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Clin Cancer Res. 2007 May 15;13(10):2986-91.

Temozolomide as monotherapy is effective in treatment of advanced malignant neuroendocrine tumors.

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1
Department of Medical Sciences, Uppsala University, Uppsala, Sweden.

Abstract

PURPOSE:

A retrospective analysis of the toxicity and efficacy of temozolomide in advanced neuroendocrine tumors.

EXPERIMENTAL DESIGN:

Thirty-six patients with advanced stages of neuroendocrine tumor (1 gastric, 7 thymic and 13 bronchial carcinoids, 12 pancreatic endocrine tumors, 1 paraganglioma, 1 neuroendocrine foregut, and 1 neuroendocrine cecal cancer) were treated with temozolomide (200 mg/m(2)) for 5 days every 4 weeks. Patients had previously received a mean of 2.4 antitumoral medical regimens. Tumor response was evaluated radiologically according to the Response Evaluation Criteria in Solid Tumors every 3 months on an intent-to-treat basis. The circulating tumor marker plasma chromogranin A was also assessed. The expression of O(6)-methylguanine DNA methyltransferase, an enzyme implicated in chemotherapy resistance, was studied by immunohistochemistry (n=23) and compared with response to temozolomide.

RESULTS:

Median overall time to progression was 7 months (95% confidence interval, 3-10). Radiologic response was seen in 14% of patients and stable disease in 53%. Side effects were mainly hematologic; 14% experienced grade 3 or 4 thrombocytopenia (National Cancer Institute toxicity criteria). Ten patients had tumors with O(6)-methylguanine DNA methyltransferase immunoreactivity in <10% of nuclei, whereas four patients showed radiologic responses.

CONCLUSIONS:

Temozolomide as monotherapy had acceptable toxicity and antitumoral effects in a small series of patients with advanced malignant neuroendocrine tumors and four of these showed radiologic responses.

PMID:
17505000
DOI:
10.1158/1078-0432.CCR-06-2053
[Indexed for MEDLINE]
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