Efficacy and Toxicity of 5-Fluorouracil–Oxaliplatin in Gastroenteropancreatic Neuroendocrine Neoplasms. Issue 7 (August 2020)

• Record Type: Journal Article
• Authors: Merola, Elettra; Dal Buono, Arianna; Denecke, Timm; Arsenic, Ruza; Pape, Ulrich-Frank; Jann, Henning; Wiedenmann, Bertram; Pavel, Marianne E.
• Is Part Of: Pancreas. Volume 49:Issue 7(2020)
• Publication Date: 2020-08
• Subjects: neuroendocrine neoplasm -- FOLFOX -- progression-free survival -- first line therapy -- tolerability; Pancreas -- Diseases -- Periodicals; Pancreas -- Periodicals; Neuroendocrine tumors -- Periodicals; 616.37005
• DOI: 10.1097/MPA.0000000000001593
• Languages: English
• ISSNs: 0885-3177

Abstract

Abstract : Objectives: The objective of this study was to investigate the efficacy and tolerability of 5-fluorouracil–oxaliplatin (FOLFOX) in advanced gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs). Methods: Retrospective analysis of consecutive 72 advanced GEP-NENs treated with FOLFOX between 2005 and 2016 at a single German referral center for NENs was performed. We assessed treatment response by response evaluation criteria in solid tumors 1.0 criteria, progression-free survival by Kaplan-Meyer method, and risk factor analysis by Cox-regression model. Results: Patients were 44.5% G1/G2, 55.5% G3, receiving a median of 7 treatment cycles (range, 2–21), and had a median of 18 months of follow-up (range, 3–111 months). Disease control was achieved in 75.0% of cases but 91.3% in the 23 patients receiving FOLFOX as first line ( P = 0.04). Median progression-free survival of the overall population was 8 months. A better outcome was significantly related to treatment duration ( P = 0.02) and grade of histological differentiation for G3 patients (well differentiated vs poorly differentiated, P = 0.03). Adverse events occurred in 88.8% of patients, mostly grade 1 and 2 hematotoxicity and chemotherapy-induced peripheral sensory neuropathy (84.1% and 50.0% of patients, respectively). Conclusions: Our results support FOLFOX as therapeutic option in advanced GEP-NENs with poor prognosis, either at first or further therapy line. Longer duration of therapy was associated with a more durable benefit. Abstract : Supplemental digital content is available in the text.