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Human Neuroendocrine Tumor Cell Lines as a Three-Dimensional Model for the Study of Human Neuroendocrine Tumor Therapy
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Capecitabine and Temozolomide in Advanced Lung Neuroendocrine Neoplasms

Taymeyah Al-Toubah1, Brian Morse2, Jonathan Strosberg1

  • 1Department of GI Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.

The Oncologist
|August 29, 2019
PubMed
Abstract

Insights

The capecitabine and temozolomide (CAPTEM) regimen shows a 30% response rate in advanced lung neuroendocrine neoplasms (NENs). This treatment offers a tolerable option for patients with limited therapeutic choices.

Area of Science:

  • Oncology
  • Medical Research
  • Pharmacology

Background:

  • Advanced lung neuroendocrine neoplasms (NENs) present limited therapeutic avenues.
  • The capecitabine and temozolomide (CAPTEM) regimen has demonstrated efficacy in pancreatic neuroendocrine tumors (NETs).
  • Data regarding CAPTEM's use in lung NETs remains scarce.

Purpose of the Study:

  • To evaluate the efficacy and safety of the capecitabine and temozolomide (CAPTEM) regimen in patients with metastatic lung NENs.
  • To determine the objective response rate (ORR) and disease control rate (DCR) of CAPTEM therapy.
  • To assess progression-free survival (PFS), overall survival (OS), and toxicity associated with CAPTEM.

Main Methods:

  • Retrospective review of patients with metastatic lung NENs treated with capecitabine and temozolomide (CAPTEM) between January 2008 and September 2018.
  • Exclusion of small cell lung cancer patients.
  • Evaluation of response based on RECIST 1.1 criteria, alongside assessment of PFS, OS, and toxicity.

Main Results:

  • The study identified 20 patients treated with CAPTEM; 14 had typical lung NETs, 5 atypical carcinoids, and 1 large-cell neuroendocrine carcinoma.
  • An objective response rate (ORR) of 30% and a disease control rate (DCR) of 85% were observed.
  • Median progression-free survival (PFS) was 13 months, and median overall survival (OS) was 68 months, with a generally mild toxicity profile.

Conclusions:

  • The capecitabine and temozolomide (CAPTEM) regimen demonstrates a high response rate and acceptable toxicity in advanced lung NENs.
  • CAPTEM represents a promising treatment option for patients with lung NENs.
  • Further investigation of the CAPTEM regimen in a prospective clinical trial is warranted.
Keywords:
Atypical carcinoidBronchialCapecitabineLungNeuroendocrine neoplasmNeuroendocrine tumorTemozolomideTypical carcinoid

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