1. Systemic chemotherapy with FOLFOX in metastatic grade 1/2 neuroendocrine cancer
- Author
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Gerard Cavaglione, Marjorie Faure, L. Mineur, Aurélie Autret, Jean-Luc Raoul, and Patricia Niccoli
- Subjects
Oncology ,Cancer Research ,medicine.medical_specialty ,response rate ,break in treatment ,medicine.medical_treatment ,Neuroendocrine tumors ,chemotherapy ,Gastroenterology ,survival ,03 medical and health sciences ,0302 clinical medicine ,FOLFOX ,Internal medicine ,medicine ,5-fluorouracil ,030212 general & internal medicine ,Chemotherapy ,business.industry ,oxaliplatin ,Cancer ,Articles ,medicine.disease ,Primary tumor ,Oxaliplatin ,Tolerability ,quality of life ,Response Evaluation Criteria in Solid Tumors ,030220 oncology & carcinogenesis ,neuroendocrine tumors ,business ,medicine.drug - Abstract
Neuroendocrine tumors (NETs) comprise a heterogeneous group of malignancies with various clinical presentations and evolution. NETs are often diagnosed at a late stage, when they are already metastatic. Treatment is currently based on traditional chemotherapies, such as streptozocin, with serious side effects. The favorable toxicity profile of the combination of 5-fluorouracil with oxaliplatin, together with its significant antitumor activity in several gastrointestinal malignancies, led to the evaluation of its efficacy and tolerability in patients with advanced grade 1/2 (G1/G2) NETs. The endpoints of the study were tumor response (according to the Response Evaluation Criteria in Solid Tumors 1.1), overall survival (OS), progression-free survival (PFS) and symptom improvement. From January, 2013 to January, 2015, during our Regional Multidisciplinary Tumor Board dedicated to NETs (RENATEN network), FOLFOX was recommended for the treatment of metastatic NETs as first-line therapy or after failure of other therapies. The inclusion criteria were metastatic, well-differentiated G1/G2 NETs, progressing within the last 3 months. Cases with previous antitumor therapy were allowed. The patients received modified FOLFOX-6 and were assessed every 3 months by computed tomography or magnetic resonance imaging examinations. A total of 31 patients were included. The median follow-up was 20 months [95% confidence interval (CI): 15-27]. Nine patients (29%) exhibited a partial response, and 13 (41%) achieved stable disease; the disease control rate was 70%. A total of 9 patients exhibited disease progression. The control rate was 78% for pancreatic and 65% for extrapancreatic NETs. The median OS was not reached; the 1- and 2-year OS rates were 89 and 70%, respectively (Fig. 1). No significant difference in OS was observed between the
- Published
- 2016