title: Treatment of poorly differentiated neuroendocrine tumours with etoposide and cisplatin.
abstract: The purpose of this study was to evaluate by a retrospective analysis of 53 patients the efficacy of chemotherapy combining etoposide and cisplatin in the treatment of neuroendocrine tumours. The regimen was a combination of etoposide 100 mg m(-2) day(-1) for 3 days and cisplatin 100 mg m(-2) on day 1, given by 2-h intravenous infusion, administered every 21 days. Twelve patients had a well-differentiated and 41 a poorly differentiated neuroendocrine tumour. Toxicity of treatment was assessed in 50 patients and efficacy in 52 patients. Among the 11 patients with a well-differentiated tumour evaluable for tumoural response, only one (9.4%) had a partial response for 8.5 months. Forty-one patients with a poorly differentiated tumour showed an objective response rate of 41.5% (four complete and 13 partial responses); the median duration of response was 9.2 months, the median overall survival 15 months and the median progression-free survival 8.9 months. Haematological grade 3-4 toxicity was observed in 60% of the cases with one treatment-related death, digestive grade 3-4 toxicity in 40% and grade 3 alopecia was constant. No severe renal, hearing and neurological toxicities were observed (grade 1 in 6%, 14%, 72% respectively and no grade >1). We confirm that poorly differentiated neuroendocrine tumours are chemosensitive to the etoposide plus cisplatin combination. However, the prognosis remains poor with a 2-year survival lower than 20% confirming that new therapeutic strategies have to be developed.
authors.affiliation: Department of Gastroenterology, Institut Gustave Roussy, Villejuif, France.
authors.forename: E
authors.initials: E
authors.lastname: Mitry
authors.forename: E
authors.initials: E
authors.lastname: Baudin
authors.forename: M
authors.initials: M
authors.lastname: Ducreux
authors.forename: J C
authors.initials: JC
authors.lastname: Sabourin
authors.forename: P
authors.initials: P
authors.lastname: Rufié
authors.forename: T
authors.initials: T
authors.lastname: Aparicio
authors.forename: T
authors.initials: T
authors.lastname: Aparicio
authors.forename: P
authors.initials: P
authors.lastname: Lasser
authors.forename: D
authors.initials: D
authors.lastname: Elias
authors.forename: P
authors.initials: P
authors.lastname: Duvillard
authors.forename: M
authors.initials: M
authors.lastname: Schlumberger
authors.forename: P
authors.initials: P
authors.lastname: Rougier
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002454:Cell Differentiation; D002945:Cisplatin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000188:drug therapy* / Q000473:pathology; D016019:Survival Analysis
chemical_list: D005047:Etoposide; D002945:Cisplatin