Temozolomide alone or in combination with capecitabine in patients with advanced neuroendocrine neoplasms: an Italian multicenter real-world analysis

Spada, Francesca; Maisonneuve, Patrick; Fumagalli, Caterina; Marconcini, Riccardo; Gelsomino, Fabio; Antonuzzo, Lorenzo; Campana, Davide; Puliafito, Ivana; Rossi, Giulio; Faviana, Pinuccia; Messerini, Luca; Barberis, Massimo; Fazio, Nicola

doi:10.1007/s12020-020-02421-2

Cited by 14 publications

(16 citation statements)

References 40 publications

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“…Poorer performance status is reported to be significantly associated with decreased PFS/OS with chemotherapy in panNEN patients [ 302 , 303 , 304 , 305 , 306 , 307 ], as well as those with G3 tumors [ 298 , 308 ] ( Table 4 ). Higher age [ 304 , 305 , 309 , 310 , 311 ] and the prior lack of primary tumor resection [ 302 , 306 , 312 , 313 ] are also reported to correlate with worse outcomes with chemotherapy, while the effect of functional status remains controversial [ 302 , 312 ].…”

Section: Predictive Factors For Response To Chemotherapy In Advanced ...mentioning

confidence: 99%

“…This is consistent with another study that analyzed 70 patients G3 panNETs/NECs and reported a Ki-67 value of >55% as an independent predictor for poor prognosis [ 295 ] post platinum-based chemotherapy. It is also reported that within G3 NENs, patients with poorly-differentiated tumors had a significantly higher rate of radiological response/stabilization, but a shorter OS with chemotherapy [ 295 , 299 , 307 , 319 , 323 , 324 , 325 , 326 ]. The importance of the differences in differentiation is emphasized in the latest 2017 WHO classification system for panNENs (i.e., G3 NETs vs. G3 NECs) [ 294 ], as mentioned above, which will help clinicians to predict responsiveness to platinum-based chemotherapy, specifically in patients with G3 tumors.…”

Section: Predictive Factors For Response To Chemotherapy In Advanced ...mentioning

confidence: 99%

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Predictive Factors for Resistant Disease with Medical/Radiologic/Liver-Directed Anti-Tumor Treatments in Patients with Advanced Pancreatic Neuroendocrine Neoplasms: Recent Advances and Controversies

Lee

Ramos-Álvarez

Jensen

2022

Cancers

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Purpose: Recent advances in the diagnosis, management and nonsurgical treatment of patients with advanced pancreatic neuroendocrine neoplasms (panNENs) have led to an emerging need for sensitive and useful prognostic factors for predicting responses/survival. Areas covered: The predictive value of a number of reported prognostic factors including clinically-related factors (clinical/laboratory/imaging/treatment-related factors), pathological factors (histological/classification/grading), and molecular factors, on therapeutic outcomes of anti-tumor medical therapies with molecular targeting agents (everolimus/sunitinib/somatostatin analogues), chemotherapy, radiological therapy with peptide receptor radionuclide therapy, or liver-directed therapies (embolization/chemoembolization/radio-embolization (SIRTs)) are reviewed. Recent findings in each of these areas, as well as remaining controversies and uncertainties, are discussed in detail, particularly from the viewpoint of treatment sequencing. Conclusions: The recent increase in the number of available therapeutic agents for the nonsurgical treatment of patients with advanced panNENs have raised the importance of prognostic factors predictive for therapeutic outcomes of each treatment option. The establishment of sensitive and useful prognostic markers will have a significant impact on optimal treatment selection, as well as in tailoring the therapeutic sequence, and for maximizing the survival benefit of each individual patient. In the paper, the progress in this area, as well as the controversies/uncertainties, are reviewed.

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Section: Predictive Factors For Response To Chemotherapy In Advanced ...mentioning

confidence: 99%

Section: Predictive Factors For Response To Chemotherapy In Advanced ...mentioning

confidence: 99%

Predictive Factors for Resistant Disease with Medical/Radiologic/Liver-Directed Anti-Tumor Treatments in Patients with Advanced Pancreatic Neuroendocrine Neoplasms: Recent Advances and Controversies

Lee

Ramos-Álvarez

Jensen

2022

Cancers

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“…Ostwal et al [ 132 ] included in their series of 29 NENs G2-G3 also 12 Sb-NENs, obtaining a median PFS for the overall cohort of 33.7 mo. Spada et al [ 133 ] analyzed data regarding 170 NETs treated with temozolomide-based chemotherapy, including 21 gastrointestinal primary cases and G1 cases. Objective response of the overall population was 28%, median OS 35.6 mo, and median PFS 14.7 mo.…”

Section: Advanced or Metastatic Diseasementioning

confidence: 99%

“…Of these, O6-methylguanine accounts for many of their cytotoxic effects and can be repaired by the O6-methylguanine-methyltransferase (MGMT). Approximately half of Pan-NETs are MGMT-deficient, as determined by impaired tumor MGMT expression or by MGMT promoter methylation[ 133 ]. An open issue is whether the MGMT deficiency may be a relevant biomarker for increased response and improved survival in these patients.…”

Section: Advanced or Metastatic Diseasementioning

confidence: 99%

Therapeutic strategies for gastroenteropancreatic neuroendocrine neoplasms: State-of-the-art and future perspectives

Merola¹,

Michielan²,

Rozzanigo³

et al. 2022

WJGS

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Although gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) have always been considered rare tumors, their incidence has risen over the past few decades. They represent a highly heterogeneous group of neoplasms with several prognostic factors, including disease stage, proliferative index (Ki67), and tumor differentiation. Most of these neoplasms express somatostatin receptors on the cell surface, a feature that has important implications in terms of prognosis, diagnosis, and therapy. Although International Guidelines propose algorithms aimed at guiding therapeutic strategies, GEP-NEN patients are still very different from one another, and the need for personalized treatment continues to increase. Radical surgery is always the best option when feasible; however, up to 80% of cases are metastatic upon diagnosis. Regarding medical treatments, as GEP-NENs are characterized by relatively long overall survival, multiple therapy lines are adopted during the lifetime of these patients, but the optimum sequence to be followed has never been clearly defined. Furthermore, although new molecular markers aimed at predicting the response to therapy, as well as prognostic scores, are currently being studied, their application is still far from being part of daily clinical practice. As they represent a complex disease, with therapeutic protocols that are not completely standardized, GEP-NENs require a multidisciplinary approach. This review will provide an overview of the available therapeutic options for GEP-NENs and attempts to clarify the possible approaches for the management of these patients and to discuss future perspectives in this field.

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“…As for chemotherapy, temozolomide-based chemotherapy can be used in rapidly progressive or high tumor burden well differentiated NENs mainly from the pancreas. Although the low level of literature evidence due to the heterogeneity of the selected population, the type of studies, mainly retrospective, and the potential risk of biases, temozolomide-based chemotherapy seems to be active, including for functioning NEN patients [140].…”

Section: Othermentioning

confidence: 99%

Carcinoid Syndrome and Hyperinsulinemic Hypoglycemia Associated with Neuroendocrine Neoplasms: A Critical Review on Clinical and Pharmacological Management

et al. 2021

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The carcinoid syndrome (CS) and hyperinsulinemic hypoglycemia (HH) represent two of the most common clinical syndromes associated with neuroendocrine neoplasms (NENs). The former is mainly related to the serotonin secretion by a small bowel NEN, whereas the latter depends on an insulin hypersecretion by a pancreatic insulinoma. Both syndromes/conditions can affect prognosis and quality of life of patients with NENs. They are often diagnosed late when patients become strongly symptomatic. Therefore, their early detection and management are a critical step in the clinical management of NEN patients. A dedicated and experienced multidisciplinary team with appropriate therapeutic strategies is needed and should be encouraged to optimize clinical outcomes. This review aims to critically analyze clinical features, evidence and treatment options of CS and HH and therefore to improve their management.

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Temozolomide alone or in combination with capecitabine in patients with advanced neuroendocrine neoplasms: an Italian multicenter real-world analysis

Cited by 14 publications

References 40 publications

Predictive Factors for Resistant Disease with Medical/Radiologic/Liver-Directed Anti-Tumor Treatments in Patients with Advanced Pancreatic Neuroendocrine Neoplasms: Recent Advances and Controversies

Predictive Factors for Resistant Disease with Medical/Radiologic/Liver-Directed Anti-Tumor Treatments in Patients with Advanced Pancreatic Neuroendocrine Neoplasms: Recent Advances and Controversies

Therapeutic strategies for gastroenteropancreatic neuroendocrine neoplasms: State-of-the-art and future perspectives

Carcinoid Syndrome and Hyperinsulinemic Hypoglycemia Associated with Neuroendocrine Neoplasms: A Critical Review on Clinical and Pharmacological Management

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