학술논문
Second-line treatment and prognostic factors in neuroendocrine carcinoma: the RBNEC study.
Document Type
Academic Journal
Author
Hadoux J; Oncologie Endocrinienne, Département d'Imagerie, Gustave Roussy, Villejuif, France.; Walter T; Service d'Oncologie, ENETS Centre of Excellence, Hospices Civils de Lyon et Université de Lyon, Lyon, France.; Kanaan C; Service de Pathologie, Département de Biologie et Pathologie Médicale, Gustave Roussy, Villejuif, France.; Hescot S; Département d'Oncologie, Institut Curie, Paris, France.; Hautefeuille V; Service d'Hépato-gastro-entérologie et Cancérologie Digestive, CHU Amiens Picardie, Amiens, France.; Perrier M; Département d'Hépato-gastro-entérologie, CHU de Reims, Reims, France.; Tauveron I; Service d'Endocrinologie, Diabétologie et Maladies Métaboliques, CHU Clermont-Ferrand, Clermont-Ferrand, France.; Laboratoire GReD, Université Clermont Auvergne, Clermont-Ferrand, France.; Laboureau S; Département d'Endocrinologie-Diabétologie-Nutrition, CHU d'Angers, Angers Cedex 9, France.; Do Cao C; CHU de Lille, Service d'Endocrinologie, Lille, France.; Petorin C; CHU Clermont-Ferrand, Service de Chirurgie Digestive et Hépatobiliaire, Clermont-Ferrand, France.; Blanchet O; CRB, CHU d'Angers, Angers Cedex 9, France.; Faron M; Département de Chirurgie, Gustave Roussy, Villejuif, France.; Leteurtre E; CANTHER - Cancer Heterogeneity Plasticity and Resistance to Therapies, Université de Lille, CNRS, Inserm, CHU Lille, UMR9020-U1277, Lille, France.; Rousselet MC; Département de Pathologie, CHU d'Angers, Angers Cedex 9, France.; Joubert Zakeyh J; Laboratoire d'Anatomie Pathologique, CHU Clermont-Ferrand, Clermont-Ferrand, France.; Marchal A; Service d'Anatomo-Pathologie, CHU Reims, Reims, France.; Chatelain D; Service d'Anatomo-Pathologie, CHU Amiens, Amiens, France.; Beaulaton C; Service d'Anatomo-Pathologie, Institut Curie, Paris, France.; Hervieu V; Service d'Anatomo-Pathologie, ENETS Centre of Excellence, Hospices Civils de Lyon et Université de Lyon, Lyon, France.; Lombard-Bohas C; Service d'Oncologie, ENETS Centre of Excellence, Hospices Civils de Lyon et Université de Lyon, Lyon, France.; Ducreux M; Service d'Oncologie Digestive, Département de Médecine, Gustave Roussy, Villejuif, France.; Faculté de Médecine, Université Paris Saclay, Le Kremlin-Bicêtre, France.; Scoazec JY; Service de Pathologie, Département de Biologie et Pathologie Médicale, Gustave Roussy, Villejuif, France.; Faculté de Médecine, Université Paris Saclay, Le Kremlin-Bicêtre, France.; Baudin E; Oncologie Endocrinienne, Département d'Imagerie, Gustave Roussy, Villejuif, France.
Source
Publisher: BioScientifica Country of Publication: England NLM ID: 9436481 Publication Model: Electronic-Print Cited Medium: Internet ISSN: 1479-6821 (Electronic) Linking ISSN: 13510088 NLM ISO Abbreviation: Endocr Relat Cancer Subsets: MEDLINE
Subject
Language
English
Abstract
Neuroendocrine carcinomas (NEC) are aggressive malignant diseases. Etoposide-based rechallenge (EBR) and the prognostic role of RB transcriptional corepressor 1 (RB1) status in second-line chemotherapy (2L) have not been studied. The objectives of this study were to report the results of 2L including EBR as well as prognostic factors in a national retrospective multicentre study. NEC patients treated with 2L and further, with tissue samples available, were included. RB1 status and morphological classification were reviewed centrally. Among the 121 NEC patients (40% female, median age 61 years) included, there were 73 small-cell NEC (60%), 34 large-cell NEC (28%) and 14 NEC (not otherwise specified, 12%). Primary sites were lung (39%), gastroenteropancreatic (36%), other (13%) and unknown (12%). Median Ki-67 index was 80%. Median progression-free survival (PFS) and overall survival (OS) under 2L were 2.1 and 6.2 months, respectively. No difference was observed between patients who received an 'adenocarcinoma-like' or a 'neuroendocrine-like' 2L or according to the RB1 status. Thoracic NEC primary was the only adverse prognostic factor for OS. EBR, administered to 31 patients, resulted in a 62% disease control rate with a median PFS and OS of 3.2 and 11.7 months, respectively. In the 94 patients with a relapse-free interval of ≥3 months after first-line platinum-etoposide chemotherapy, the median OS was 12 months in patients who received EBR as compared to 5.9 months in patients who did not (P = 0.043). EBR could be the best 2L option for patient with initial response to first-line platinum-etoposide lasting at least 3 months. RB1 status does not provide prognostic information in this setting.