Maratta Maria Grazia, Sparagna Ileana, Occhipinti Denis, Roca Luigi, Sgambato Margherita, Raia Salvatore, Bianchi Antonio, Chiloiro Sabrina, Rossi Ernesto, Rindi Guido, Tortora Giampaolo, Schinzari Giovanni
Medical Oncology Unit, Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli-IRCCS, 00168 Rome, Italy.
Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
Cancers (Basel). 2025 May 3;17(9):1561. doi: 10.3390/cancers17091561.
(1) Background: GEP-NETs are frequently diagnosed at advanced stage. For well-differentiated somatostatin receptor-positive (SSTR+) NETs, SSA are the preferred first-line therapy. However, in newly diagnosed patients with G2/G3 and a high tumor burden, SSA alone might not be enough; (2) Methods: We conducted a retrospective analysis to assess the effectiveness of combining oxaliplatin-fluoropyrimidine chemotherapy with SSA as an upfront strategy in newly diagnosed metastatic G2/G3 GEP-NET patients treated with oxaliplatin-fluoropyrimidine-based chemotherapy; (3) Results: Between March 2017 and October 2023, 32 pts (19 males, 13 females; M:F = 1.5:1; median age 54 years, range 31-82) were deemed eligible to receive oxaliplatin-fluoropyrimidine chemotherapy in addition to SSA; 14 received XELOX and 18 FOLFOX. After a median follow-up of 26 mo., each patient had completed at least two cycles of chemotherapy. The ORR was 25%, with a median DoR of 21.3 mo. The DCR was 87.5%. Notably, 28.1% of patients experienced tumor shrinkage sufficient for radical surgery on residual tumor lesions, encompassing both primary tumors and metastases; (4) Conclusions: Upfront treatment with the combination of oxaliplatin-fluoropyrimidine and SSA demonstrated effectiveness and safety. This approach may be considered to facilitate conversion surgery in eligible patients.
(1) 背景：胃肠胰神经内分泌肿瘤（GEP-NETs）常于晚期被诊断出来。对于分化良好的生长抑素受体阳性（SSTR+）NETs，生长抑素类似物（SSA）是首选的一线治疗方法。然而，在新诊断的G2/G3且肿瘤负荷高的患者中，仅使用SSA可能并不足够；(2) 方法：我们进行了一项回顾性分析，以评估在接受基于奥沙利铂-氟尿嘧啶的化疗的新诊断转移性G2/G3 GEP-NET患者中，将奥沙利铂-氟尿嘧啶化疗与SSA联合作为初始治疗策略的有效性；(3) 结果：在2017年3月至2023年10月期间，32例患者（19例男性，13例女性；男:女 = 1.5:1；中位年龄54岁，范围31 - 82岁）被认为除SSA外还适合接受奥沙利铂-氟尿嘧啶化疗；14例接受XELOX方案，18例接受FOLFOX方案。中位随访26个月后，每位患者至少完成了两个周期的化疗。客观缓解率（ORR）为25%，中位缓解持续时间（DoR）为21.3个月。疾病控制率（DCR）为87.5%。值得注意的是，28.1%的患者肿瘤缩小到足以对残留肿瘤病灶（包括原发肿瘤和转移灶）进行根治性手术；(4) 结论：奥沙利铂-氟尿嘧啶与SSA联合的初始治疗显示出有效性和安全性。对于符合条件的患者，可考虑采用这种方法以促进转化手术。
