title: Chemotherapy for advanced poorly differentiated pancreatic neuroendocrine carcinoma.
abstract: Pancreatic neuroendocrine carcinoma (P-NEC) resembles small cell lung carcinoma in its biologic and clinical features, such as rapid growth and relatively high sensitivity to platinum-based chemotherapy. And, etoposide plus cisplatin (EP) or irinotecan plus cisplatin (IP), recommended by guidelines for the treatment of small cell lung carcinoma, has also been widely used for the treatment of unresectable NEC. Both regimens have been demonstrated to show favorable efficacy and have been acknowledged as de facto standard regimens for unresectable NEC, although it remains unclear which of the two regimens might yield more favorable outcomes. Therefore, a phase III trial of EP vs. IP has been planned for unresectable gastrointestinal, hepatobiliary or pancreatic NEC by the Japan Clinical Oncology Group. For patients with unresectable NEC who are refractory or intolerant to these regimens, no standard regimens have been established. Everolimus, an mTOR inhibitor, is likely to be effective in such patients, as there have been sporadic reports of the usefulness of everolimus in the treatment of P-NEC. A multicenter phase II trial is underway to elucidate the efficacy and safety of everolimus in patients with P-NEC who are refractory or intolerant to EP or IP.
authors.affiliation: Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, 6-56-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan. masikeda@east.ncc.go.jp.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Ikeda
authors.affiliation: Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, 6-56-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Okuyama
authors.affiliation: Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, 6-56-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Takahashi
authors.affiliation: Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, 6-56-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
authors.forename: Izumi
authors.initials: I
authors.lastname: Ohno
authors.affiliation: Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, 6-56-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Shimizu
authors.affiliation: Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, 6-56-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Mitsunaga
authors.affiliation: Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Kondo
authors.affiliation: Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Chigusa
authors.initials: C
authors.lastname: Morizane
authors.affiliation: Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Ueno
authors.affiliation: Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Takuji
authors.initials: T
authors.lastname: Okusaka
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D018278:Carcinoma, Neuroendocrine / Q000188:drug therapy*; D002945:Cisplatin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D005047:Etoposide / Q000008:administration & dosage; D000068338:Everolimus / Q000008:administration & dosage; D006801:Humans; D000077146:Irinotecan; D010190:Pancreatic Neoplasms / Q000188:drug therapy*
chemical_list: D000970:Antineoplastic Agents; D000972:Antineoplastic Agents, Phytogenic; D005047:Etoposide; D000077146:Irinotecan; D000068338:Everolimus; D002945:Cisplatin; D002166:Camptothecin
keywords: Chemotherapy; Cisplatin; Everolimus; Ki-67; Neuroendocrine carcinoma