OBJECTIVES: A platinum/etoposide doublet is standard first-line therapy for poorly differentiated neuroendocrine carcinoma (PD NEC); however, evidence to guide treatment beyond first-line regimens is lacking. This study aimed to evaluate the efficacy of second-line regimens in PD NEC. METHODS: We performed a retrospective analysis of patients treated with second-line chemotherapy for PD NEC. Inclusion criteria were previous first-line therapy with platinum/etoposide, extrapulmonary PD NEC, and follow-up data. The primary end points were overall survival (OS) and progression-free survival (PFS) after second-line therapy. Secondary end points included OS and PFS from first-line therapy. RESULTS: Sixty-four patients were included. The median OS from initiation of second-line therapy was 6.2 months (95% confidence interval [CI], 4.9-8.9). The median PFS was 2.3 months (95% CI, 2.0-3.2). No second-line regimen showed a statistically significant difference in OS or PFS. There was a significant increase in OS for cisplatin first-line regimens compared with carboplatin (17.0 months [95% CI, 12.5-22.6] vs 11.7 months [95% CI, 8.0-14.0]). CONCLUSIONS: The efficacy of current second-line therapy in PD NEC is poor. No second-line regimen showed statistically significant superiority. Cisplatin was associated with longer OS regardless of second-line regimen or age. However, unmeasured confounders such as performance status or comorbidities may explain this effect.
OBJECTIVES: A platinum/etoposide doublet is standard first-line therapy for poorly differentiated neuroendocrine carcinoma (PD NEC); however, evidence to guide treatment beyond first-line regimens is lacking. This study aimed to evaluate the efficacy of second-line regimens in PD NEC. METHODS: We performed a retrospective analysis of patients treated with second-line chemotherapy for PD NEC. Inclusion criteria were previous first-line therapy with platinum/etoposide, extrapulmonary PD NEC, and follow-up data. The primary end points were overall survival (OS) and progression-free survival (PFS) after second-line therapy. Secondary end points included OS and PFS from first-line therapy. RESULTS: Sixty-four patients were included. The median OS from initiation of second-line therapy was 6.2 months (95% confidence interval [CI], 4.9-8.9). The median PFS was 2.3 months (95% CI, 2.0-3.2). No second-line regimen showed a statistically significant difference in OS or PFS. There was a significant increase in OS for cisplatin first-line regimens compared with carboplatin (17.0 months [95% CI, 12.5-22.6] vs 11.7 months [95% CI, 8.0-14.0]). CONCLUSIONS: The efficacy of current second-line therapy in PD NEC is poor. No second-line regimen showed statistically significant superiority. Cisplatin was associated with longer OS regardless of second-line regimen or age. However, unmeasured confounders such as performance status or comorbidities may explain this effect.
Authors: T Walter; D Tougeron; E Baudin; K Le Malicot; T Lecomte; D Malka; O Hentic; S Manfredi; I Bonnet; R Guimbaud; R Coriat; C Lepère; C Desauw; A Thirot-Bidault; L Dahan; G Roquin; T Aparicio; J-L Legoux; C Lombard-Bohas; J-Y Scoazec; C Lepage; G Cadiot Journal: Eur J Cancer Date: 2017-05-11 Impact factor: 9.162
Authors: Antonio Rossi; Massimo Di Maio; Paolo Chiodini; Robin Michael Rudd; Hiroaki Okamoto; Dimosthenis Vasilios Skarlos; Martin Früh; Wendi Qian; Tomohide Tamura; Epaminondas Samantas; Taro Shibata; Francesco Perrone; Ciro Gallo; Cesare Gridelli; Olga Martelli; Siow-Ming Lee Journal: J Clin Oncol Date: 2012-04-02 Impact factor: 44.544
Authors: E Mitry; E Baudin; M Ducreux; J C Sabourin; P Rufié; T Aparicio; T Aparicio; P Lasser; D Elias; P Duvillard; M Schlumberger; P Rougier Journal: Br J Cancer Date: 1999-12 Impact factor: 7.640
Authors: Guido Rindi; David S Klimstra; Behnoush Abedi-Ardekani; Sylvia L Asa; Frederik T Bosman; Elisabeth Brambilla; Klaus J Busam; Ronald R de Krijger; Manfred Dietel; Adel K El-Naggar; Lynnette Fernandez-Cuesta; Günter Klöppel; W Glenn McCluggage; Holger Moch; Hiroko Ohgaki; Emad A Rakha; Nicholas S Reed; Brian A Rous; Hironobu Sasano; Aldo Scarpa; Jean-Yves Scoazec; William D Travis; Giovanni Tallini; Jacqueline Trouillas; J Han van Krieken; Ian A Cree Journal: Mod Pathol Date: 2018-08-23 Impact factor: 7.842