title: Treatment of metastatic neuroendocrine carcinomas based on WHO classification.
abstract: A single institution prospective trial was conducted to evaluate the efficacy of biotherapy or chemotherapy in metastatic neuroendocrine carcinomas (NECs). The choice of therapy was based on the revised histological classification criteria of the WHO in an effort to define a standardized protocol for therapy of these cancers. Patients with well-differentiated NECs (WD-NECs; n=11) received therapy with octreotide long-acting release and interferon-alpha-2b for a maximum of 1 year; cases with poorly-differentiated NECs (PD-NECs; n=8) were given combination cisplatin, L-leucovorin and 5-fluorouracil chemotherapy for a maximum of 9 cycles. Five patients (4 with WD-NECs) had carcinoid syndrome. Among the patients with WD-NECs (median follow-up 20 months, range 4-40), 4 had partial responses and 7 had stable disease. In patients with PD-NECs (median follow-up 10.5 months, range 3-30), 3 had partial response, 2 stable disease, and the disease progressed in 3 cases. The 2-year survival rate in WD-NECs and PD-NECs was 88% and 66%, respectively. Grade 3-4 side-effects were limited to 9% thrombocytopenia and 12.5% neutropenia. Both these treatment regimens had a good therapeutic index and compared favourably with those previously reported for metastatic WD-NECs and PD-NECs.
authors.affiliation: Ospedale Niguarda Ca' Granda, Piazza Ospedale Maggiore 3, 1-20162 Milan, Italy. oncologia@ospedaleniguarda.it
authors.forename: Salvatore
authors.initials: S
authors.lastname: Artale
authors.forename: Laura
authors.initials: L
authors.lastname: Giannetta
authors.forename: Giulio
authors.initials: G
authors.lastname: Cerea
authors.forename: Dario
authors.initials: D
authors.lastname: Maggioni
authors.forename: Paolo
authors.initials: P
authors.lastname: Pedrazzoli
authors.forename: Ilaria
authors.initials: I
authors.lastname: Schiavetto
authors.forename: Marcello
authors.initials: M
authors.lastname: Napolitano
authors.forename: Silvio
authors.initials: S
authors.lastname: Veronese
authors.forename: Emanuela
authors.initials: E
authors.lastname: Bramerio
authors.forename: Marcello
authors.initials: M
authors.lastname: Gambacorta
authors.forename: Angelo
authors.initials: A
authors.lastname: Vanzulli
authors.forename: Salvatore
authors.initials: S
authors.lastname: Pisconti
authors.forename: Raffaele
authors.initials: R
authors.lastname: Pugliese
authors.forename: Salvatore
authors.initials: S
authors.lastname: Siena
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D018278:Carcinoma, Neuroendocrine / Q000097:blood / Q000145:classification* / Q000188:drug therapy* / Q000556:secondary; D002864:Chromogranins / Q000097:blood; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D018572:Disease-Free Survival; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000097:blood; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000009:adverse effects; D002955:Leucovorin / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000008:administration & dosage / Q000009:adverse effects; D010751:Phosphopyruvate Hydratase / Q000097:blood; D011446:Prospective Studies; D011994:Recombinant Proteins
chemical_list: D002864:Chromogranins; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D006897:Hydroxyindoleacetic Acid; D010751:Phosphopyruvate Hydratase; D002945:Cisplatin; D002955:Leucovorin; D015282:Octreotide; D005472:Fluorouracil