Abstract 4175
Background
EP-HG-NEC are rare malignancies with poor prognosis, mainly from the gastrointestinal (GI) tract, although they may originate anywhere in the body due to the wide distribution of the neuroendocrine system. Platinum plus etoposide regimen (PE) is standard of care. Our goal was to characterise EP-HG-NEC at our institute, evaluate primary tumor location as prognostic factor and the effectiveness of PE as first-line (1L) therapy.
Methods
Records of patients (pts) diagnosed with EP-HG-NEC at a Portuguese terciary cancer center were reviewed retrospectively (January 2000-March 2019).
Results
Fifty-eight pts (52% males) identified: median (m) follow-up was 21 months (M) (range: 4-43); at diagnosis, m age was 61 years (range 30-85), 81% had ECOG performance status of 0-1, 83% were symptomatic, 64% had metastatic disease (70% with liver metastasis), 48% had Ki67 above 55%. Primary tumor location was GI in 27 pts (33% Esophagus, 19% colorectal, 15% pancreas), unknown (CUP) in 24 pts and genitourinary (GU) in 7 pts. For all EP-HG-NEC, m overall survival (OS) was 15,7M. Pts with CUP seemed to have a worse prognosis (mOS=8,5M), whereas GU and GI had a similar prognosis (mOS=19,2 and 18,7M, respectively) (p = 0.357).Thirty-nine pts (67%) got PE, 7 pts received a different chemotherapy (ChT) regimen and 9 pts got best supportive care (BSC) only. mPFS was 4,6M for PE group and 7,3M for other ChT regimen group (platinum alone, CAPTEM, 5FU-STZ) with no statistical significance (p = 0.547). mOS was 15,7M for PE group and 6,9M for BSC group (p = 0.54). With PE, 41% had grade 3 adverse events and no toxic deaths were reported. After 1L PE, 24 pts received a second L ChT, 50% with CAPTEM.
Conclusions
Considering the limited data available, this retrospective case series contributes to a better understanding of this entity. Primary tumor location tends to predict outcome. We hypothesised that delaying treatment initiation for CUP while searching for primary tumor might be related to worse outcomes. The outcomes of 1L PE suggest that other options might be needed as standard of care. EP-HG-NEC has prognostic heterogeneity, multi-center studies are needed.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
3353 - Results of the 3rd interim analysis of C-Patrol: A non-interventional study on olaparib in German routine clinical practice
Presenter: Jalid Sehouli
Session: Poster Display session 2
Resources:
Abstract
740 - A real-world analysis of the treatment of advanced ovarian cancer with PARPIs
Presenter: Alejandra Martinez de Pinillos
Session: Poster Display session 2
Resources:
Abstract
5867 - Incidence of tumour BRCA1/2 variants in relapsed, platinum-sensitive ovarian, fallopian tube and primary peritoneal cancer
Presenter: Robert Morgan
Session: Poster Display session 2
Resources:
Abstract
2966 - Frequency of mutations in 21 hereditary breast and ovarian cancer susceptibility genes among 882 high-risk individuals
Presenter: Jihong Liu
Session: Poster Display session 2
Resources:
Abstract
1687 - BRCA testing of 1,284 Brazilian patients for hereditary breast and ovarian cancer in a routine diagnostic setting
Presenter: Fernanda Milanezi
Session: Poster Display session 2
Resources:
Abstract
3162 - A multi-center integrative study on cancer predisposition genes in Chinese patients with epithelial ovarian carcinoma
Presenter: Changbin Zhu
Session: Poster Display session 2
Resources:
Abstract
5993 - Incidental Early Occult Ovarian Cancer after Risk-Reducing Salpingo-Oophorectomy in BRCA1/2 Mutation Carriers followed in a Community Public Hospital
Presenter: Begona Grana Suarez
Session: Poster Display session 2
Resources:
Abstract
5334 - Response to chemotherapy in ovarian cancer (OC) patients with or without prior breast cancer (BC), stratified by BRCA mutation (BRCAm) status
Presenter: Angela George
Session: Poster Display session 2
Resources:
Abstract
4565 - Advanced ovarian cancer: is residual disease after debulking surgery affected by genetics factors involved in angiogenesis and immunity pathways?
Presenter: Michele Bartoletti
Session: Poster Display session 2
Resources:
Abstract
3251 - Surrogate endpoint of progression-free (PFS) and overall survival (OS) for advanced ovarian cancer (AOC) patients (pts) treated with neo-adjuvant chemotherapy (NACT): Results of the CHIVA randomized phase II GINECO study
Presenter: Fabrice Lecuru
Session: Poster Display session 2
Resources:
Abstract