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01.04.2015 | Original Article

Amrubicin monotherapy for patients with extrapulmonary neuroendocrine carcinoma after platinum-based chemotherapy

verfasst von: Kenta Nio, Shuji Arita, Taichi Isobe, Hitoshi Kusaba, Kenichi Kohashi, Tatsuhiro Kajitani, Shingo Tamura, Gen Hirano, Kenji Mitsugi, Akitaka Makiyama, Taito Esaki, Hiroshi Ariyama, Yoshinao Oda, Koichi Akashi, Eishi Baba

Erschienen in: Cancer Chemotherapy and Pharmacology | Ausgabe 4/2015

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Abstract

Purpose

Extrapulmonary neuroendocrine carcinomas (EPNEC) are rarely observed and are associated with poor outcomes. Based on the clinicopathological similarity, treatment used for small cell lung carcinoma has also been employed for EPNEC, but the response to such therapy has not been well examined. The goal of this study was to investigate amrubicin (AMR) monotherapy as a salvage therapy for EPNEC arising from digestive organs.

Methods

Patients with EPNEC of the digestive organs who had prior platinum-based chemotherapy and were subsequently treated with AMR between July 2005 and December 2013 at any one of four institutions were retrospectively examined to characterize the safety and efficacy of AMR.

Results

Thirteen patients (ten males, three females; median age 64 years) were examined. Primary cancer sites included stomach (n = 6), rectum (n = 3), esophagus (n = 2), liver (n = 1) and pancreas (n = 1). Prior irinotecan- and etoposide-containing chemotherapies were used in ten and six patients, respectively. Median initial dose of AMR was 40 mg/m²/day for three consecutive days, and median of treatment cycles was 4 (range 1–9). The objective response rate (ORR) was 38.5 %. Median progression-free survival (PFS) and overall survival (OS) were 107 (range 22–275) and 215 days (range 71–535), respectively. Common severe adverse events (grade 3/4) were neutropenia (84.6 %) and febrile neutropenia (30.8 %). Patient with longer platinum-free interval (>90 days) exhibited longer PFS and OS than those with shorter platinum-free interval (190 vs. 63 days and 348 vs. 145 days, respectively).

Conclusions

AMR showed evidence of clinical activity and safety when used for the treatment of EPNEC. It might be especially useful for populations with sensitive relapse.

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Titel: Amrubicin monotherapy for patients with extrapulmonary neuroendocrine carcinoma after platinum-based chemotherapy
verfasst von: Kenta Nio
Shuji Arita
Taichi Isobe
Hitoshi Kusaba
Kenichi Kohashi
Tatsuhiro Kajitani
Shingo Tamura
Gen Hirano
Kenji Mitsugi
Akitaka Makiyama
Taito Esaki
Hiroshi Ariyama
Yoshinao Oda
Koichi Akashi
Eishi Baba
Publikationsdatum: 01.04.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: Cancer Chemotherapy and Pharmacology / Ausgabe 4/2015
Print ISSN: 0344-5704
Elektronische ISSN: 1432-0843
DOI: https://doi.org/10.1007/s00280-015-2706-y

Springer Medizin

Amrubicin monotherapy for patients with extrapulmonary neuroendocrine carcinoma after platinum-based chemotherapy