.342]. Patients with Ki67 above 5% and ≤5% had median PFS of 4.0 and 4.7 months, respectively (P=0.260). CapTem showed good activity among PNETs, but its broader role in the treatment of carcinoid tumors remains unclear.Keywords
This publication has 15 references indexed in Scilit:
- Phase II study of single agent capecitabine in the treatment of metastatic non-pancreatic neuroendocrine tumoursBritish Journal of Cancer, 2011
- Everolimus for Advanced Pancreatic Neuroendocrine TumorsThe New England Journal of Medicine, 2011
- Sunitinib Malate for the Treatment of Pancreatic Neuroendocrine TumorsThe New England Journal of Medicine, 2011
- First‐line chemotherapy with capecitabine and temozolomide in patients with metastatic pancreatic endocrine carcinomasCancer, 2010
- Phase II Study of Temozolomide and Thalidomide in Patients With Metastatic Neuroendocrine TumorsJournal of Clinical Oncology, 2006
- Carcinoid TumorsThe New England Journal of Medicine, 1999
- Neuroendocrine tumours in various organ systems in a ten-year periodEuropean Journal of Surgical Oncology, 1995
- Streptozocin–Doxorubicin, Streptozocin–Fluorouracil, or Chlorozotocin in the Treatment of Advanced Islet-Cell CarcinomaThe New England Journal of Medicine, 1992
- Antitumor activity and pharmacokinetics in mice of 8-carbamoyl-3-methyl-imidazo[5,1-d]-1,2,3,5-tetrazin-4(3H)-one (CCRG 81045; M & B 39831), a novel drug with potential as an alternative to dacarbazine.1987
- Chemotherapy of endocrine malignancies: a review.1987