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Clinical Trial
. 2010 Mar 30;102(7):1106-12.
doi: 10.1038/sj.bjc.6605618. Epub 2010 Mar 16.

Chemotherapy with 5-fluorouracil, cisplatin and streptozocin for neuroendocrine tumours

N C Turner  1 , S J Strauss, D Sarker, R Gillmore, A Kirkwood, A Hackshaw, A Papadopoulou, J Bell, I Kayani, C Toumpanakis, F Grillo, A Mayer, D Hochhauser, R H Begent, M E Caplin, T Meyer
Affiliations
Clinical Trial

Chemotherapy with 5-fluorouracil, cisplatin and streptozocin for neuroendocrine tumours

N C Turner et al. Br J Cancer. .

Abstract

Background: The role of chemotherapy for neuroendocrine tumours remains controversial and there is no standard regimen.

Method: We report the outcome for a consecutive series of chemonaive patients with metastatic or locally advanced neuroendocrine tumours treated with a combination of 5-fluorouracil (500 mg m(-2)), cisplatin (70 mg m(-2)) and streptozocin (1000 mg m(-2)) (FCiSt) administered three weekly for up to six cycles. Patients were assessed for radiological response, toxicity and survival.

Results: In the 79 patients assessable for response, treatment with FCiSt was associated with an overall response rate of 33% (38% for pancreatic primary sites and 25% for non-pancreatic primary sites). Stable disease occurred in a further 51%, with progression in 16%. The median time to progression was 9.1 months and median overall survival was 31.5 months. The most common grade 3-4 toxicity was neutropaenia (28% patients) but grade 3-4 infection was rare (7%). The most frequent non-haematological grade 3-4 toxicity was nausea and vomiting (17%). Prognostic factors included Ki-67, mitotic index, grade and chromogranin A, whereas response to chemotherapy was predicted by mitotic index, grade and alpha-fetoprotein.

Conclusions: FCiSt is an effective regimen for neuroendocrine tumours with an acceptable toxicity profile. Grade and mitotic index are the best predictors of response.

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Figures

Figure 1
Figure 1
Overall survival (A) and progression-free survival (B). Overall survival according to differentiation status (C), normal or elevated serum chromogranin A (D) mitotic index (MI) (E) Ki-67 index (F).
See this image and copyright information in PMC

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