Poorly Differentiated Neuroendocrine Tumors

Combination of Irinotecan and a Platinum Agent for Poorly Differentiated Neuroendocrine Carcinomas

“…In the two previously mentioned studies addressing the use of the same combination for patients with unselected PDNEC, treatment was well tolerated and no grade 5 toxicities were reported. 19,20 In contrast, in the series reported by Okita et al . including patients with gastric PDNEC, the rates of grade 3 or 4 neutropenia and diarrhea were 58% and 17%, respectively 25 .…”

“…2,5,15 Despite the remarkable advances in the management of neuroendocrine tumors with the use of sunitinib and everolimus, only patients with well and moderately differentiated NET were included in the prospective trials that approved these new agents 16-18 . Therefore, for this selected group of patients with PDNEC, the backbone of the treatment of neuroendocrine carcinomas still relies on combinations cytotoxic agents 19 . In a recent series of more than 300 individuals with gastrointestinal PDNEC, median survival for patients treated with palliative chemotherapy was 11 months, in contrast to 1 month for patients receiving best supportive care only 2 …”

Guidelines for the management of neuroendocrine tumours by the Brazilian gastrointestinal tumour group

“…NECs or G3 are rare and associated with poor prognosis, with a median OS of less than a year [ 104 ]. Retrospective studies suggest OS gains with adjuvant therapy [ 105 ]. For metastatic disease, platinum-based chemotherapy is considered standard [ 104 ], without apparent clinically relevant differences between cisplatin and carboplatin [ 106 ].…”

“…Consider definitive treatment with platinum-based chemotherapy combined with radiotherapy for locally advanced or unresectable tumours [ 105 ] [IVA].…”

“…Adjuvant chemotherapy with cisplatin (or carboplatin) associated with etoposide or irinotecan for 4–6 cycles can be considered in patients with good performance status after surgical resection [ 105 ] [IVC].…”