Efficacy of Second-Line Chemotherapy in Extrapulmonary Neuroendocrine Carcinoma

Autor: Timothy J. Hobday, Thorvardur R. Halfdanarson, Patrick W. McGarrah, Gustavo Figueiredo Marcondes Westin, Julian R. Molina, Konstantinos Leventakos, Heidi D. Finnes
Rok vydání: 2020
Předmět:
Male
Oncology
Endocrinology
Diabetes and Metabolism
medicine.medical_treatment
Salvage therapy
Kaplan-Meier Estimate
Digestive System Neoplasms
Carboplatin
chemistry.chemical_compound
0302 clinical medicine
Endocrinology
Antineoplastic Combined Chemotherapy Protocols
Etoposide
Aged
80 and over
Cell Differentiation
Middle Aged
Progression-Free Survival
Treatment Outcome
Head and Neck Neoplasms
030220 oncology & carcinogenesis
Female
030211 gastroenterology & hepatology
medicine.drug
Adult
medicine.medical_specialty
Small-cell carcinoma
Article
Young Adult
03 medical and health sciences
Internal medicine
Internal Medicine
medicine
Humans
Progression-free survival
Aged
Proportional Hazards Models
Retrospective Studies
Salvage Therapy
Chemotherapy
Hepatology
Performance status
business.industry
medicine.disease
Carcinoma
Neuroendocrine
Regimen
chemistry
Cisplatin
business
Urogenital Neoplasms
Zdroj: Pancreas
ISSN: 1536-4828
0885-3177
DOI: 10.1097/mpa.0000000000001529
Popis: Objectives A platinum/etoposide doublet is standard first-line therapy for poorly differentiated neuroendocrine carcinoma (PD NEC); however, evidence to guide treatment beyond first-line regimens is lacking. This study aimed to evaluate the efficacy of second-line regimens in PD NEC. Methods We performed a retrospective analysis of patients treated with second-line chemotherapy for PD NEC. Inclusion criteria were previous first-line therapy with platinum/etoposide, extrapulmonary PD NEC, and follow-up data. The primary end points were overall survival (OS) and progression-free survival (PFS) after second-line therapy. Secondary end points included OS and PFS from first-line therapy. Results Sixty-four patients were included. The median OS from initiation of second-line therapy was 6.2 months (95% confidence interval [CI], 4.9-8.9). The median PFS was 2.3 months (95% CI, 2.0-3.2). No second-line regimen showed a statistically significant difference in OS or PFS. There was a significant increase in OS for cisplatin first-line regimens compared with carboplatin (17.0 months [95% CI, 12.5-22.6] vs 11.7 months [95% CI, 8.0-14.0]). Conclusions The efficacy of current second-line therapy in PD NEC is poor. No second-line regimen showed statistically significant superiority. Cisplatin was associated with longer OS regardless of second-line regimen or age. However, unmeasured confounders such as performance status or comorbidities may explain this effect.
Databáze: OpenAIRE
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