Center for Liver and Pancreatobiliary Cancer, National Cancer Center, Goyang, Korea.
Cancer Center, Mittaphab Hospital, Vientiane, Laos.
Korean J Intern Med. 2022 Nov;37(6):1216-1222. doi: 10.3904/kjim.2022.100. Epub 2022 Nov 1.
BACKGROUND/AIMS: The combination of capecitabine and temozolomide (CAPTEM) is one of the treatment options for metastatic pancreatic neuroendocrine neoplasms (pNENs). This study aims to evaluate the efficacy of CAPTEM in patients with metastatic intermediate to high-grade pancreatic neuroendocrine tumor (pNET) or carcinoma (pNEC).
This study was conducted retrospectively in a single center. Patients were treated for intermediate to high-grade tumor with 750 mg/m² of capecitabine twice daily from day 1 to 14 and 200 mg/m² of temozolomide once daily from day 10 to 14, repeating twice in a cycle of 28 days. The primary outcomes were durations of overall survival (OS) and progression-free survival (PFS). The secondary outcomes consisted of objective response rate and disease control rate.
A total of 12 patients (grade 2 NET in six, grade 3 NET in three, NEC in three patients) who received CAPTEM were included in this study. Patients received a median of five cycles (range, 2 to 46) of CAPTEM. The median dose combined 1,150 mg of capecitabine and 300 mg of temozolomide. The median OS and PFS were 41.2 months (range, 3.2 to 167) and 39.7 months (range, 2.1 to 100), respectively. Patients with NET had longer OS and PFS compared to those of patients with NEC (p = 0.002 and p = 0.028). High Ki-67 proliferative index (> 50%) was significantly associated with poor survival outcomes.
CAPTEM showed favorable survival outcomes in patients with metastatic intermediate to high-grade pNENs. Our study supports that CAPTEM may be an effective treatment option for metastatic pNENs.
背景/目的：卡培他滨联合替莫唑胺（CAPTEM）是治疗转移性胰腺神经内分泌肿瘤（pNENs）的治疗选择之一。本研究旨在评估 CAPTEM 在转移性中高级胰腺神经内分泌瘤（pNET）或神经内分泌癌（pNEC）患者中的疗效。
本研究在一家单中心进行回顾性研究。患者接受治疗的中高级别肿瘤患者，卡培他滨每天两次，每次 750mg/m²，从第 1 天到第 14 天；替莫唑胺每天一次，每次 200mg/m²，从第 10 天到第 14 天，28 天为一个周期，重复两次。主要结局是总生存期（OS）和无进展生存期（PFS）的持续时间。次要结局包括客观缓解率和疾病控制率。
本研究共纳入 12 例接受 CAPTEM 治疗的患者（2 级 NET6 例，3 级 NET3 例，NEC3 例）。患者接受 CAPTEM 治疗的中位数为 5 个周期（范围 2 至 46）。卡培他滨和替莫唑胺联合剂量的中位数为 1150mg 和 300mg。中位 OS 和 PFS 分别为 41.2 个月（范围 3.2 至 167）和 39.7 个月（范围 2.1 至 100）。NET 患者的 OS 和 PFS 均长于 NEC 患者（p = 0.002 和 p = 0.028）。高 Ki-67 增殖指数（>50%）与较差的生存结局显著相关。
CAPTEM 在转移性中高级 pNENs 患者中显示出良好的生存结果。我们的研究支持 CAPTEM 可能是转移性 pNENs 的有效治疗选择。
