Capecitabine-Temozolomide (CAPTEM) in advanced Grade 2 and grade 3 Neuroendocrine neoplasms (NENs) – benefits of chemotherapy in NENs with significant 18FDG uptake

The objective of this study was to evaluate activity of the CAPTEM in patients with grade 2 and grade 3 NENs and identify prognostic factors Materials and methods A retrospective analysis of patients with metastatic grade 2 and grade 3 NENs, who were with baseline significant dual uptake on68Ga-DOTATATE/ 18F-FDG-PET-CT scan and treated with CAPTEM chemotherapy between January 2014 and December 2019 at Tata Memorial Hospital was conducted. The clinical variables and survival data were collected. Progression free survival (PFS) was estimated using Kaplan-Meier method. Results A total of 68 patients received the CAPTEM regimen, of whom 29 patients (43%) received CAPTEM alone and 39 patients (57%) received concurrent PRRT. The primary sites were pancreas in 32 (47%) and small intestine in 12 (18%) patients. Mean Ki-67 index was 12.6% (range: 3-50). 45 patients (65%) were treatment na ïve. There were no significant differences in baseline clinical variables between patients treated with CAPTEM alone or with CAPTEM-PRRT . Both regimens were well tolerated. With a median follow up of 22.1 months, the median PFS for the entire cohort was 27.5 months. There was no statistical differ ence in median PFS between patients receiving CAPTEM alone or CAPTEM-PRRT (33.7 months vs. 22 months; p=0.199). A Ki67 index of greater than 5% predicted for inferior PFS on multivariate analysis [24 months vs. 73.8 months; p=0.04; Hazard ratio -3.77; 95% confidence interval: 1.07-13.26). Conclusio n...
Source: Neuroendocrinology - Category: Endocrinology Source Type: research