Capecitabine and temozolomide or temozolomide alone in patients with atypical carcinoids.

IF 3.7 3区医学 Q2 Medicine

Endocrine Pub Date : 2025-01-24 DOI:10.1007/s12020-025-04171-5

Linda Galvani, Arianna Zappi, Sara Pusceddu, Fabio Gelsomino, Anna La Salvia, Simone Oldani, Francesco Panzuto, Elisa Andrini, Giuseppe Lamberti, Davide Campana

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引用次数: 0

Abstract

Background: Lung neuroendocrine neoplasms (NENs) represent about 20% of all lung cancers. Few therapeutic options are available for atypical carcinoids (ACs). Single-agent temozolomide (TEM) is active in lung NENs, but whether the addition of capecitabine (CAPTEM) is associated with improved outcomes, is unknown. We sought to investigate the TEM-based therapies (TEM or CAPTEM) in patients with advanced AC.

Material and methods: This was a retrospective analysis of prospectively collected data from patients with AC of the lung referred to our institution from January 2003 to January 2023 who have received chemotherapy with either TEM or CAPTEM as any line treatment. Primary endpoint was progression free survival (PFS), secondary endpoints included overall response rate (ORR) and overall survival (OS).

Results: In this study we included 31 patients with advanced AC. Median Ki-67 was 14.4% (3-30). CAPTEM in 17 patients (54.8%), while TEM was administered in 14 patients (45.2%). Overall, ORR was 39% (N = 12/31, all partial responses), while median PFS and OS were 57.4 months (95%CI: 43.2-71.7) and 24.4 months (95% confidence interval [95%CI]: 14.7-34.1). Median PFS was 33.9 months (15.6-52.1) in the CAPTEM group, while it was 15.5 (7.3-23.8) in the TEM group (p = 0.047). When adjusting for potential confounding factors, treatment with TEM vs CAPTEM retained its independent association with an increased risk of progression (HR: 4.01 [95%CI: 1.18-13.68]; p = 0.027).

Conclusions: Treatment with CAPTEM is associated with longer PFS than TEM alone in patients with AC. Prospective studies with larger sample size are needed to validate this finding.

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卡培他滨和替莫唑胺或单独替莫唑胺治疗非典型类癌。

背景：肺神经内分泌肿瘤（NENs）约占所有肺癌的20%。非典型类癌（ACs）的治疗选择很少。单药替莫唑胺（TEM）在肺部NENs中有活性，但卡培他滨（capecitabine）的加入是否与改善预后相关尚不清楚。我们试图研究以TEM为基础的治疗方法（TEM或CAPTEM）在晚期AC患者中的应用。材料和方法：这是一项回顾性分析，前瞻性收集了2003年1月至2023年1月在我们机构就诊的接受过TEM或CAPTEM化疗的肺AC患者的数据。主要终点是无进展生存期（PFS），次要终点包括总缓解率（ORR）和总生存期（OS）。结果：在这项研究中，我们纳入了31例晚期AC患者，中位Ki-67为14.4%（3-30）。CAPTEM 17例（54.8%），TEM 14例（45.2%）。总体而言，ORR为39% （N = 12/31，全部部分缓解），中位PFS和OS分别为57.4个月（95% ci: 43.2-71.7）和24.4个月（95%可信区间[95% ci]: 14.7-34.1）。CAPTEM组中位PFS为33.9个月（15.6-52.1），TEM组中位PFS为15.5个月（7.3-23.8）（p = 0.047）。当调整潜在的混杂因素时，TEM与CAPTEM治疗与进展风险增加保持独立关联(HR: 4.01 [95%CI: 1.18-13.68]；p = 0.027)。结论：在AC患者中，CAPTEM治疗与单独使用TEM相比，PFS更长。需要更大样本量的前瞻性研究来验证这一发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine 医学-内分泌学与代谢

CiteScore

6.40

自引率

5.40%

发文量

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.