Efficacy of a chemotherapy combination for the treatment of metastatic neuroendocrine tumours

Objectives Neuroendocrine tumours (NETs) are heterogeneous neoplasms for which there is no standard treatment. We have previously proposed an effective polychemotherapy (5-fluorouracil, dacarbazine and epirubicin), which only produced objective responses of brief duration. The present study aimed to...

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Bibliographic Details
Published in:	Annals of oncology 2002-04, Vol.13 (4), p.614-621
Main Authors:	Bajetta, E., Ferrari, L., Procopio, G., Catena, L., Ferrario, E., Martinetti, A., Di Bartolomeo, M., Buzzoni, R., Celio, L., Vitali, M., Beretta, E., Seregni, E., Bombardieri, E.
Format:	Article
Language:	eng
Subjects:	Adult Aged Antineoplastic agents Antineoplastic Combined Chemotherapy Protocols - administration & dosage Antineoplastic Combined Chemotherapy Protocols - therapeutic use Biological and medical sciences Chemotherapy chromogranin A Dacarbazine - administration & dosage Disease Progression Epirubicin - administration & dosage Female Fluorouracil - administration & dosage Humans Infusions, Intravenous Key words: chemotherapy Lung Neoplasms - drug therapy Lung Neoplasms - pathology Male Medical sciences metastatic disease Middle Aged Neuroendocrine Tumors - drug therapy Neuroendocrine Tumors - pathology neuroendocrine tumours Pancreatic Neoplasms - drug therapy Pancreatic Neoplasms - pathology Pharmacology. Drug treatments Stomach Neoplasms - drug therapy Stomach Neoplasms - pathology Survival Analysis Treatment Outcome
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Summary:	Objectives Neuroendocrine tumours (NETs) are heterogeneous neoplasms for which there is no standard treatment. We have previously proposed an effective polychemotherapy (5-fluorouracil, dacarbazine and epirubicin), which only produced objective responses of brief duration. The present study aimed to assess in a multidisciplinary manner the efficacy of the same regimen at intensified doses in patients with advanced NETs. Patients and methods Eighty-two consecutive patients entered the study, of whom 21 had inoperable, locally advanced disease and 61 had metastatic disease. Seventy-two patients were evaluated for objective, biochemical and subjective responses. Response rate, time to progression (TTP) and overall survival (OS) were evaluated based on histotype. Results An objective response was observed in 20 patients (intention-to-treat and standard analysis 24.4% and 27.8%, respectively). Complete biochemical and subjective responses were obtained in 25.1% and 38.9% of the cases. The median duration of treatment was 4 months and the objective responses had a median duration of 38 months. After a 60-month follow-up the median TTP and OS were 21 and 38 months, respectively. Conclusions Our polychemotherapy regimen is effective, with long duration, and is well tolerated both for gastroenteropancreatic and lung NETs, as well as for tumours with a more aggressive clinical behaviour. The new WHO endocrine tumour histotyping, examining also the tumour biology, may give additional information for selecting patients to chemotherapy.
ISSN:	0923-7534 1569-8041