Post-first line FOLFOX chemotherapy in Grade 3 neuroendocrine carcinoma.
Hadoux J1,
Malka D2,
Planchard D3,
Scoazec JY4,
Caramella C5,
Guigay J6,
Boige V7,
Leboulleux S8,
Burtin P9,
Berdelou A10,
Loriot Y11,
Duvillard P12,
Chougnet CN13,
Déandreis D14,
Sclumberger M15,
Borget I16,
Ducreux M17,
Baudin E18.
Abstract
There is no standard for second line chemotherapy in poorly differentiated grade 3 neuroendocrine carcinoma (G3-NEC) patients. We analyzed the antitumor efficacy of 5-fluroruracil and Oxaliplatin (FOLFOX) chemotherapy in this population. A single center retrospective analysis of G3-NEC consecutive patients treated with FOLFOX chemotherapy after failure of cisplatinum-based regimen between December 2003 and June 2012 was performed. Progression-free survival, overall survival, response rate and safety were assessed according to RECIST 1.1 and NCI.CTC v4 criteria. Twenty consecutive patients were included (7 males, 13 females; median age 55; range 23-87 years) with a performance status of 0 to 1 in 75% of them. Primary location was gastro-enteropancreatic in 12, thoracic in 4, other in 2 and unknown in 2 patients. There were 12 (65%) large cell, 7 (30%) small cell grade 3 neuroendocrine carcinoma tumors and 1 (5%) unknown. All patients had distant metastases. Twelve (60%) patients received FOLFOX as second line and 8 (40%) as third line or more and median number of administered cycles was 6 (range 3-14). The median follow-up was 19 months. Median progression-free survival was 4.5 months. Among the 17 evaluable patients, 5 partial responses (29%), 6 stable diseases (35%) and 6 progressive diseases (35%) were observed. Median overall survival was 9.9 months. Main Grade 3-4 toxicities were neutropenia (35%), thrombopenia (20%), nausea/vomiting (10%), anemia (10%) and elevated liver transaminases (10%). Our results suggest that FOLFOX regimen could be considered as a second-line option in poorly differentiated grade 3 neuroendocrine carcinoma patients after cisplatinum-based first line treatment but warrant further confirmation in future larger prospective studies.
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