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
1619 - Meta-analysis of KRAS Mutation as prognostic factor in patients (pts.) with resection of colorectal (CRC) liver metastases: Tumor burden and Sideness analysis.
Presenter: Maria Romina Luca
Session: Poster Display session 2
Resources:
Abstract
2104 - Clinical implications of regorafenib-induced hypothyroidism in metastatic colorectal cancer refractory to standard therapies: A prospective evaluation
Presenter: Jwa Hoon Kim
Session: Poster Display session 2
Resources:
Abstract
2143 - Clinical impact of BRAF V600E mutations in patients (pts) with resectable solitary colorectal liver metastases (CRLM)
Presenter: Shin Kobayashi
Session: Poster Display session 2
Resources:
Abstract
3136 - Trifluridine/tipiracil in metastatic colorectal cancer: an updated multicentre real-world analysis on efficacy, safety and predictive factors.
Presenter: Chara Stavraka
Session: Poster Display session 2
Resources:
Abstract
4234 - Correlation between p53 expression and clinical outcome in RAS/BRAF wild type metastatic colorectal cancer patients receiving later-line irinotecan-cetuximab
Presenter: Eleonora Lai
Session: Poster Display session 2
Resources:
Abstract
4287 - Safety and effectiveness of aflibercept + FOLFIRI for the treatment of patients with metastatic colorectal cancer (mCRC): OZONE secondary analyses
Presenter: Ian Chau
Session: Poster Display session 2
Resources:
Abstract
1820 - A Phase Ib study of the safety and efficacy of atezolizumab (atezo) + bevacizumab (bev) + cobimetinib (cobi) in patients (pts) with metastatic colorectal cancer (mCRC)
Presenter: Johanna Bendell
Session: Poster Display session 2
Resources:
Abstract
5644 - Development and validation of a metastasis-associated immune prognostic model for concurrent metastatic colorectal cancer
Presenter: Zhiwen Luo
Session: Poster Display session 2
Resources:
Abstract
5697 - Prognostic role of blood cell count-based immuno-inflammatory parameters in the Valentino trial
Presenter: Giovanni Fuca
Session: Poster Display session 2
Resources:
Abstract
4704 - Evaluation of safety, immunogenicity and preliminary efficacy of PolyPEPI1018 vaccine in subjects with metastatic colorectal cancer (mCRC) with a predictive biomarker
Presenter: Joleen Hubbard
Session: Poster Display session 2
Resources:
Abstract