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PLoS One. 2015 Dec 2;10(12):e0143822. doi: 10.1371/journal.pone.0143822. eCollection 2015.

Streptozocin-Based Chemotherapy in Patients with Advanced Neuroendocrine Neoplasms--Predictive and Prognostic Markers for Treatment Stratification.

Author information

1
Department of Gastroenterology, University of Marburg, Marburg, Germany.
2
Institute of Medical Biometry, University of Marburg, Marburg, Germany.
3
Institute of Pathology, University of Marburg, Marburg, Germany.
4
Department of Gastroenterology and Hepatology, University of Halle, Halle, Germany.

Abstract

BACKGROUND AND AIM:

Chemotherapy with streptozocin (STZ) in combination with 5-FU or doxorubicin (Dox) represents a standard of care for patients with metastatic pancreatic neuroendocrine neoplasms (pNEN). However, predictive markers for patient selection are still missing. The aim of this study was a retrospective evaluation of the clinicopathological characteristics of pNEN patients receiving STZ-based chemotherapies and to identify predictive and prognostic markers.

PATIENTS AND METHODS:

We retrospectively analyzed 77 patients treated at our center between 1995 and 2013. The median overall survival (OS) and progression-free survival (PFS) were calculated using Kaplan-Meier and Cox regression methods, respectively. Uni- and multivariate analyses were performed.

RESULTS:

The median PFS (mPFS) in patients receiving STZ/5-FU/Dox was 16 months with a median OS (mOS) of 28 months. Objective response rate (ORR) and disease control rate (DCR) were 34% and 72%, respectively. Biochemical response and positive octreotide scintigraphy predicted objective response. Univariate analysis revealed Ki-67 > 10% and the absence of biochemical or objective response by imaging as independent risk factors for shorter PFS. Additionally, performance status (PS) and resection of the primary tumor were observed to influence mOS. Treatment was well tolerated with less than 10% grade 3 and 4 toxicities.

CONCLUSIONS:

STZ-based chemotherapy is an effective and well-tolerated treatment option in patients with well differentiated neuroendocrine neoplasms. Positive octreotide scintigraphy and biochemical response predict objective response.

PMID:
26630134
PMCID:
PMC4668106
DOI:
10.1371/journal.pone.0143822
[Indexed for MEDLINE]
Free PMC Article

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