Treatment of neuroendocrine tumours with infusional 5-fluorouracil, folinic acid and streptozocin

Gonzalez, Marielle; Biswas, Swethajit; Clifton, Lisa G.; Corrie, Pippa

doi:10.1038/sj.bjc.6601167

Cited by 33 publications

(11 citation statements)

References 10 publications

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“…In patients with aggressive tumor biology (highly proliferative and/or poorly differentiated) or metastatic lesions without uptake on SRS images, systemic chemotherapy can be considered (86,136,143). Even without prolonged remission (median of 6 months), cytotoxic chemotherapy can produce a response rate of 42%-67% for highly proliferative NETs (Ki-67 index .…”

Section: State Of the Art: Gastroenteropancreatic Neuroendocrine Tumorsmentioning

confidence: 99%

Gastroenteropancreatic Neuroendocrine Tumors: Role of Imaging in Diagnosis and Management

Sahani¹,

Bonaffini²,

Castillo³

et al. 2013

Radiology

163

119

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Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are a heterogeneous group of neoplasms that arise from cells of the diffuse neuroendocrine system and are characterized by a wide spectrum of clinical manifestations. All NETs are potentially malignant but differ in their biologic characteristics and the probability of metastatic disease. The pathologic classification of these tumors relies on their proliferation and differentiation. In the past decades, several nomenclatures have been proposed to stratify neuroendocrine tumors, but the World Health Organization classification is the one that is most widely accepted and used. The diagnosis of neuroendocrine tumor relies on clinical manifestation, laboratory parameters, imaging features, and tissue biomarkers in a biopsy specimen. With improved understanding of the natural history and lesion biology, management of GEP-NETs has also evolved. Although surgery remains the only potentially curative therapy for patients with primary GEP-NETs, other available treatments include chemotherapy, interferon, somatostatin analogs, and targeted therapies. Recent improvements in both morphologic and functional imaging methods have contributed immensely to patient care. Morphologic imaging with contrast agent-enhanced multidetector computed tomography and magnetic resonance imaging is most widely used for initial evaluation and staging of disease in these patients, whereas functional imaging techniques are useful both for detection and prognostic evaluation and can change treatment planning.

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Section: State Of the Art: Gastroenteropancreatic Neuroendocrine Tumorsmentioning

confidence: 99%

Gastroenteropancreatic Neuroendocrine Tumors: Role of Imaging in Diagnosis and Management

Sahani¹,

Bonaffini²,

Castillo³

et al. 2013

Radiology

163

119

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“…On the basis of randomized published studies (Moertel & Hanley 1979, Engstrom et al 1984, Haller et al 1990, Sun et al 2005), the efficacy of a combination of STZ and fluoropyrimidine is modest, but, in the absence of other active chemotherapy regimen, this combination has been widely used for the treatment of advanced carcinoid tumors in case of progressive disease (Conseil Scientifique de la FFCD 2003). It has been shown that this regimen has an acceptable toxicity profile in the management of metastatic carcinoids (Gonzalez et al 2003). Moreover, 5-FU-STZ combination was still a recommended option at the end of the study for patients with extrahepatic metastasis or hepatic metastasis after failure of transarterial hepatic chemoembolization even if the recent ENETS Consensus Conference did not recommend chemotherapy in midgut tumors (Eriksson et al 2008).…”

Section: Discussionmentioning

confidence: 99%

Phase III trial of chemotherapy using 5-fluorouracil and streptozotocin compared with interferon α for advanced carcinoid tumors: FNCLCC–FFCD 9710

Dahan¹,

Bonnetain²,

Rougier³

et al. 2009

Endocrine-Related Cancer

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The aim of this randomized multicenter phase III trial was to compare chemotherapy and interferon (IFN) in patients with metastatic carcinoid tumors. Patients with documented progressive, unresectable, metastatic carcinoid tumors were randomized between 5-fluorouracil plus streptozotocin (day 1-5) and recombinant IFN-a-2a (3 MU!3 per week). Primary endpoint was progression-free survival (PFS). From February 1998 to June 2004, 64 patients were included. The two arms were well matched for median age, sex ratio, PS 0-1, previous chemotherapy, surgery, or radiotherapy. The median PFS for chemotherapy was 5.5 months versus 14.1 for IFN (hazard ratioZ0.75 (0.41-1.36)). Overall survival (OS), tolerance, and effects on carcinoid symptoms were not significantly different. Despite a trend in favor of IFN, there was no difference in PFS and OS in advanced metastatic carcinoid tumors and therapeutic effect of both treatments was mild.

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“…A chemotherapy regimen consisting of doxorubicin, streptozocin and 5FU has great and significant activity in patients with locally advanced and metastatic pancreatic endocrine carcinomas (29,30). A combination of streptozocin with the De Gramont infusional 5FU regimen is also efficacious with low toxicity profile for the treatment of unresectable NETs (31). After the diagnosis of operable colon cancer, our patient had surgery.…”

Section: Discussionmentioning

confidence: 99%

A patient with nonfunctional pancreatic neuroendocrine tumor and incidental metachronous colon carcinoma detected by positron emission tomography: Case report

Demirkan

Ünek²,

Eriksson

et al. 2009

Turk J Gastroenterol

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Treatment of neuroendocrine tumours with infusional 5-fluorouracil, folinic acid and streptozocin

Cited by 33 publications

References 10 publications

Gastroenteropancreatic Neuroendocrine Tumors: Role of Imaging in Diagnosis and Management

Gastroenteropancreatic Neuroendocrine Tumors: Role of Imaging in Diagnosis and Management

Phase III trial of chemotherapy using 5-fluorouracil and streptozotocin compared with interferon α for advanced carcinoid tumors: FNCLCC–FFCD 9710

A patient with nonfunctional pancreatic neuroendocrine tumor and incidental metachronous colon carcinoma detected by positron emission tomography: Case report

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