التفاصيل البيبلوغرافية
| العنوان: |
Metronomic temozolomide as second line treatment for metastatic poorly differentiated pancreatic neuroendocrine carcinoma. |
| المؤلفون: |
De Divitiis, C.1, von Arx, C.2, Grimaldi, A. M.3, Cicala, D.4, Tatangelo, F.5, Arcella, A.6, Romano, G. M.1, Simeone, E.3, Iaffaioli, R. V.1, Ascierto, P. A.3, Tafuto, S.1 salvatore.tafuto@libero.it, European Neuroendocrine Tumor Society (ENETS) Center of Excellence-Multidisciplinary Group for Neuroendocrine Tumors in Naples (Italy) (CORPORATE AUTHOR) |
| المصدر: |
Journal of Translational Medicine. 5/3/2016, Vol. 14, p1-12. 12p. |
| مصطلحات موضوعية: |
*PANCREATIC cancer treatment, *TEMOZOLOMIDE, *METASTASIS, *NEUROENDOCRINE tumors, *CANCER patients |
| مستخلص: |
Neuroendocrine Neoplasms (NEN) are a group of heterogeneous malignancies derived from neuroendocrine cell compartment, with different roles in both endocrine and nervous system. Most NETs have gastroentero-pancreatic (GEP) origin, arising in the foregut, midgut, or hindgut. The 2010 WHO classification divides GEP-NETs into two main subgroups, neuroendocrine tumors (NET) and neuroendocrine carcinomas (NEC), according with Ki-67 levels. NET are tumors with low (<20 %) Ki-67 value, and NECs, including small cell lung carcinomas and Merkel Cell carcinomas, are all NETs with high Ki-67 levels (>20 %-G3). Poorly differentiated neuroendocrine carcinomas (NEC) are usually treated with cisplatin-based chemotherapy regimens. Here we present a case of a patient with pancreatic NEC progressing after cisplatin and etoposide, treated with temozolomide as palliative, second line treatment. According with the poor Performance Status (PS = 2) and to reduce the toxicity of the treatment was chosen an intermittent dosing regimen of metronomic temozolomide (75 mg/m(2)/day-one-week-on/on-week-off). MGMT resulted methylated. On July 2014 the patient started the treatment. On August 2014 the patient obtained a significant clinical benefit (PS = 0) and the total body CT scan performed on October 2014 showed a RECIST partial response on all the sites of disease. No drug-related side effects were reported by the patient. After 18 months of therapy the treatment continues without significant toxicity, and with further remission of the metastases. Treatment with metronomic "one-week-on/on-week-off" Temozolomide can be considered a good treatment option in patients with poor performance status, affected by pNEC with MGMT methylation. [ABSTRACT FROM AUTHOR] |
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