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Multicenter Study
. 2023 Oct 3;28(10):875-884.
doi: 10.1093/oncolo/oyad257.

Efficacy of Capecitabine and Temozolomide Regimen in Neuroendocrine Tumors: Data From the Turkish Oncology Group

Çağlar Ünal  1 , Abdulmunir Azizy  2 , Senem Karabulut  2 , Didem Taştekin  2 , Arif Akyıldız  3 , Serkan Yaşar  3 , Şuayib Yalçın  3 , Eyüp Çoban  4 , Türkkan Evrensel  4 , Ziya Kalkan  5 , Zeynep Oruç  5 , Sümeyra Derin  6 , Zeynep Hande Turna  6 , Doğan Bayram  7 , Fahriye Tuğba Köş  7 , Mehmet Ali Nihat Şendur  7 , Nadiye Sever  8 , Özlem Ercelep  8 , Mustafa Seyyar  9 , Umut Kefeli  9 , Kazım Uygun  9 , Melike Özçelik  10 , Sercan Ön  11 , Ulus Ali Şanlı  11 , Kübra Canaslan  12 , İlkay Tuba Ünek  12 , Kadriye Bir Yücel  13 , Nuriye Özdemir  13 , Ozan Yazıcı  13 , Halil Göksel Güzel  14 , Derya Kıvrak Salim  14 , Sema Sezgin Göksu  15 , Ali Murat Tatlı  15 , Çetin Ordu  16 , Oğuzhan Selvi  17 , Abdullah Sakin  18 , Mehmet Emin Büyükbayram  19 , Bengü Dursun  20 , Yüksel Ürün  20 , Hacı Arak  21 , Gözde Ağdaş  22 , Muzaffer Uğraklı  23 , Engin Hendem  23 , Melek Karakurt Eryılmaz  23 , Burak Bilgin  24 , Atakan Topçu  25 , Melih Şimşek  25 , Mahmut Büyükşimşek  26 , Büşra Akay  27 , Gülçin Şahingöz Erdal  28 , Fatih Karataş  29 , Özkan Alan  30 , Melek Çağlayan  31 , Fatma Akdağ Kahvecioğlu  32 , Ayşe Demirci  32 , Nail Paksoy  33 , Bülent Çetin  34 , Mahmut Gümüş  35 , Naziye Ak  36 , Yasemin Aydınalp  37 , Semra Paydaş  37 , Deniz Can Güven  38 , Saadettin Kılıçkap  39 , Sezer Sağlam  40
Affiliations
Multicenter Study

Efficacy of Capecitabine and Temozolomide Regimen in Neuroendocrine Tumors: Data From the Turkish Oncology Group

Çağlar Ünal et al. Oncologist. .

Abstract

Introduction: This study aims to report the efficacy and safety of capecitabine plus temozolomide (CAPTEM) across different lines of treatment in patients with metastatic neuroendocrine tumors (NETs).

Methods: We conducted a multicenter retrospective study analyzing the data of 308 patients with metastatic NETs treated with CAPTEM between 2010 and 2022 in 34 different hospitals across various regions of Turkey.

Results: The median follow-up time was 41.0 months (range: 1.7-212.1), and the median age was 53 years (range: 22-79). Our results across the entire patient cohort showed a median progression-free survival (PFS) of 10.6 months and a median overall survival (OS) of 60.4 months. First-line CAPTEM treatment appeared more effective, with a median PFS of 16.1 months and a median OS of 105.8 months (median PFS 16.1, 7.9, and 9.6 months in first-, second- and ≥third-line respectively, P = .01; with median OS values of 105.8, 47.2, and 24.1 months, respectively, P = .003) In terms of ORR, the first-line treatment again performed better, resulting in an ORR of 54.7% compared to 33.3% and 30.0% in the second and third or higher lines, respectively (P < .001). Grade 3-4 side effects occurred only in 22.5% of the patients, leading to a discontinuation rate of 9.5%. Despite the differences in outcomes based on treatment line, we did not observe a significant difference in terms of side effects between the first and subsequent lines of treatment.

Conclusions and relevance: The substantial superior outcomes in patients receiving first-line CAPTEM treatment highlight its potential as an effective treatment strategy for patients with metastatic NET.

Keywords: CAPTEM; capecitabine; neuroendocrine neoplasia; neuroendocrine tumors; temozolomide.

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Conflict of interest statement

The authors report no Conflict of Interest in any product mentioned or concept discussed in this article.

Figures

Figure 1.
Figure 1.
Progression-free survival according to the line of treatment (first-line therapy, n = 139; second-line therapy, n = 118; ≥third-line therapy, n = 51 patients).
Figure 2.
Figure 2.
Survival analysis of all patients treated with CAPTEM treatment according to grade.
Figure 3.
Figure 3.
Progression-free survival according to the Ki-67 groups (<3%, 3%-20%, 20%-55%) (n = 308).
See this image and copyright information in PMC

References

    1. Yao JC, Hassan M, Phan A, et al. . One hundred years after “carcinoid”: epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States. J Clin Oncol. 2008;26(18):3063-3072. 10.1200/JCO.2007.15.4377 - DOI - PubMed
    1. Dasari A, Shen C, Halperin D, et al. . Trends in the incidence, prevalence, and survival outcomes in patients with neuroendocrine tumors in the United States. JAMA Oncol. 2017;3(10):1335-1342. 10.1001/jamaoncol.2017.0589 - DOI - PMC - PubMed
    1. Unal C, Saglam S.. Metastatic neuroendocrine carcinoma: liver metastases presenting with diffuse nodular calcifications on CT. J Cancer Res Ther. 2023.. 10.4103/jcrt.jcrt_497_21 - DOI - PubMed
    1. Pavel M, Öberg K, Falconi M, et al. . Gastroenteropancreatic neuroendocrine neoplasms: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2020;31(7):844-860. 10.1016/j.annonc.2020.03.304 - DOI - PubMed
    1. Kaltsas GA, Besser GM, Grossman AB.. The diagnosis and medical management of advanced neuroendocrine tumors. Endocr Rev. 2004;25(3):458-511. 10.1210/er.2003-0014 - DOI - PubMed

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