Temozolomide Alone or Combined with Capecitabine for the Treatment of Metastatic Neuroendocrine Neoplasia: a “Real World” data analysis

Background: Neuroendocrine neoplasia (NEN) are a rare group of tumors with different prognosis and response to therapy. Their heterogeneity is dependent on the site of origin, morphology and Ki67. Temozolomide (TEM) appears to be active in metastatic NENs (mNENs) but there is limited evidence about its efficacy in gastrointestinal NENs. We analyzed “real-world” data on the use of TEM alone or in association with capecitabine (CAPTEM) in patients with mNENs. Patients and Methods: One hundred consecutive patients with advanced NENs treated with TEM or CAPTEM between 2009 and 2019 were included. A pre-treatment tumor growth rate (TGR0) was ca lculated. Overall survival (OS), progression-free survival (PFS), tolerance, objective response rate (ORR) and disease control rate (DCR) were analyzed. A propensity score analysis and inverse probability of treatment weights for Cox-regression models were used. Results: TEM-based therapy was admini stered to 95 patients (26.3% CAPTEM and 83.7% TEM) with a median age of 59 years (range 26-85) years. ECOG performance status was 0-2. Carcinoid syndrome was reported in 12 (12.6%) patients. Twenty (21.1%) patients with grade (G) 3 neuroendocrine carcinoma (NEC) and 9 (9.4%) with G3 neuroendocrine t umors (NET) were included in the analysis. Median PFS of the entire group was 10.4 months (95% confidence interval (CI):6.0-11.5). In multivariate analysis, a higher risk of progression was observed for NEC G3 patients (hazard ratio (HR) 2.70, 95...
Source: Neuroendocrinology - Category: Endocrinology Source Type: research