title: Amrubicin in patients with platinum-refractory metastatic neuroendocrine carcinoma and mixed adenoneuroendocrine carcinoma of the gastrointestinal tract.
abstract: Although the same treatment strategy as used for small cell lung cancer, including second-line chemotherapy, is generally applied to metastatic neuroendocrine carcinoma (NEC) and mixed adenoneuroendocrine carcinoma (MANEC) of the gastrointestinal tract (GIT; GIT-NEC/MANEC), the efficacy of amrubicin (AMR) for GIT-NEC/MANEC is not well known. We retrospectively analyzed platinum-refractory GIT-NEC/MANEC patients who received AMR between February 2004 and July 2012 at the National Cancer Center Hospital. The AMR dose administered was 30-45 mg/m on days 1-3 every 3-4 weeks. The overall response rate according to Response Evaluation Criteria in Solid Tumors guidelines, version 1.0, progression-free survival, overall survival, and adverse events by National Cancer Institute-Common Terminology Criteria for Adverse Events guidelines, version 4.0 were evaluated. Nineteen patients received AMR. The response rate for 16 assessable patients was 18.8% (95% confidence interval, 4.1-45.7), the median progression-free survival was 3.8 months (2.3-5.3), and the median overall survival was 7.7 months (7.1-8.2). Grade 3/4 neutropenia occurred in 52.6% of patients and febrile neutropenia occurred in 10.5%. Other nonhematological toxicities were mild and treatment-related deaths were not observed. AMR may have a modest effect, with tolerable toxicities, on patients with platinum-refractory GIT-NEC/MANEC. Further prospective evaluations are warranted.
authors.affiliation: aDivision of Gastrointestinal Medical Oncology bDivision of Pharmacy cDivision of Clinical Pathology, National Cancer Center Hospital, Tokyo dDepartment of Gastroenterology and Hepatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Araki
authors.forename: Atsuo
authors.initials: A
authors.lastname: Takashima
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Hamaguchi
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Honma
authors.forename: Satoru
authors.initials: S
authors.lastname: Iwasa
authors.forename: Natsuko
authors.initials: N
authors.lastname: Okita
authors.forename: Ken
authors.initials: K
authors.lastname: Kato
authors.forename: Yasuhide
authors.initials: Y
authors.lastname: Yamada
authors.forename: Hironobu
authors.initials: H
authors.lastname: Hashimoto
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Taniguchi
authors.forename: Ryoji
authors.initials: R
authors.lastname: Kushima
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nakao
authors.forename: Narikazu
authors.initials: N
authors.lastname: Boku
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Shimada
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018943:Anthracyclines / Q000009:adverse effects / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D018278:Carcinoma, Neuroendocrine / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017671:Platinum Compounds / Q000627:therapeutic use; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D018943:Anthracyclines; D000970:Antineoplastic Agents; D017671:Platinum Compounds; C055866:amrubicin