Open AccessEfficacy of topotecan in pretreated metastatic poorly differentiated extrapulmonary neuroendocrine carcinoma
Author(s) -
Apostolidis Leonidas,
Bergmann Frank,
Jäger Dirk,
Winkler Eva Caroline
Publication year - 2016
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.807
Subject(s) - topotecan , medicine , etoposide , oncology , chemotherapy , regimen , progressive disease , gastroenterology
Therapeutic options for metastatic poorly differentiated neuroendocrine carcinoma ( NEC ) after prior platinum‐based chemotherapy are limited. Topotecan is an approved second‐line chemotherapy for small cell lung cancer ( SCLC ). NEC is often considered to show a biological behavior similar to SCLC . The aim of this study was to analyze the efficacy of topotecan in pretreated metastatic NEC patients. We performed a retrospective analysis of all patients treated with topotecan for metastatic NEC who presented at our center between January 2005 and December 2014 ( n = 30). All 30 patients had received at least a platinum and etoposide containing regimen as prior chemotherapy. Median proliferation rate (Ki67) was 80%. As best response to topotecan five patients showed a stable disease, two patients a partial remission, resulting in a disease control rate of 23%. Of the remaining 23 patients, 14 (47%) showed a progressive disease, nine (30%) died before radiologic response could be evaluated. Median progression‐free ( PFS ) and overall survival ( OS ) after start of topotecan was 2.1 and 4.1 months, respectively. In the subgroup analysis, patients with unknown primary (vs. those with a known primary) showed a significantly prolonged PFS of 3.5 months (vs. 1.9, P = 0.0107) and OS of 6.7 months (vs. 2.6 months, P = 0.0168). Grade 3/4 hematotoxicity was observed in 60% of patients. Topotecan shows only moderate antitumor activity in metastatic NEC . Disease control rate is lower than reported for SCLC . However, antitumor activity of topotecan seems higher in patients with unknown primary.