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Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

5308 - Carboplatin (CB) combined with oral or intravenous (IV) etoposide (ET) for advanced extra-pulmonary (EP) poorly differentiated (PD) neuroendocrine carcinoma (NEC); real-world findings from two European Neuroendocrine Tumour Society Centres of Excellence.

Date

21 Oct 2018

Session

Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

Presenters

Melissa Frizziero

Citation

Annals of Oncology (2018) 29 (suppl_8): viii467-viii478. 10.1093/annonc/mdy293

Authors

M. Frizziero1, F. Spada2, A. Lamarca1, Z. Kordatou1, J. Barriuso3, C. Nuttall1, M.G. McNamara3, R. Hubner1, W. Mansoor1, P. Manoharan4, N. Fazio2, J.W. Valle3

Author affiliations

  • 1 Medical Oncology, The Christie NHS Foundation Trust, M20 4BX - Manchester/GB
  • 2 Gastrointestinal And Neuroendocrine Tumors Unit, Medical Oncology, Istituto Europeo di Oncologia, 20141 - Milan/IT
  • 3 Medical Oncology/division Of Cancer Sciences, The Christie NHS Foundation Trust/Univeristy of Manchester, M20 4BX - Manchester/GB
  • 4 Radiology And Nuclear Medicine, The Christie NHS Foundation Trust, M20 4BX - Manchester/GB
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Resources

Abstract 5308

Background

Carboplatin-Etoposide is a 1st-line (1L) option for patients (pts) with advanced EP-PD-NEC. Schedules with oral or IV ET are used in clinical practice. Data from randomised trials are lacking.

Methods

Records of pts diagnosed with advanced EP-PD-NEC and treated with CB/oral-ET and CB/IV-ET were reviewed retrospectively (09/96-02/17). First-line survival/activity/toxicity data are reported.

Results

One-hundred-thirteen pts were identified: median (med) follow-up was 11.5 months (m); med age was 65.8 years (range 24-88); male=64%; ECOG performance status 0-1=81%; no/mild comorbidities=81%; gastro-entero-pancreatic origin=54%; stage IV = 90% (53% liver metastases). Median Ki-67=70% (95%CI 60-80%), Ki-67>55%=59%. A total of 123 courses of CB-ET were administered: 106 (86%) 1L, 16 (13%) 2nd-line (2L) and 1 (1%) 3rd-line; med cycles/line=4; oral-ET 45%, IV-ET 55%. Median CB-ET dose-intensity (available for 82 courses): 96% (1L), 90% (2L). Median 1L-progression free survival (PFS) was 5.9m (95%CI 5.0-7.1): oral-ET 5.6m, IV-ET 6.2m, hazard ratio (HR)=0.76 (95%CI 0.51-1.14). Median 1L-overall survival (OS) was 11.5m (95%CI 8.9-13.6): oral-ET 8.9m, IV-ET 12.1m, HR = 0.68 (95%CI 0.45-1.03), p = 0.07. Radiological response (assessed for 95 pts), 1L-disease control rate was 75.8% (95%CI 67.1-84.6): oral-ET 69.8% (95%CI 55.5-84.1), IV-ET 80.8% (95%CI 69.7-91.8). Liver metastases were the only independent factor related to worse 1L-PFS on multivariable analysis, HR = 1.71 (95%CI 1.11-2.63). Commonest 1L-grade 3-4 adverse event (AE) was myelosuppression (47.2%); no significant differences between oral-ET and IV-ET AEs, except for venous thromboembolism; oral-ET 12.5%, IV-ET 1.7% (p = 0.04).

Conclusions

This is one of the largest series of pts with advanced EP-PD-NEC treated with CB-ET in the current literature. Oral-ET and IV-ET schedules are associated with comparable 1L-PFS/activity/toxicity data. There is a trend towards better 1L-OS for IV-ET schedules; this, however, may be driven by differences in patient selection between the two subgroups.

Clinical trial identification

Legal entity responsible for the study

The Christie NHS Foundation Trust.

Funding

Has not received any funding.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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