title: Irinotecan plus cisplatin followed by octreotide long-acting release maintenance treatment in advanced gastroenteropancreatic neuroendocrine carcinoma: IPO-NEC study.
abstract: There have been very few prospective studies of first-line chemotherapy on advanced gastroenteropancreatic neuroendocrine carcinoma (GEP-NEC). This phase II study assessed the activity and safety of irinotecan plus cisplatin (IP) followed by octreotide long-acting release (LAR) maintenance treatment in advanced GEP-NEC. Forty patients were treated and eighteen patients (45.0%) had a partial response. The median progression-free survival (PFS) and overall survival (OS) were 5.7 months and 12.9 months, respectively. Because GEP-NECs are heterogeneous, a subgroup analysis was conducted by dividing all patients into a high proliferation neuroendocrine tumor (NET) group (well differentiated neuroendocrine neoplasms with a Ki-67 level between 20-60%) or a poorly differentiated NEC (PDNEC) group. Compared with the PDNEC group, the patients in high proliferation NET group had a lower response rate (0% versus 51.4%) but longer PFS (8.9 versus 5.7 months) and received more octreotide LAR treatment (median cycles, 7 versus 3). The most common toxicities included grade 3/4 leukopenia/neutropenia (60%), nausea/vomiting (17.5%) and diarrhea (12.5%). Therefore, IP is an active regimen in patients with advanced GEP-PDNEC and should probably not be given to patients with advanced high proliferative NET. The benefit of octreotide LAR maintenance therapy on high proliferation NETs requires further study.
authors: Department of GI Oncology, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, China.
authors: Jie
authors: J
authors: Li
authors: Department of GI Oncology, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, China.
authors: Ming
authors: M
authors: Lu
authors: Department of GI Oncology, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, China.
authors: Zhihao
authors: Z
authors: Lu
authors: Department of Pathology, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, China.
authors: Zhongwu
authors: Z
authors: Li
authors: Department of Pathology, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, China.
authors: Yiqiang
authors: Y
authors: Liu
authors: Center of clinical oncology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.
authors: Li
authors: L
authors: Yang
authors: Department of GI Oncology, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, China.
authors: Jian
authors: J
authors: Li
authors: Department of GI Oncology, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, China.
authors: Xiaotian
authors: X
authors: Zhang
authors: Department of GI Oncology, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, China.
authors: Jun
authors: J
authors: Zhou
authors: Department of GI Oncology, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, China.
authors: Xicheng
authors: X
authors: Wang
authors: Department of GI Oncology, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, China.
authors: Jifang
authors: J
authors: Gong
authors: Department of GI Oncology, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, China.
authors: Jing
authors: J
authors: Gao
authors: Department of GI Oncology, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, China.
authors: Yan
authors: Y
authors: Li
authors: Department of GI Oncology, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, China.
authors: Lin
authors: L
authors: Shen
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D015415:Biomarkers; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D002945:Cisplatin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D060828:Induction Chemotherapy; D007414:Intestinal Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D000077146:Irinotecan; D060046:Maintenance Chemotherapy; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D018358:Neuroendocrine Tumors / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D015282:Octreotide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D000077146:Irinotecan; D002945:Cisplatin; D015282:Octreotide; D002166:Camptothecin
keywords: cisplatin; gastroenteropancreatic neuroendocrine carcinomas; heterogeneous; irinotecan; octreotide long-acting release