Temozolomide-Capecitabine Chemotherapy for Neuroendocrine Neoplasms: The Dilemma of Treatment Duration

Lamarca, Ángela; Barriuso, Jorge; McNamara, Mairéad G.; Mansoor, Wasat; Valle, Juan W

doi:10.1159/000503392

Cited by 8 publications

(12 citation statements)

References 8 publications

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“…Significantly increased treatment related G3-4 AEs in the CAPTEM arm were neutropenia (13 vs. 4%), nausea (8 vs. 0%), vomiting (8 vs. 0%), diarrhea (8 vs. 0%) and fatigue (8 vs. 1%). Treatment in the E2211 trial was continued until disease progression or unacceptable toxicity to a maximum of 13 cycles, although the optimal treatment duration is a matter of debate [32,33].…”

Section: Pancreatic Netsmentioning

confidence: 99%

Chemotherapy in NEN: still has a role?

Espinosa-Olarte

Salvia

Riesco-Martinez

et al. 2021

Rev Endocr Metab Disord

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Neuroendocrine neoplasms (NENs) comprise a broad spectrum of tumors with widely variable biological and clinical behavior. Primary tumor site, extent of disease, tumor differentiation and expression of so matostatin receptors, proliferation and growth rates are the major prognostic factors that determine the therapeutic strategy. Treatment options for advanced disease have considerably expanded in recent years, particularly for well differentiated tumors (NETs). Novel drugs approved over the past decade in this context include somatostatin analogues and 177Lu-oxodotreotide for somatostatin-receptor-positive gastroenteropancreatic (GEP) NETs, sunitinib for pancreatic NETs (P-NETs), and everolimus for P-NETs and non-functioning lung or gastrointestinal NETs. Nevertheless, chemotherapy remains an essential component of the treatment armamentarium of patients with NENs, particularly of patients with P-NETs or those with bulky, symptomatic or rapidly progressive tumors (generally G3 or high-G2 NENs). In this manuscript we will comprehensively review available evidence related to the use of chemotherapy in lung and GEP NENs and will critically discuss its role in the treatment algorithm of this family of neoplasms.

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Section: Pancreatic Netsmentioning

confidence: 99%

Chemotherapy in NEN: still has a role?

Espinosa-Olarte

Salvia

Riesco-Martinez

et al. 2021

Rev Endocr Metab Disord

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Section: Chemotherapie Bei Netunclassified

“…Die optimale Therapiedauer der Chemotherapie bei pNET ist bisher nicht definiert und wird kontrovers diskutiert [23,24]. Als Mindesttherapiedauer werden 6 Monate empfohlen [3], das weitere Vorgehen muss individualisiert festgelegt werden: Chemotherapie bis zur Tumorprogression/Toxizität, Chemotherapie für 6 bis 12 Monate und anschließende Therapiepause mit watch & wait [23] oder anschließende Erhaltungstherapie zum Beispiel mit Lanreotid in Analogie zur REMINET Studie [19] sind mögliche Therapiestrategien. Bei Tumorprogress nach Chemotherapiepause führte eine Reexposition gegenüber einem erneuten Chemotherapieregime mit alkylierenden Substanzen in der retrospektiven Serie von De Rycke et al [25] nur noch zu einer Tumorkontrolle mit best response stable disease 62 % und PFS 9,2 Monate.…”

Section: Chemotherapie Bei Netunclassified

Medikamentöse Systemtherapie bei Neuroendokrinen Neoplasien des GastroEnteropankreatischen Systems

Auernhammer

Bock

Westphalen

et al. 2021

Der Nuklearmediziner

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ZusammenfassungNeuroendokrine Neoplasien (NEN) des GastroEnteroPankreatischens Systems (GEP-Systems) im inoperablen fortgeschrittenen Stadium erfordern eine differenzierte Systemtherapie abhängig von Klassifikation und Grading, Primärtumorlokalisation, Somatostatinrezeptorexpression, Tumordynamik, Tumorlast und Funktionalität. Somatostatinanaloga, Peptid Rezeptor Radionuklid Therapie (PRRT), Streptozotocin- oder Temozolomid-basierte Chemotherapieprotokolle und molekular zielgerichtete Therapien mit Everolimus oder Sunitinib sind jeweils etablierte Therapieoptionen bei verschiedenen neuroendokrinen Tumoren (NET). Neue vielversprechende Therapieansätze sind Multityrosinkinaseinhibitoren (TKIs) wie Surufatinib, Cabozantinib, Lenvatinib oder Pazopanib. Cisplatin/Etoposid ist die Standard 1st-line Chemotherapie bei neuroendokrinen Karzinomen (NEC). Bisher zeigten die meisten klinischen Studien zur Immuntherapie bei NET G1/G2 enttäuschende Studienergebnisse, aber die mögliche Effektivität der kombinierten Checkpoint-Inhibition sollte bei höherproliferativen NEN G3 weiter untersucht werden. Molekularpathologie mit Next Generation Sequencing (NGS) und personalisierte Therapie spielen auch bei den NEN eine zunehmende Rolle.

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“…The study showed an improvement in PFS in favour of TemCap (median PFS 22.7 vs. 14.4 months), regardless of the tumour grade (p-value 0.410); of note there was a higher prevalence of G1 patients in the TemCap arm. Toxicity is mainly in the form of myelosuppression, which raises the issue of the optimal length of therapy [96].…”

Section: Evidence Supporting the Use Of Chemotherapymentioning

confidence: 99%

Systemic Treatment Selection for Patients with Advanced Pancreatic Neuroendocrine Tumours (PanNETs)

Megdanova-Chipeva

Lamarca

Backen

et al. 2020

Cancers

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Pancreatic neuroendocrine tumours (PanNETs) are rare diseases and a good example of how research is not only feasible, but also of crucial importance in the scenario of rare tumours. Many clinical trials have been performed over the past two decades expanding therapeutic options for patients with advanced PanNETs. Adequate management relies on optimal selection of treatment, which may be challenging for clinicians due to the fact that multiple options of therapy are currently available. A number of therapies already exist, which are supported by data from phase III studies, including somatostatin analogues and targeted therapies (sunitinib and everolimus). In addition, chemotherapy remains an option, with temozolomide and capecitabine being one of the most popular doublets to use. Peptide receptor radionuclide therapy was successfully implemented in patients with well-differentiated gastro-entero-pancreatic neuroendocrine tumours, but with certain questions waiting to be solved for the management of PanNETs. Finally, the role of immunotherapy is still poorly understood. In this review, the data supporting current systemic treatment options for locally advanced or metastatic PanNETs are summarized. Strategies for treatment selection in patients with PanNETs based on patient, disease, or drug characteristics is provided, as well as a summary of current evidence on prognostic and predictive biomarkers. Future perspectives are discussed, focusing on current and forthcoming challenges and unmet needs of patients with these rare tumours.

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Temozolomide-Capecitabine Chemotherapy for Neuroendocrine Neoplasms: The Dilemma of Treatment Duration

Cited by 8 publications

References 8 publications

Chemotherapy in NEN: still has a role?

Chemotherapy in NEN: still has a role?

Medikamentöse Systemtherapie bei Neuroendokrinen Neoplasien des GastroEnteropankreatischen Systems

Systemic Treatment Selection for Patients with Advanced Pancreatic Neuroendocrine Tumours (PanNETs)

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