TY - JOUR
T1 - Efficacy of Second-Line Chemotherapy in Extrapulmonary Neuroendocrine Carcinoma
AU - McGarrah, Patrick W.
AU - Leventakos, Konstantinos
AU - Hobday, Timothy J.
AU - Molina, Julian R.
AU - Finnes, Heidi D.
AU - Westin, Gustavo F.
AU - Halfdanarson, Thorvardur R.
N1 - Funding Information:
T.R.H. declares research support from Ipsen, Thermo Fisher Scientific, Agios, and ArQule and consultancy (advisory boards) with Lexicon, Advanced Accelerator Applications, Novartis, and Curium. The other authors declare no conflict of interest.
Funding Information:
This study was supported by Grant Number UL1 TR002377 from the National Center for Advancing Translational Sciences (NCATS). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health.
Publisher Copyright:
© Wolters Kluwer Health, Inc. All rights reserved.
PY - 2020/4/1
Y1 - 2020/4/1
N2 - Objectives A platinum/etoposide doublet is standard first-line therapy for poorly differentiated neuroendocrine carcinoma (PD NEC); however, evidence to guide treatment beyond first-line regimens is lacking. This study aimed to evaluate the efficacy of second-line regimens in PD NEC. Methods We performed a retrospective analysis of patients treated with second-line chemotherapy for PD NEC. Inclusion criteria were previous first-line therapy with platinum/etoposide, extrapulmonary PD NEC, and follow-up data. The primary end points were overall survival (OS) and progression-free survival (PFS) after second-line therapy. Secondary end points included OS and PFS from first-line therapy. Results Sixty-four patients were included. The median OS from initiation of second-line therapy was 6.2 months (95% confidence interval [CI], 4.9-8.9). The median PFS was 2.3 months (95% CI, 2.0-3.2). No second-line regimen showed a statistically significant difference in OS or PFS. There was a significant increase in OS for cisplatin first-line regimens compared with carboplatin (17.0 months [95% CI, 12.5-22.6] vs 11.7 months [95% CI, 8.0-14.0]). Conclusions The efficacy of current second-line therapy in PD NEC is poor. No second-line regimen showed statistically significant superiority. Cisplatin was associated with longer OS regardless of second-line regimen or age. However, unmeasured confounders such as performance status or comorbidities may explain this effect.
AB - Objectives A platinum/etoposide doublet is standard first-line therapy for poorly differentiated neuroendocrine carcinoma (PD NEC); however, evidence to guide treatment beyond first-line regimens is lacking. This study aimed to evaluate the efficacy of second-line regimens in PD NEC. Methods We performed a retrospective analysis of patients treated with second-line chemotherapy for PD NEC. Inclusion criteria were previous first-line therapy with platinum/etoposide, extrapulmonary PD NEC, and follow-up data. The primary end points were overall survival (OS) and progression-free survival (PFS) after second-line therapy. Secondary end points included OS and PFS from first-line therapy. Results Sixty-four patients were included. The median OS from initiation of second-line therapy was 6.2 months (95% confidence interval [CI], 4.9-8.9). The median PFS was 2.3 months (95% CI, 2.0-3.2). No second-line regimen showed a statistically significant difference in OS or PFS. There was a significant increase in OS for cisplatin first-line regimens compared with carboplatin (17.0 months [95% CI, 12.5-22.6] vs 11.7 months [95% CI, 8.0-14.0]). Conclusions The efficacy of current second-line therapy in PD NEC is poor. No second-line regimen showed statistically significant superiority. Cisplatin was associated with longer OS regardless of second-line regimen or age. However, unmeasured confounders such as performance status or comorbidities may explain this effect.
KW - cisplatin
KW - extrapulmonary small-cell carcinoma
KW - large cell carcinoma
KW - neuroendocrine carcinoma
KW - poorly differentiated neuroendocrine tumor
KW - small-cell carcinoma
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U2 - 10.1097/MPA.0000000000001529
DO - 10.1097/MPA.0000000000001529
M3 - Article
C2 - 32282766
AN - SCOPUS:85083396593
VL - 49
SP - 529
EP - 533
JO - Pancreas
JF - Pancreas
SN - 0885-3177
IS - 4
ER -