Abstract 5842
Background
Therapeutic options for metastatic poorly differentiated extrapulmonary neuroendocrine carcinoma (EPNEC) after prior platinum-based chemotherapy are limited. Combination chemotherapy protocols with cyclophosphamide, vincristine and either doxorubicin/adriamycin (CAV) or epirubicin (CEV) are possible treatment options for small cell lung cancer (SCLC), however have not been systematically evaluated in EPNEC so far. The aim of this study was to analyze the efficacy and toxicity of CAV/CEV in metastatic EPNEC patients.
Methods
We reviewed the combined prospective and retrospective NEN database of our center for patients treated with CAV or CEV between January 2009 and January 2019. Histological findings of all patients were reevaluated by the investigators in order to comply with the most current WHO classification.
Results
A total of 22 patients could be identified, 19 received CAV, 3 CEV. Patients had been treated with a median of 1 line of prior chemotherapy. Median proliferation rate (Ki67) was 70 %, small cell histology was present in 63.6 % of cases. Primaries were gastrointestinal (27.3 %), pancreatobiliary (22.7%), urogenital (22.7 %), head/neck (9.1 %) or unknown (18.2 %). Best response to CAV/CEV was stable disease in 3 patients, partial remission (PR) in 5, resulting in an overall response rate of 22.7 % and disease control rate of 36.4 %. Most notably, PR was observed in both 2 patients included with a prostatic primary. Of the remaining 14 patients, 12 (54.5 %) showed a progressive disease, 1 showed a mixed response and 1 was not evaluable for response. Median progression free (PFS) and overall survival (OS) after start of CAV/CEV was 2.0 and 10.0 months respectively. Significant toxicity (mainly hematotoxicity) was observed in 63.6 % of patients.
Conclusions
In this first analysis of CAV/CEV in EPNEC so far, moderate antitumor activity could be detected, most notably in patients with a prostatic primary. Despite some encouraging responses, PFS was limited and significant toxicities were observed in the majority of patients.
Clinical trial identification
The trial was approved by the institutional research ethics committee (approval S-428/2014).
Editorial acknowledgement
Legal entity responsible for the study
National Center for Tumor Diseases (NCT) Heidelberg.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
2444 - Assessing the clinical utility of circulating tumour DNA through longitudinal liquid biopsy sampling in Oesophageal adenocarcinoma
Presenter: Emma Ococks
Session: Poster Display session 2
Resources:
Abstract
2670 - Molecular subtypes of metastatic(met) gastric cancer(GC) (MoTriGastric): new biomarkers closer to the clinics
Presenter: Maria Alsina Maqueda
Session: Poster Display session 2
Resources:
Abstract
3797 - Exploring candidate signal transduction pathways for targeted therapy in esophageal cancer
Presenter: Aafke Creemers
Session: Poster Display session 2
Resources:
Abstract
5485 - Clinical implication of CLDN18, RhoGAP, and E-cadherin in gastric signet ring cell carcinoma
Presenter: Hyunho Kim
Session: Poster Display session 2
Resources:
Abstract
1970 - Identification of a spectrum of germline mutations for hereditary diffuse gastric cancer in the Russian population by next-generation sequencing.
Presenter: IRINA EFIMOVA
Session: Poster Display session 2
Resources:
Abstract
4989 - The molecular profiling and prognostic value of Chinese gastric signet ring cell carcinoma patients
Presenter: Jia Wei
Session: Poster Display session 2
Resources:
Abstract
7145 - A phase 2 basket study of MCLA-128, a bispecific antibody targeting the HER3 pathway, in NRG1 fusion-positive advanced solid tumors
Presenter: Alison Schram
Session: Poster Display session 2
Resources:
Abstract
1406 - Simultaneous Resection of Pancreatic Cancer and Liver Oligometastases After Induction Chemotherapy in Stage IV Patients:an Open-Label Prospective Randomized Multicenter phase 3 trial(CSPAC-1)
Presenter: Miaoyan Wei
Session: Poster Display session 2
Resources:
Abstract
1530 - Multicenter randomized phase II trial of 5-Fluorouracil/leucovorin (5-FU/LV) with or without liposomal irinotecan (nal-IRI) in metastatic biliary tract cancer (BTC) as second-line therapy after progression on gemcitabine plus cisplatin (GemCis): NIFTY trial
Presenter: Changhoon Yoo
Session: Poster Display session 2
Resources:
Abstract
1563 - A randomized phase II study of Maintenance therapy with multiepitope vaccine Tedopi (OSE2101) ± nivolumab or FOLFIRI after induction chemotherapy (CT) with FOLFIRINOX in patients (Pts) with advanced Pancreatic ductal adenocarcinoma (aPDAC) (TEDOPaM – PRODIGE 63 GERCOR study)
Presenter: Cindy Neuzillet
Session: Poster Display session 2
Resources:
Abstract