Refractory neuroendocrine tumor-response to liposomal doxorubicin and capecitabine.
BACKGROUND
A 61-year-old patient with no relevant medical or family history presented with a 2 month history of refractory dry cough that led to the diagnosis of typical carcinoid tumor of the lung metastatic to the mediastinal lymph nodes and liver. She initially received a long-acting somatostatin analog (octreotide) and chemotherapy with cisplatin and etoposide, which was ineffective.


METHODS
Physical examination, laboratory test, chromogranin A test, CT scan, (111)In-diethylenetriaminepentaacetic acid (DTPA)-octreotide scan, (18)F-FDG-PET scan, fine-needle and tissue core liver biopsies.


METHODS
Pulmonary spindle-cell carcinoid tumor with metastases to mediastinal lymph nodes and liver.


RESULTS
Systemic treatment with oral capecitabine (1,500 mg/m(2) daily from day 1 to day 21) and intravenous liposomal doxorubicin (10 mg/m(2) on days 1, 8 and 15), both repeated every 4 weeks, administered concomitantly with long-acting octreotide 30 mg every 3 weeks. The patient achieved a significant and long-lasting response with the combination of capecitabine and liposomal doxorubicin. She reported no severe adverse effects.
UO Oncologia Medica 2 Universitaria, Ospedale Santa Chiara, Pisa, Italy. gl.masi@tin.it
Gianluca
G
Masi
Lorenzo
L
Fornaro
Samanta
S
Cupini
Fotios
F
Loupakis
Enrico
E
Vasile
Giacomo G
GG
Baldi
Irene
I
Stasi
Lisa
L
Salvatore
Alfredo
A
Falcone
D000970:Antineoplastic Agents / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000069287:Capecitabine; D018278:Carcinoma, Neuroendocrine / Q000000981:diagnostic imaging / Q000188:drug therapy*; D002945:Cisplatin / Q000627:therapeutic use; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D004317:Doxorubicin / Q000008:administration & dosage; D005047:Etoposide / Q000627:therapeutic use; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use; D011859:Radiography; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D018931:Antineoplastic Agents, Hormonal; D000972:Antineoplastic Agents, Phytogenic; D003841:Deoxycytidine; D000069287:Capecitabine; D005047:Etoposide; D004317:Doxorubicin; D002945:Cisplatin; D015282:Octreotide; D005472:Fluorouracil