Temozolomide/capecitabine therapy for metastatic neuroendocrine tumors of the pancreas. A retrospective review

Autor: A. L. Pecora, Rebecca A. Moss, Robert L. Fine, W. H. Isacoff
Rok vydání: 2006
Předmět:
Zdroj: Journal of Clinical Oncology. 24:14023-14023
ISSN: 1527-7755
0732-183X
DOI: 10.1200/jco.2006.24.18_suppl.14023
Popis: 14023 Background: Our laboratory studies suggest additive to synergistic cytotoxicity when neuroendocrine (NET) cells were given continuous exposure to 5 fluorouracil (5-FU) which preceded exposure to temozolomide (T). Based on this in vitro efficacy, salvage treatment with capecitabine (C), an orally-available fluoropyrimidine that is metabolized to 5-FU, and T was initiated in 17 patients (pts) with advanced NET of the pancreas. Methods: A retrospective review was conducted of the 17 pts who received C 1000mg bid on days # 1–14 and T 150–200mg/m2 on days #10–14 of a 28-day cycle, beginning in October, 2002. Pts had imaging performed after every 2 cycles, and serum tumor markers (TM), when present, were measured at every cycle. Median Age 54 (range 33–70). There were 9 men and 8 women. All of the pts had failed first-line treatment with escalating doses of sandostatin LAR. 11 pts had failed multiagent chemotherapy (range 1–5 regimens). Pathology: 10 pts had NET, 3 had non-secretory carcinoid, 1 had secretory carcinoid, one had a glucagonoma; 2 had non-secretory beta cell tumors and one pt had Multiple Endocrine Neoplasia Type I. Results: 13 of the pts are still alive and 12 remain on therapy with SD or PR. One pt did not complete cycle #1 and is not evaluable for response, but is included in an intent-to-treat (ITT) analysis. Grade 3 toxicity was thrombocytopenia in 2 pts, 1 of whom had splenectomy with resolution, and hand-foot syndrome in 1 pt who resumed therapy at reduced dose of C. Of 17 pts with unidimensionally measurable disease, 1 (6%) achieved a complete pathological response. 9 pts (53%) achieved a partial response by RECIST criteria, with a median duration of PR of 284 days (range 85–364 days). Of the 7 pts with evaluable TM, 6 (86%) had a greater than 50% decline. Median overall survival by ITT analysis in the 4 pts now deceased was 268 days (range 111–613 days). Median time to treatment failure was 340 days (range 111–470 days) in 5 pts. Conclusion: The results of this retrospective review suggest that a combination of T + C is active, well tolerated and may prolong survival and palliate symptoms in pts with NET. [Table: see text]
Databáze: OpenAIRE
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