Irinotecan-based chemotherapy in extrapulmonary neuroendocrine carcinomas: survival and safety data from a multicentric Italian experience

• DOI: 10.1007/s12020-021-02813-y
• Publication Date: 2021-07-06T18:02:45Z
• Authors: Camilla Bardasi; Andrea Spallanzani; Stefania Benatti; Francesca Spada; Alice Laffi; Lorenzo Antonuzzo; Daniele Lavacchi; Riccardo Marconcini; Marco Ferrari; Margherita Rimini; Francesco Caputo; Chiara Santini; Krisida Cerma; Andrea Casadei-Ga...; Kalliopi Andrikou; Massimiliano Salati; Federica Bertolini; Annalisa Fontana; Massimo Dominici; Gabriele Luppi; Fabio Gelsomino
• Keywords: Adult; Male; 0301 basic medicine; Middle Aged; Irinotecan; Chemotherapy; Irinotecan; NEC; Neuroendocrine carcinoma; Second-line treatment; Survival; Carcinoma, Neuroendocrine; 3. Good health; Neuroendocrine Tumors; 03 medical and health sciences; Italy; Antineoplastic Combined Chemotherapy Protocols; Chemotherapy; Irinotecan; NEC; Neuroendocrine carcinoma; Second-line treatment; Survival; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Female; Humans; Irinotecan; Italy; Male; Middle Aged; Carcinoma, Neuroendocrine; Neuroendocrine Tumors; Humans; Female; Aged

Abstract Purpose: Neuroendocrine carcinomas (NECs) are a rare subgroup of neuroendocrine neoplasms that occasionally originate from gastro-entero-pancreatic (GEP) tract. Evidence of the effectiveness of chemotherapy is scarce. Platinum plus Etoposide regimens are currently the standard treatment in first-line, while little data are available on second-line treatments. The aim of this study is to evaluate the efficacy and safety of Irinotecan (IRI)-based chemotherapy in a series of extrapulmonary NECs. Methods: Patients with NEC diagnosis treated at University Hospitals of Modena, Florence, Pisa, and European Institute of Oncology of Milan with an IRI-based regimen (FOLFIRI or XELIRI) after progression to a first-line platinum-based therapy were enrolled. Objective responses were assessed according to RECIST criteria. Progression-free survival (PFS) and overall survival (OS) were calculated. Results: 34 patients, 16 males, and 18 females, median age of 59 years (range 32-77), with metastatic NEC were included. Twenty-seven pts had Ki-67 ≥ 55% and 4 pts Ki-67 of < 55% (for 3 pts data was not available). The median number of treatment cycles of the IRI-based regimen was 7.5 (range 1-16). Six partial responses (17.6%) and 9 stable diseases (26.5%) were observed, with a disease control rate of 44.1%. Median PFS and OS were 4.4 and 5.9 months, respectively. Neutropenia, anemia, and nausea were the only G3-G4 toxicities reported. Conclusion: Despite the relatively small sample size, IRI-based therapy demonstrated to be a valid option for patients with pre-treated extrapulmonary NEC.