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Activity and Safety...
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Chatzellis, EleftheriosUniv Athens, Dept Propaedeut Internal Med 1, Athens, Greece;251 HAF & VA Hosp, Athens, Greece
(author)
Activity and Safety of Standard and Prolonged Capecitabine/Temozolomide Administration in Patients with Advanced Neuroendocrine Neoplasms
- Article/chapterEnglish2019
Publisher, publication year, extent ...
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2019-06-03
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S. Karger,2019
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printrdacarrier
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LIBRIS-ID:oai:DiVA.org:uu-398579
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-398579URI
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https://doi.org/10.1159/000500135DOI
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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Background: Capecitabine and temozolomide combination (CAPTEM) is associated with high response rates in patients with advanced neuroendocrine neoplasms (NENs). We evaluated the real-world activity and safety of CAPTEM from 3 NEN centers. Methods: Clinicopathological characteristics and outcomes of patients treated with CAPTEM for bulky or progressive disease (PD) were retrospectively analyzed. -Results: Seventy-nine patients with gastroenteropancreatic (grades 1-2 [n = 38], grade 3 [n = 24]) and lung/thymic (n = 17) NENs were included. Median treatment duration was 12.1 months (range 0.6-55.6). Overall, partial responses (PRs) occurred in 23 (29.1%), stable (SD) in 24 (30.4%), and PD in 28 (35.4%) patients. Median progression-free survival (PFS) and overall survival (OS) were 10.1 (6-14.2) and 102.9 months (43.3-162.5), respectively. On univariate analysis, NENs naive to chemotherapy and low Ki67 were associated with favorable responses (partial response [PR] + SD; p = 0.011 and 0.045), PFS (p < 0.0001 and 0.002) and OS (p = 0.005 and 0.001). Primary site (pancreas and lung/thymus) was also a significant prognostic factor for PFS (p < 0.0001) and OS (p < 0.0001). On multivariate analysis, gastrointestinal and unknown primary NENs (hazard ratio [HR] 0.3, 95% CI 0.1-0.8, p = 0.009 and p = 0.018) and prior surgery (HR 2.4, 95% CI 11-4.9, p = 0.021) were independent prognostic factors for PFS. Ki-67 was a poor predictor for favorable response in receiver operating characteristic analysis (area under the curve 0.678). Safety analysis of CAPTEM indicated rare events of serious (grades 3-4) toxicities (n = 4) and low discontinuation rates (n = 8) even in patients with prolonged administration (>12 months). Conclusions: CAPTEM treatment can be an effective and safe treatment even after prolonged administration for patients with NENs of various sites and Ki67 labeling index, associated with significant favorable responses and PFS.
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Angelousi, AnnaUniv Athens, Dept Propaedeut Internal Med 1, Athens, Greece
(author)
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Daskalakis, KosmasUppsala universitet,Endokrinkirurgi,Univ Athens, Dept Propaedeut Internal Med 1, Athens, Greece(Swepub:uu)kosda475
(author)
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Tsoli, MarinaUniv Athens, Dept Propaedeut Internal Med 1, Athens, Greece
(author)
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Alexandraki, Krystallenia I.Univ Athens, Dept Propaedeut Internal Med 1, Athens, Greece
(author)
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Wachula, EwaMed Univ Silesia, Dept Clin Oncol & Radiotherapy, Katowice, Poland
(author)
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Meirovitz, AmichayHadassah Hebrew Univ Med Ctr, Dept Oncol, Jerusalem, Israel;Hadassah Hebrew Univ Med Ctr, Radiat Therapy Unit, Jerusalem, Israel
(author)
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Maimon, OfraHadassah Hebrew Univ Med Ctr, Dept Oncol, Jerusalem, Israel;Hadassah Hebrew Univ Med Ctr, Radiat Therapy Unit, Jerusalem, Israel
(author)
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Grozinsky-Glasberg, SimonaHadassah Hebrew Univ Med Ctr, Dept Endocrinol & Metab, Neuroendocrine Tumour Unit, Jerusalem, Israel
(author)
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Gross, DavidHadassah Hebrew Univ Med Ctr, Dept Endocrinol & Metab, Neuroendocrine Tumour Unit, Jerusalem, Israel
(author)
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Kos-Kudla, BeataMed Univ Silesia, Dept Endocrinol & Neuroendocrine Neoplasms, Dept Endocrinol & Pathophysiol, Katowice, Poland
(author)
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Koumarianou, AnnaUniv Athens, Attikon Univ Gen Hosp, Hematol Oncol Unit, Dept Internal Med 4, Athens, Greece
(author)
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Kaltsas, GregoryUniv Athens, Dept Propaedeut Internal Med 1, Athens, Greece
(author)
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Univ Athens, Dept Propaedeut Internal Med 1, Athens, Greece;251 HAF & VA Hosp, Athens, GreeceUniv Athens, Dept Propaedeut Internal Med 1, Athens, Greece
(creator_code:org_t)
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In:Neuroendocrinology: S. Karger109:4, s. 333-3450028-38351423-0194
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