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J Chemother. 2018 Feb;30(1):53-58. doi: 10.1080/1120009X.2017.1340127. Epub 2017 Jun 22.

Good performance of platinum-based chemotherapy for high-grade gastroenteropancreatic and unknown primary neuroendocrine neoplasms.

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a Department of Experimental, Diagnostic and Speciality Medicine , 'L. & A. Seragnoli' Institute of Hematology and Medical Oncology, Sant'Orsola-Malpighi Hospital , Bologna , Italy.
b Interdepartmental Center for Cancer Research (CIRC) , Sant'Orsola-Malpighi Hospital , Bologna , Italy.
c Internal Medicine Unit, Medical and Surgical Sciences Department , Sant'Orsola-Malpighi Hospital , Bologna , Italy.
d Cytological and Pathological Anatomy Unit , Maggiore Hospital , Bologna , Italy.


To evaluate efficacy and safety of platinum and etoposide combination in the treatment of advanced gastroenteropancreatic (GEP) and unknown primary (CUP) neuroendocrine carcinomas (NEC), we analysed the records of 21 consecutive patients treated with this regimen from 1999 to 2012. Objective responses were obtained in 11 patients (52%) and disease stability (DS) in 5 (24%). Median progression-free survival (PFS) was 7 months (95% CI, 5.33-8.66). Median overall survival (OS) was 16 months (95% CI, 14.97-17.03). Patients with limited liver disease had a significantly (p = 0.002) better PFS than patients with extrahepatic disease at diagnosis with 9 months (95% CI, 7.14-10.85) vs. 4 months (95% CI, 1.60-6.40). Two patients experienced durable complete response (30 and 90 months). The most common grade 3-4 toxicities were neutropenia (61%), anaemia (50%), nausea and vomiting (27%) and fatigue (22%). The platinum plus etoposide regimen has an acceptable toxicity profile and is effective in patients with GEP and CUP-NECs.


Chemotherapy; Etoposide; Gastroenteropancreatic neuroendocrine neoplasms; High-grade neuroendocrine tumors; Neuroendocrine carcinomas; Platinum; Unknown primary neuroendocrine neoplasms

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