Temozolomide as Monotherapy Is Effective in Treatment of Advanced Malignant Neuroendocrine Tumors
Sara Ekeblad,Anders Sundin,Eva Tiensuu Janson,Staffan Welin,Dan Granberg,Henrik Kindmark,Kristina Dunder,Gordana Kozlovacki,Håkan Örlefors,Mattias Sigurd,Kjell Öberg,Barbro Eriksson,Britt Skogseid +12 more
TLDR
Temozolomide as monotherapy had acceptable toxicity and antitumoral effects in a small series of patients with advanced malignant neuroendocrine tumors and four of these showed radiologic responses.Abstract:
Purpose: A retrospective analysis of the toxicity and efficacy of temozolomide in advanced neuroendocrine tumors. Experimental Design: Thirty-six patients with advanced stages of neuroendocrine tumor (1 gastric, 7 thymic and 13 bronchial carcinoids, 12 pancreatic endocrine tumors, 1 paraganglioma, 1 neuroendocrine foregut, and 1 neuroendocrine cecal cancer) were treated with temozolomide (200 mg/m 2 ) for 5 days every 4 weeks. Patients had previously received a mean of 2.4 antitumoral medical regimens. Tumor response was evaluated radiologically according to the Response Evaluation Criteria in Solid Tumors every 3 months on an intent-to-treat basis. The circulating tumor marker plasma chromogranin A was also assessed. The expression of O 6 -methylguanine DNA methyltransferase, an enzyme implicated in chemotherapy resistance, was studied by immunohistochemistry ( n = 23) and compared with response to temozolomide. Results: Median overall time to progression was 7 months (95% confidence interval, 3-10). Radiologic response was seen in 14% of patients and stable disease in 53%. Side effects were mainly hematologic; 14% experienced grade 3 or 4 thrombocytopenia (National Cancer Institute toxicity criteria). Ten patients had tumors with O 6 -methylguanine DNA methyltransferase immunoreactivity in Conclusions: Temozolomide as monotherapy had acceptable toxicity and antitumoral effects in a small series of patients with advanced malignant neuroendocrine tumors and four of these showed radiologic responses.read more
Citations
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References
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MGMT Gene Silencing and Benefit from Temozolomide in Glioblastoma
Monika E. Hegi,Annie-Claire Diserens,Thierry Gorlia,Marie-France Hamou,Nicolas de Tribolet,Nicolas de Tribolet,Michael Weller,Johan M. Kros,Johannes A. Hainfellner,Warren P. Mason,Luigi Mariani,Jacoline E C Bromberg,Peter Hau,René O. Mirimanoff,J. Gregory Cairncross,Robert C. Janzer,Roger Stupp +16 more
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Randomized Phase III Study of Temozolomide Versus Dacarbazine in the Treatment of Patients With Advanced Metastatic Malignant Melanoma
Mark R. Middleton,Jean-Jacques Grob,Neil K. Aaronson,G. Fierlbeck,Wolfgang Tilgen,S. Seiter,M. E. Gore,Steinar Aamdal,Jonathan Cebon,Alan S. Coates,Brigitte Dréno,M. Henz,Dirk Schadendorf,Alexander Kapp,Jürgen Weiss,U. Fraass,P. Statkevich,Martin J. Muller,Nick Thatcher +18 more
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TL;DR: Overall PFS significantly improved with TMZ, with a median PFS of 12.4 weeks in the TMZ group and 8.32 months in the PCB group, and freedom from disease progression was associated with maintenance of HRQL, regardless of treatment received.
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Clinical Trial Substantiates the Predictive Value of O-6-Methylguanine-DNA Methyltransferase Promoter Methylation in Glioblastoma Patients Treated with Temozolomide
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TL;DR: The association of the epigenetic inactivation of the DNA repair gene MGMT with better outcome in this homogenous cohort may have important implications for the design of future trials and supports efforts to deplete MGMT by O-6-benzylguanine, a noncytotoxic substrate of this enzyme.
Journal ArticleDOI
Phase II Study of Temozolomide and Thalidomide in Patients With Metastatic Neuroendocrine Tumors
Matthew H. Kulke,Keith Stuart,Peter C. Enzinger,David P. Ryan,Jeffrey W. Clark,Alona Muzikansky,Michele Vincitore,Ann Michelini,Charles S. Fuchs +8 more
TL;DR: Orally administered temozolomide and thalidomide seems to be an active regimen for the treatment of neuroendocrine tumors in patients with metastatic carcinoid, pheochromocytoma, or pancreatic neuro endocrine tumors.
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