title: Oxaliplatin-Fluoropyrimidine Chemotherapy Plus Bevacizumab in Advanced Neuroendocrine Tumors: An Analysis of 2 Phase II Trials.
abstract: This study aimed to determine the safety and effectiveness of bevacizumab (B) plus FOLFOX or CAPOX in advanced neuroendocrine tumors (NETs) by performing a combined analysis of 2 separate prospective phase II studies.
  
  
  
  In the FOLFOX/B study, patients received chemotherapy without scheduled breaks in 3 cohorts: carcinoid, pancreatic NET, and poorly differentiated neuroendocrine carcinomas. In the CAPOX/B study, NET subtypes were pooled, and patients were treated with 4 cycles of CAPOX/B followed by optional maintenance therapy. Primary end points were radiographic response rate (RR) after 12 cycles (FOLFOX/B), progression-free survival (PFS) (CAPOX/B), and toxicity (both).
  
  
  
  Seventy-six patients (FOLFOX/B, n = 36; CAPOX/B, n = 40) were included. In FOLFOX/B, RR for carcinoid at 12 cycles 3/22 (13.6%), median PFS 19.3 months; RR for pancreatic NET at 12 cycles 4/12 (41.7%), median PFS 21 months; RR 1/2 (50%) in poorly differentiated neuroendocrine carcinoma; pooled RR 25% and median PFS 21 months (1-year PFS 68%). In CAPOX/B (pooled NET), RR 18% and median PFS 16.7 months (1-year PFS 65%). Predictable toxicity was observed.
  
  
  
  Neither study met its primary end point, but radiographic responses and prolonged disease stability in previously progressing patients suggest that selected patients with NET may benefit from oxaliplatin-fluoropyrimidine chemotherapy plus bevacizumab and that the combination may warrant further study.
authors.affiliation: From the *Department of Medicine, Stanford University School of Medicine, Stanford, CA; †Department of Public Health Sciences, University of Miami School of Medicine, Miami, FL; ‡Department of Oncology, Kaiser Permanente Medical Center, Vallejo; §Department of Oncology, Kaiser Permanente Medical Center, Santa Clara; Departments of ∥Medicine, and ¶Biostatistics and Computational Biology, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA.
authors.forename: Pamela L
authors.initials: PL
authors.lastname: Kunz
authors.forename: Raymond R
authors.initials: RR
authors.lastname: Balise
authors.forename: Louis
authors.initials: L
authors.lastname: Fehrenbacher
authors.forename: Minggui
authors.initials: M
authors.lastname: Pan
authors.forename: Alan P
authors.initials: AP
authors.lastname: Venook
authors.forename: George A
authors.initials: GA
authors.lastname: Fisher
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Tempero
authors.forename: Andrew H
authors.initials: AH
authors.lastname: Ko
authors.forename: W Michael
authors.initials: WM
authors.lastname: Korn
authors.forename: Jimmy
authors.initials: J
authors.lastname: Hwang
authors.forename: Emily K
authors.initials: EK
authors.lastname: Bergsland
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols; D000068258:Bevacizumab; D000069287:Capecitabine; D005472:Fluorouracil; D006801:Humans; D018358:Neuroendocrine Tumors / Q000188:drug therapy*; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D011446:Prospective Studies
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D000068258:Bevacizumab; D000069287:Capecitabine; D005472:Fluorouracil