FOLFIRI regimen: an effective second-line chemotherapy after failure of etoposide-platinum combination in patients with neuroendocrine carcinomas grade 3

被引：146
作者：
Hentic, O. [1 ]
Hammel, P. [1 ]
Couvelard, A. [2 ]
Rebours, V. [1 ]
Zappa, M. [3 ]
Palazzo, M. [1 ]
Maire, F. [1 ]
Goujon, G. [1 ]
Gillet, A. [1 ]
Levy, P. [1 ]
Ruszniewski, P. [1 ]
机构：
[1] Hop Beaujon, Serv Gastroenterol Pancreatol, F-92110 Clichy, France
[2] Hop Beaujon, Serv Pathol, F-92110 Clichy, France
[3] Hop Beaujon, Serv Radiol, F-92110 Clichy, France
来源：
ENDOCRINE-RELATED CANCER | 2012年 / 19卷 / 06期
关键词：
PROGNOSTIC-FACTORS; PHASE-II; FLUOROURACIL FAILURE; CONSENSUS GUIDELINES; ENDOCRINE TUMORS; RANDOMIZED-TRIAL; LIVER METASTASES; IRINOTECAN; MANAGEMENT; CISPLATIN;
D O I：
10.1530/ERC-12-0002
中图分类号：
R73 [肿瘤学];
学科分类号：
100214 ;
摘要：
Patients with neuroendocrine carcinomas (NECs) grade 3 have a poor prognosis. Etoposide-platinum combination is the standard chemotherapy but the role of a second-line therapy remains unknown. Irinotecan alone or in combination has shown some efficacy in patients treated for small cell lung cancer which had pathological similarities with neuroendocine tumors. The aim of this study is to determine safety and efficacy of the FOLFIRI regimen in patients with NECs grade 3 after failure of etoposide-platinum combination. This study was retrospective, including patients with NECs grade 3 and treated with the FOLFIRI regimen after progression or toxicity of etoposide-platinum combination in first-line. Patients with Eastern Cooperative Oncology Group (ECOG) performance status >= 3 and/or serum alkaline phosphatase >= 5X upper limit of normal value (ULN) and/or bilirubin >= 1.5XULN were excluded. Among 39 patients who failed etoposide-platinum combination, 19 (49%; 12 women, median age 53 (29-78) years) received the FOLFIRI regimen with a median number of 6 (1-16) courses. Six patients (31%) had at least one episode of grades 3-4 toxicity (neutropenia, n=3; diarrhea, n=3) without toxic death. Six patients (31%) had objective response, 6 (31%) stable disease, and 7 (38%) tumor progression. Median progression-free survival under FOLFIRI was 4 months. Overall survival was 18 vs 6.8 months in noneligible patients. FOLFIRI regimen is a safe and potentially efficient chemotherapy given as second-line in patients with NECs grade 3 who remain in good condition and with correct liver tests after failure of etoposide-platinum combination. These results should be confirmed in a future prospective study. Endocrine-Related Cancer (2012) 19 751-757
引用
收藏
页码：751 / 757
页数：7
相关论文
共 28 条
[1]   Poorly-differentiated endocrine carcinomas of midgut and hindgut origin [J].
Ahlman, Hakan ;
Nilsson, Ola ;
McNicol, Anne M. ;
Ruszniewski, Philippe ;
Niederle, Bruno ;
Ricke, Jens ;
Jensen, Robert ;
Kos-Kudla, Beata ;
Oberg, Kjell ;
O'Connor, Juan M. ;
Pavel, Marianne E. ;
Vullierme, Marie-Pierre .
NEUROENDOCRINOLOGY, 2008, 87 (01) :40-46
[2]   Prognostic factors at diagnosis and value of WHO classification in a mono-institutional series of 180 non-functioning pancreatic endocrine tumours [J].
Bettini, R. ;
Boninsegna, L. ;
Mantovani, W. ;
Capelli, P. ;
Bassi, C. ;
Pederzoli, P. ;
Delle Fave, G. F. ;
Panzuto, F. ;
Scarpa, A. ;
Falconi, M. .
ANNALS OF ONCOLOGY, 2008, 19 (05) :903-908
[3]   Phase II study of first-line FOLFIRI for progressive metastatic well-differentiated pancreatic endocrine carcinoma [J].
Brixi-Benmansour, Hedia ;
Jouve, Jean-Louis ;
Mitry, Emmanuel ;
Bonnetain, Franck ;
Landi, Bruno ;
Hentic, Olivia ;
Bedenne, Laurent ;
Cadiot, Guillaume .
DIGESTIVE AND LIVER DISEASE, 2011, 43 (11) :912-916
[4]   Randomised trial of irinotecan plus supportive care versus supportive care alone after fluorouracil failure for patients with metastatic colorectal cancer [J].
Cunningham, D ;
Pyrhönen, S ;
James, RD ;
Punt, CJA ;
Hickish, TF ;
Heikkila, R ;
Johannesen, TB ;
Starkhammar, H ;
Topham, CA ;
Awad, L ;
Jacques, C ;
Herait, P .
LANCET, 1998, 352 (9138) :1413-1418
[5]   A phase II study of irinotecan with 5-fluorouracil and leucovorin in patients with pretreated gastroenteropancreatic well-differentiated endocrine carcinomas [J].
Ducreux, M. P. ;
Boige, V. ;
Leboulleux, S. ;
Malka, D. ;
Kergoat, P. ;
Dromain, C. ;
Elias, D. ;
de Baere, T. ;
Sabourin, J. C. ;
Duvillard, P. .
ONCOLOGY, 2006, 70 (02) :134-140
[6]  
Fjällskog MLH, 2001, CANCER, V92, P1101, DOI 10.1002/1097-0142(20010901)92:5<1101::AID-CNCR1426>3.0.CO
[7]  
2-V
[8]   Phase II trial of paclitaxel, carboplatin, and etoposide in advanced poorly differentiated neuroendocrine carcinoma: A Minnie Pearl Cancer Research Network Study [J].
Hainsworth, John D. ;
Spigel, David R. ;
Litchy, Sharlene ;
Greco, F. Anthony .
JOURNAL OF CLINICAL ONCOLOGY, 2006, 24 (22) :3548-3554
[9]   Ki-67 index, tumor differentiation, and extent of liver involvement are independent prognostic factors in patients with liver metastases of digestive endocrine carcinomas [J].
Hentic, O. ;
Couvelard, A. ;
Rebours, V. ;
Zappa, M. ;
Dokmak, S. ;
Hammel, P. ;
Maire, F. ;
O'Toole, D. ;
Levy, P. ;
Sauvanet, A. ;
Ruszniewski, P. .
ENDOCRINE-RELATED CANCER, 2011, 18 (01) :51-59
[10]  
Langer C J, 2001, Oncology (Williston Park), V15, P15
123