1166P - 21-day modified CAPTEM protocol is effective and safe for patients with advanced well-differentiated grade 1/2 pancreatic neuroendocrine tumors

Background

The typical chemotherapy choice for patients with advanced well-differentiated grade 1/2 pancreatic neuroendocrine tumors (PNET) is on the combination of Capecitabine and Temozolomide (CAPTEM), based on the ECOG-ACRIN E2211 study. The standard CAPTEM includes capecitabine on days 1–14 and temozolomide on days 10-14, given in 28-day cycles. There is limited data on the efficacy of a CAPTEM regimen given in 21-day cycles for patients with PNET.

Methods

A retrospective analysis of patients with metastatic PNET treated with a 21-day CAPTEM regimen at a Tertiary Cancer Center. This modified CAPTEM protocol involved administering Capecitabine 1000 mg/m2/BID on days 1–14 and Temozolomide 150 mg/m2 on days 1–5 every 21 days. Patient and tumor characteristics, previous interventions, and outcomes were gathered from the medical records.

Results

The study included 22 patients, with a median age at diagnosis of 65.0 years (interquartile range [IQR] 46.8, 69.8). The tumors’ primary sites were in the pancreas (n=16), stomach (n=3), lung (n=1), and unknown (n=2). Seven patients (31.8%) received peptide-receptor radionuclide therapy (PRRT) before CAPTEM initiation, three (13.6%) received chemotherapy, and four (18.2%) received everolimus or sunitinib. The disease control rate was 57.1% with an objective response rate of 33.3%. Treatment-related adverse events were reported with grade G1/G2 in 12 patients (75.0%) and G3 in 4 (25.0%). In a multivariate logistic regression analysis, adjuster for age, sex, primary tumor site, grade and previous PRRT treatment, male sex was associated with a trend towards lower risk for disease progression (odds ratio [OR]=0.1, p=0.1) and previous PRRT treatment - with a higher risk (OR=16.2, p=0.08).

Conclusions

Our retrospective data support the effectiveness and tolerability of a modified CAPTEM protocol given in 21-day cycles in patients with advanced well-differentiated PNET.

Clinical trial identification

Editorial acknowledgement

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.