title: Amrubicin Monotherapy for Patients with Platinum-Refractory Gastroenteropancreatic Neuroendocrine Carcinoma.
abstract: Objective. Patients with gastroenteropancreatic neuroendocrine carcinoma (NEC) have a poor prognosis. Platinum-based combination chemotherapy is commonly used as first-line treatment; however, the role of salvage chemotherapy remains unknown. This study aimed to analyze the efficacy and safety of amrubicin monotherapy in patients with platinum-refractory gastroenteropancreatic NEC. Methods. Among 22 patients with advanced gastroenteropancreatic NEC, 10 received amrubicin monotherapy between September 2007 and May 2014 after failure of platinum-based chemotherapy. The efficacy and toxicity of the treatment were analyzed retrospectively. Results. Eight males and two females (median age, 67 years (range, 52-78)) received platinum-based chemotherapy, including cisplatin plus irinotecan (n = 7, 70%), cisplatin plus etoposide (n = 2, 20%), and carboplatin plus etoposide (n = 1, 10%) before amrubicin therapy. Median progression-free survival and overall survival after amrubicin therapy were 2.6 and 5.0 months, respectively. Two patients had partial response (20% response rate), and their PFS were 6.2 months and 6.3 months, respectively. Furthermore, NEC with response for amrubicin had characteristics with a high Ki-67 index and receipt of prior chemotherapy with cisplatin and irinotecan. Grade 3-4 neutropenia and anemia were observed in four and five patients, respectively. Conclusion. Amrubicin monotherapy appears to be potentially active and well-tolerated for platinum-refractory gastroenteropancreatic NEC.
authors.affiliation: Department of Gastroenterology and Hematology, Faculty of Medicine, University of Toyama, Sugitani, Toyama 2630, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Ando
authors.affiliation: Department of Gastroenterology and Hematology, Faculty of Medicine, University of Toyama, Sugitani, Toyama 2630, Japan.
authors.forename: Ayumu
authors.initials: A
authors.lastname: Hosokawa
authors.affiliation: Department of Gastroenterology and Hematology, Faculty of Medicine, University of Toyama, Sugitani, Toyama 2630, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Yoshita
authors.affiliation: Department of Gastroenterology and Hematology, Faculty of Medicine, University of Toyama, Sugitani, Toyama 2630, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Ueda
authors.affiliation: Department of Gastroenterology and Hematology, Faculty of Medicine, University of Toyama, Sugitani, Toyama 2630, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Kajiura
authors.affiliation: Department of Gastroenterology and Hematology, Faculty of Medicine, University of Toyama, Sugitani, Toyama 2630, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mihara
authors.affiliation: Department of Gastroenterology and Hematology, Faculty of Medicine, University of Toyama, Sugitani, Toyama 2630, Japan.
authors.forename: Sohachi
authors.initials: S
authors.lastname: Nanjo
authors.affiliation: Department of Gastroenterology and Hematology, Faculty of Medicine, University of Toyama, Sugitani, Toyama 2630, Japan.
authors.forename: Haruka
authors.initials: H
authors.lastname: Fujinami
authors.affiliation: Department of Gastroenterology and Hematology, Faculty of Medicine, University of Toyama, Sugitani, Toyama 2630, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Nishikawa
authors.affiliation: Department of Gastroenterology and Hematology, Faculty of Medicine, University of Toyama, Sugitani, Toyama 2630, Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Ogawa
authors.affiliation: Department of Diagnostic Pathology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Sugitani, Toyama 2630, Japan.
authors.forename: Takahiko
authors.initials: T
authors.lastname: Nakajima
authors.affiliation: Department of Diagnostic Pathology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Sugitani, Toyama 2630, Japan.
authors.forename: Johji
authors.initials: J
authors.lastname: Imura
authors.affiliation: Department of Gastroenterology and Hematology, Faculty of Medicine, University of Toyama, Sugitani, Toyama 2630, Japan.
authors.forename: Toshiro
authors.initials: T
authors.lastname: Sugiyama