title: Lack of efficacy of streptozocin and doxorubicin in patients with advanced pancreatic endocrine tumors.
abstract: BACKGROUND
  The combination of streptozocin and doxorubicin has been considered the standard palliative chemotherapy regimen in patients with advanced pancreatic endocrine tumors (PETs). However, a recent review failed to confirm high antitumor activity in patients with advanced PETs.
  
  
  METHODS
  We retrospectively reviewed the records of 16 consecutive patients who received streptozocin and doxorubicin for advanced PETs at Dana Farber/Partners Cancer Care institutions. Baseline patient characteristics, radiographic response to therapy, treatment-related toxicity, progression-free and overall survival were analyzed.
  
  
  RESULTS
  One patient demonstrated an objective partial response to therapy (objective response rate [ORR], 6%; 95% confidence interval [CI], 0-18%). Six patients achieved stable disease (38%; 95% CI, 14-62%) and 9 patients demonstrated disease progression on initial restaging (56%; 95% CI, 33-77%). The median progression-free survival and overall survival were 3.9 months (95% CI, 2.8-8.8) and 20.2 months (95% CI, 9.7-37.4), respectively.
  
  
  CONCLUSIONS
  In this retrospective cohort, the combination of streptozocin and doxorubicin failed to demonstrate substantial antitumor activity in patients with advanced PET. Our findings underscore the need for new therapeutic options in this patient population.
authors.affiliation: Baylor University Medical Center-Charles A. Sammons Cancer Center, Dallas, Texas 75246, USA. david.mccollum@usoncology.com
authors.forename: A David
authors.initials: AD
authors.lastname: McCollum
authors.forename: Matthew H
authors.initials: MH
authors.lastname: Kulke
authors.forename: David P
authors.initials: DP
authors.lastname: Ryan
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Clark
authors.forename: Lawrence N
authors.initials: LN
authors.lastname: Shulman
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Mayer
authors.forename: Sylvia
authors.initials: S
authors.lastname: Bartel
authors.forename: Charles S
authors.initials: CS
authors.lastname: Fuchs
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000188:drug therapy*; D012189:Retrospective Studies; D013311:Streptozocin / Q000008:administration & dosage; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D013311:Streptozocin; D004317:Doxorubicin