title: Irinotecan plus cisplatin in patients with extensive-disease poorly differentiated neuroendocrine carcinoma of the esophagus.
abstract: BACKGROUND
  Poorly-differentiated neuroendocrine carcinoma (NEC) of the esophagus is a rare subtype that has a poor prognosis and is distinguished from well-differentiated neuroendocrine neoplasms in accordance with the 2010 World Health Organization classification. Irinotecan-plus-cisplatin (IP) is used as first-line chemotherapy for extensive-disease (ED) small-cell lung cancer and its use is plausible for first-line chemotherapy in ED esophageal NEC. We retrospectively analyzed the efficacy and toxicity of IP for ED esophageal NEC.
  
  
  METHODS
  Patients with ED esophageal NEC treated with IP between 2000 and 2013 were retrospectively identified from our database. The end-points were objective response rate, progression-free survival (PFS) and overall survival (OS). Data on adverse events were also collected.
  
  
  RESULTS
  An objective response was achieved in 50% (95% confidence interval [CI]: 25% to 75%) of 12 identified patients. Median progression-free survival was 4.0 months (95% CI: 0.9 to 7.6) and overall survival was 12.6 months (95% CI: 4.6 to 28.6). Grade 3/4 hematological toxicities included leukopenia in 50% of patients and neutropenia in 67%. The rate of febrile neutropenia was 25%. No treatment-related deaths were observed.
  
  
  CONCLUSIONS
  IP appears acceptable as first-line chemotherapy for ED esophageal NEC.
authors.affiliation: Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan Department of Medical Oncology, Graduate School of Medicine, Chiba University Hospital, Chiba, Japan.
authors.forename: Hitomi Sumiyoshi
authors.initials: HS
authors.lastname: Okuma
authors.affiliation: Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan siwasa@ncc.go.jp.
authors.forename: Satoru
authors.initials: S
authors.lastname: Iwasa
authors.affiliation: Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Shoji
authors.affiliation: Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Atsuo
authors.initials: A
authors.lastname: Takashima
authors.affiliation: Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Natsuko
authors.initials: N
authors.lastname: Okita
authors.affiliation: Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Honma
authors.affiliation: Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Kato
authors.affiliation: Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Hamaguchi
authors.affiliation: Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Yasuhide
authors.initials: Y
authors.lastname: Yamada
authors.affiliation: Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Shimada
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D018278:Carcinoma, Neuroendocrine / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D002945:Cisplatin / Q000008:administration & dosage; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D000077146:Irinotecan; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D016896:Treatment Outcome
chemical_list: D000077146:Irinotecan; D002945:Cisplatin; D002166:Camptothecin
keywords: Cisplatin; esophageal cancer; extensive disease; irinotecan hydrochloride; neuroendocrine carcinoma