Carboplatin in Combination with Oral or Intravenous Etoposide for Extra-Pulmonary, Poorly-Differentiated Neuroendocrine Carcinomas
| Autor: | Prakash Manoharan, Juan W. Valle, Jorge Barriuso, Mairéad G McNamara, Christina Nuttall, Melissa Frizziero, Francesca Spada, Richard A Hubner, Zoe Kordatou, Wasat Mansoor, Angela Lamarca, Nicola Fazio |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Endocrinology Diabetes and Metabolism Administration Oral Gastroenterology 030218 nuclear medicine & medical imaging Carboplatin chemistry.chemical_compound 0302 clinical medicine Endocrinology Antineoplastic Combined Chemotherapy Protocols Etoposide intravenous etoposide Gastrointestinal Neoplasms Aged 80 and over Manchester Cancer Research Centre Cell Differentiation carboplatin-etoposide Middle Aged Neuroendocrine Carcinomas Neuroendocrine Tumors Treatment Outcome Toxicity Administration Intravenous Female extra-pulmonary neuroendocrine carcinoma medicine.drug Adult medicine.medical_specialty 030209 endocrinology & metabolism Extra pulmonary 03 medical and health sciences Cellular and Molecular Neuroscience Young Adult Internal medicine medicine Humans Adverse effect Aged Retrospective Studies Endocrine and Autonomic Systems business.industry ResearchInstitutes_Networks_Beacons/mcrc Poorly differentiated Carcinoma Neuroendocrine chemistry oral etoposide business Venous thromboembolism |
| Zdroj: | Frizziero, M, Spadaro, F, Lamarca, A, Kordatou, Z, Barriuso, J, Nuttall, C, Mcnamara, M, Hubner, R, Mansoor, W, Manoharan, P, Fazio, N & Valle, J 2019, ' Carboplatin in combination with oral or intravenous etoposide for extra-pulmonary, poorly-differentiated neuroendocrine carcinomas ', Neuroendocrinology . https://doi.org/10.1159/000497336 |
| ISSN: | 1423-0194 |
| Popis: | Background: Carboplatin-etoposide (CarboEtop) is a 1st-line option for patients with advanced extra-pulmonary (EP), poorly-differentiated (PD) neuroendocrine carcinoma (NEC). Different schedules are used in clinical practice and randomised evidence is lacking. Objectives: To provide real-life outcomes of carboplatin combined with oral or intravenous (IV) etoposide (Etop) in advanced EP-PD-NEC, from 2 specialist centres. Methods: Activity/efficacy/toxicity data of CarboEtop were collected retrospectively and analysed. Results: We identified 113 patients; median age: 65.8 years; male: 64%; gastro-entero-pancreatic origin: 54%; stage IV: 90%; median Ki-67: 70%; median follow-up: 11.5 months. A total of 123 courses of CarboEtop (oral: 45%; IV: 55%) were administered; 106 (86%) 1st-line, 16 (13%) 2nd-line, and 1 (1%) 3rd-line. Disease control rate: 74.5% in 1st-line and 69.2% in 2nd/3rd-line, with no significant difference between oral and IV Etop in 1st-line (69.8 vs. 80.8%, p = 0.237). Median progression-free survival (PFS): 6.0 and 4.5 months in 1st-line and 2nd/3rd-line, respectively. Overall survival (OS): 11.5 and 12.5 months in 1st-line and 2nd/3rd-line, respectively. The schedule (oral versus IV Etop) did not impact on 1st-line PFS (5.6 vs. 6.2 months, p = 0.179), although there was a trend towards shorter OS (8.9 vs. 12.1 months, p = 0.069). Liver metastases correlated with worse 1st-line PFS (p = 0.015) and 1st-line OS (p < 0.001) on multivariable analysis. The commonest grade 3–4 adverse event was myelosuppression (49%), with comparable toxicity between oral and IV Etop, except for venous thromboembolism (12.5 vs. 1.7%, p = 0.04). Conclusions: CarboEtop for advanced EP-PD-NEC is active, effective, and well-tolerated. Oral and IV Etop schedules are associated with comparable toxicity; activity should be compared in larger cohorts. |
| Databáze: | OpenAIRE |
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