Efficacy of Second-Line Chemotherapy in Extrapulmonary Neuroendocrine Carcinoma

Patrick W. McGarrah, Konstantinos Leventakos, Timothy J. Hobday, Julian R. Molina, Heidi D. Finnes, Gustavo F. Westin, Thorvardur R. Halfdanarson

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)529-533
Number of pages5
JournalPancreas
Volume49
Issue number4
DOIs
StatePublished - Apr 1 2020

Keywords

  • cisplatin
  • extrapulmonary small-cell carcinoma
  • large cell carcinoma
  • neuroendocrine carcinoma
  • poorly differentiated neuroendocrine tumor
  • small-cell carcinoma

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Endocrinology

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