1. Neoadjuvant Capecitabine Plus Temozolomide in Atypical Lung NETs
- Author
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Evangelou, Georgios
- Subjects
Medical research -- Case studies ,Medicine, Experimental -- Case studies ,Cancer -- Adjuvant treatment ,Temozolomide -- Case studies ,Respiratory agents -- Case studies ,Capecitabine -- Case studies ,PET imaging -- Case studies ,Health - Abstract
Neoadjuvant and adjuvant treatment in lung neuroendocrine tumors (NETs) is a field that has not been explored in-depth, with little information on the impact on disease-free survival. This case study highlights the effectiveness of neoadjuvant treatment with capecitabine plus temozolomide (CAPTEM) in a woman with well-differentiated atypical carcinoid. The patient was asymptomatic at diagnosis and was referred to the outpatient NET clinic at Sotiria Hospital in Athens, following an incidental finding on a chest x-ray. [.sup.18]F-fluorodeoxyglucose (FDG) PET/CT and [.sup.68]Ga-Dotatoc PET/CT revealed another mass in the pancreas, with avidity in both imaging studies. The patient underwent treatment for 6 months with CAPTEM with a response in the lung NET and mediastinal lymph nodes. However, the mass in the pancreas slightly increased and was removed with a central pancreatectomy. The patient continued treatment with CAPTEM for 6 more months. There was further response according to RECIST 1.1 criteria (partial response in the mediastinal lymph nodes and a 21% regression in the primary tumor size). Pathology report after lobectomy with lymph node dissection showed a pathologic complete response in the mediastinal lymph nodes. Twenty-four months after surgery, the patient remains disease-free and has a good quality of life. Although large clinical trials are needed, this case study underlines the value of preoperative chemotherapy in atypical carcinoids., Background Lung neuroendocrine tumors (NETs) are rare malignancies, accounting for 1% to 2% of all lung cancers. (1) They are sporadic tumors with an unclear association with smoking, and aminority [...]
- Published
- 2024