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Chemotherapy Regimen for NET: Platinum Agent Plus Topoisomerase Inhibitor

The exploration of chemotherapy for advanced pancreatic neuroendocrine tumors has been somewhat sparse, but has increased pace during the past few years. Certain of these regimens have met with some success, increasing the armamentarium of clinicians.

Beijing, China researchers led by Shen from the Peking University School of Oncology have published an article in the September 2013 issue of the journal Medical Oncology that examines the outcome of such a chemo regimen: the platinum drug cisplatin in combination with the topoisomerase I inhibitor, irinotecan (in the U.S. trade name Camptosar) in those with metastatic pancreatic cancer.

In years 2007 through 2009, sixteen patients with advanced and locally-advanced gastroenteropancreatic neuroendocrine tumors were treated with the cisplatin plus irinotecan combination therapy. Several of these patients were then transitioned to long-acting release octreotide after disease control had been reached.  The median duration of progression-free survival was found to be 5.5 months.  And the median overall survival of the patients was 10.6 months.  The primary serious side-effect of this treatment regimen was hematological. The authors conclude that this combination is reasonably well tolerated, and moderately effective.

This study is encouraging, and needs further confirmation.  But it does improve our understanding as to potential treatment options for those with more advanced neuroendocrine tumors.

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Dale O’Brien, MD