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Poster Display

1451 - Capecitabine and streptozocin ± cisplatin for gastroenteropancreatic neuroendocrine tumours: predictors of long-term survival in the NET01 trial


08 Oct 2016


Poster Display


Tim Meyer


Annals of Oncology (2016) 27 (6): 136-148. 10.1093/annonc/mdw369


T. Meyer1, W. Qian2, J.W. Valle3, D. Talbot4, D. Cunningham5, N. Reed6, L. Wall7, J. Waters8, P. Ross9, A. Anthoney10, K. Sumpter11, N. Sarwar12, T. Crosby13, N. Begum2, G. Young2, R. Hardy2, P. Corrie14

Author affiliations

  • 1 Department Of Oncology, Royal Free London NHS Foundation Trust, NW3 2QG - London/GB
  • 2 Cambridge Cancer Trials Centre, Cambridge Clinical Trials Unit - Cancer Theme, Addenbrooke's Hospital University of Cambridge Hospitals, CB2 0QQ - Cambridge/GB
  • 3 Department Of Medical Oncology, University of Manchester/The Christie NHS Foundation Trust, M20 4BX - Manchester/GB
  • 4 Department Of Oncology, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, OX3 7LE - Oxford/GB
  • 5 Department Of Oncology, The Institute of Cancer Research/Royal Marsden NHS Foundation Trust, SM2 5PT - Sutton/GB
  • 6 Beatson Oncology Centre, Gartnavel General Hospital, G12 0YN - Glasgow/GB
  • 7 Edinburgh Cancer Centre, Western General Hospital, EH4 2XU - Edinburgh/GB
  • 8 Kent Oncology Centre, Maidstone Hospital, ME16 9QQ - Kent/GB
  • 9 Department Of Oncology, Guy's and St. Thomas' Hospital NHS Trust, SE1 9RT - London/GB
  • 10 St James's Institute Of Oncology, St James’s University Hospital, LS9 7TF - Leeds/GB
  • 11 Northern Centre For Cancer Care, Freeman Hospital, The Newcastle upon Tyne Hospitals NHS Foundation Trust, NE7 7DN - Newcastle upon Tyne/GB
  • 12 Department Of Oncology, Southend University Hospitals NHS Foundation Trust, SS0 0RY - Southend/GB
  • 13 Velindre Cancer Centre, Velindre NHS Trust, CF14 2TL - Cardiff/GB
  • 14 Cambridge Cancer Centre, Cambridge University Hospitals NHS Foundation Trust, CB2 0QQ - Cambridge/GB


Abstract 1451


Cytotoxic chemotherapy for advanced, unresectable pancreatic and gastrointestinal foregut neuroendocrine tumours (GEPNETs) commonly comprises 5-fluorouracil (FU) plus streptozocin (S). The NET01 trial, conducted in the pre-kinase inhibitor era, recruited a broad spectrum of patients (pts) to investigate whether capecitabine (Cap) was an acceptable alternative to FU, with or without adding cisplatin (Cis). At median follow up 3.4 years, objective responses (primary endpoint) were reported as similar in the 2 arms, but CapSCis was more toxic. Final progression-free survival (PFS) and overall survival (OS) (secondary endpoints) as well as outcome predictors are now reported with longer follow up.


Pts with previously untreated advanced, unresectable NETs of pancreatic, gastrointestinal foregut or unknown primary site were randomised to receive three-weekly Cap 625mg/m2 twice daily orally, S 1·0g/m2 IV on day 1, ± Cis 70mg/m2 IV on day 1. Pts could receive the same treatment beyond 6 cycles if there was evidence of benefit. All pts were followed 12 weekly for a minimum of 5 years.


Of 86 (44 CapS, 42 CapSCis) pts randomised, 16% had poorly differentiated histology. With long-term median follow-up of 8 years, 83 (97%) pts have progressed/died and 69 (80%) pts have died. The estimated median PFS was 11.1 months for CapS and 9·6 months for CapSCis (HR = 0.82, 95%CI: 0.53, 1.27). Median OS was 27 months for CapS and 26 months for CapSCis (HR = 0.97, 95%CI: 0.60, 1.56). Three and 5-year OS rates were 40% and 29%, with no difference between arms. Statistically significant factors predicting for OS were tumour Ki67 level, WHO grade and pt age. Addition of Cis to CapS did not appear to influence OS for high grade, poorly differentiated tumours, although numbers are small.

N Overall CapS CapSCis Median OS (yrs) Overall CapS CapSCis
Age (yrs)


PFS and OS were similar for the CapS ± Cis regimens. High patient age, tumour Ki67 and grade all predicted for poorer outcomes.

Clinical trial identification

Legal entity responsible for the study

Cambridge University Hospitals NHS Foundation Trust


UK NETwork and Cancer Research UK


J.W. Valle: Keocyt (honoraria for Advisory Board in 2010 and 2012) – this relates to streptozocin.

D. Cunningham: Research funding only to RMH from Amgen, AstraZeneca, Bayer, Celgene, Medimmune, Merrimack, Merck Serono, Sanofi. All other authors have declared no conflicts of interest.

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