BACKGROUND: Temozolomide is an active agent in metastatic pancreatic endocrine carcinomas. In vitro data indicate that the combination of capecitabine and temozolomide is synergistic for induction of apoptosis in neuroendocrine tumor cell lines. The authors retrospectively evaluated the efficacy of capecitabine and temozolomide in 30 patients with metastatic pancreatic endocrine carcinomas to assess response rate, progression free survival (PFS), and overall survival (OS). METHODS: Patients with metastatic, well, or moderately differentiated pancreatic endocrine carcinomas who had not received prior systemic chemotherapy were treated with capecitabine (750 mg/m² twice daily, days 1-14) and temozolomide (200 mg/m² once daily, days 10-14) every 28 days. RESULTS: Among 30 patients treated, 21 (70%) patients achieved an objective radiographic response. Median progression-free survival was 18 months. The rate of survival at two years was 92%. Only 4 patients (12%) experienced grade 3 or 4 adverse events. CONCLUSIONS: The combination of capecitabine and temozolomide is associated with an exceptionally high and durable response rate in metastatic endocrine carcinomas of the pancreas. Clinical endpoints, including response rate, survival, and toxicity, are superior to those observed with streptozocin-based regimens.
BACKGROUND:Temozolomide is an active agent in metastatic pancreatic endocrine carcinomas. In vitro data indicate that the combination of capecitabine and temozolomide is synergistic for induction of apoptosis in neuroendocrine tumor cell lines. The authors retrospectively evaluated the efficacy of capecitabine and temozolomide in 30 patients with metastatic pancreatic endocrine carcinomas to assess response rate, progression free survival (PFS), and overall survival (OS). METHODS:Patients with metastatic, well, or moderately differentiated pancreatic endocrine carcinomas who had not received prior systemic chemotherapy were treated with capecitabine (750 mg/m² twice daily, days 1-14) and temozolomide (200 mg/m² once daily, days 10-14) every 28 days. RESULTS: Among 30 patients treated, 21 (70%) patients achieved an objective radiographic response. Median progression-free survival was 18 months. The rate of survival at two years was 92%. Only 4 patients (12%) experienced grade 3 or 4 adverse events. CONCLUSIONS: The combination of capecitabine and temozolomide is associated with an exceptionally high and durable response rate in metastatic endocrine carcinomas of the pancreas. Clinical endpoints, including response rate, survival, and toxicity, are superior to those observed with streptozocin-based regimens.
Authors: P Therasse; S G Arbuck; E A Eisenhauer; J Wanders; R S Kaplan; L Rubinstein; J Verweij; M Van Glabbeke; A T van Oosterom; M C Christian; S G Gwyther Journal: J Natl Cancer Inst Date: 2000-02-02 Impact factor: 13.506
Authors: I M Murray-Lyon; A L Eddleston; R Williams; M Brown; B M Hogbin; A Bennett; J C Edwards; K W Taylor Journal: Lancet Date: 1968-10-26 Impact factor: 79.321
Authors: Matthew H Kulke; Bingyan Wu; David P Ryan; Peter C Enzinger; Andrew X Zhu; Jeffrey W Clark; Craig C Earle; Ann Michelini; Charles S Fuchs Journal: Dig Dis Sci Date: 2006-06 Impact factor: 3.199
Authors: Sanjay Gupta; James C Yao; Kamran Ahrar; Michael J Wallace; Frank A Morello; David C Madoff; Ravi Murthy; Marshall E Hicks; Jaffer A Ajani Journal: Cancer J Date: 2003 Jul-Aug Impact factor: 3.360
Authors: Joshua S Hill; James T McPhee; Theodore P McDade; Zheng Zhou; Mary E Sullivan; Giles F Whalen; Jennifer F Tseng Journal: Cancer Date: 2009-02-15 Impact factor: 6.860
Authors: Roeland F de Wilde; Barish H Edil; Ralph H Hruban; Anirban Maitra Journal: Nat Rev Gastroenterol Hepatol Date: 2012-02-07 Impact factor: 46.802
Authors: Jennifer A Chan; Keith Stuart; Craig C Earle; Jeffrey W Clark; Pankaj Bhargava; Rebecca Miksad; Lawrence Blaszkowsky; Peter C Enzinger; Jeffrey A Meyerhardt; Hui Zheng; Charles S Fuchs; Matthew H Kulke Journal: J Clin Oncol Date: 2012-07-09 Impact factor: 44.544
Authors: Manuel Weber; Lukas Kessler; Benedikt Schaarschmidt; Wolfgang Peter Fendler; Harald Lahner; Gerald Antoch; Lale Umutlu; Ken Herrmann; Christoph Rischpler Journal: BMC Cancer Date: 2020-04-16 Impact factor: 4.430
Authors: L Bodei; J Mueller-Brand; R P Baum; M E Pavel; D Hörsch; M S O'Dorisio; T M O'Dorisio; T M O'Dorisiol; J R Howe; M Cremonesi; D J Kwekkeboom; John J Zaknun Journal: Eur J Nucl Med Mol Imaging Date: 2013-05 Impact factor: 9.236
Authors: Nitya Raj; Emily Valentino; Marinela Capanu; Laura H Tang; Olca Basturk; Brian R Untch; Peter J Allen; David S Klimstra; Diane Reidy-Lagunes Journal: Pancreas Date: 2017-03 Impact factor: 3.327
Authors: Buddha Gurung; Xianxin Hua; Melissa Runske; Bonita Bennett; Virginia LiVolsi; Robert Roses; Douglas A Fraker; David C Metz Journal: Cancer Biol Ther Date: 2015 Impact factor: 4.742