Amrubicin Monotherapy for Patients with Platinum-Refractory Gastroenteropancreatic Neuroendocrine Carcinoma

Abstract EN

Objective.

Patients with gastroenteropancreatic neuroendocrine carcinoma (NEC) have a poor prognosis.

Platinum-based combination chemotherapy is commonly used as first-line treatment; however, the role of salvage chemotherapy remains unknown.

This study aimed to analyze the efficacy and safety of amrubicin monotherapy in patients with platinum-refractory gastroenteropancreatic NEC.

Methods.

Among 22 patients with advanced gastroenteropancreatic NEC, 10 received amrubicin monotherapy between September 2007 and May 2014 after failure of platinum-based chemotherapy.

The efficacy and toxicity of the treatment were analyzed retrospectively.

Results.

Eight males and two females (median age, 67 years (range, 52–78)) received platinum-based chemotherapy, including cisplatin plus irinotecan (n=7, 70%), cisplatin plus etoposide (n=2, 20%), and carboplatin plus etoposide (n=1, 10%) before amrubicin therapy.

Median progression-free survival and overall survival after amrubicin therapy were 2.6 and 5.0 months, respectively.

Two patients had partial response (20% response rate), and their PFS were 6.2 months and 6.3 months, respectively.

Furthermore, NEC with response for amrubicin had characteristics with a high Ki-67 index and receipt of prior chemotherapy with cisplatin and irinotecan.

Grade 3-4 neutropenia and anemia were observed in four and five patients, respectively.

Conclusion.

Amrubicin monotherapy appears to be potentially active and well-tolerated for platinum-refractory gastroenteropancreatic NEC.