Targeted Therapies Provide Treatment Options for Poorly Differentiated Pancreatic Neuroendocrine Carcinomas
Targeted Therapies Provide Treatment Options for Poorly Differentiated Pancreatic Neuroendocrine Carcinomas
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DOI：
10.1159/000452279
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发表时间：
2017-01-01
期刊：
影响因子：
3.5
通讯作者：
Kavan, Petr
中科院分区：
文献类型：
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作者：
Gilabert, Marine;Rho, Young Soo;Kavan, Petr
低分化胰腺神经内分泌癌（PD pNECs）是一种罕见的疾病，预后不良，采用全身化疗作为标准治疗。我们介绍了6例诊断为PD pNEC的化疗初治患者，他们拒绝全身化疗，并接受舒尼替尼（37.5 mg/天，5例患者）或哺乳动物雷帕霉素靶点（mTOR）抑制剂依维莫司（10 mg/天，1例患者）作为一线治疗的靶向治疗。我们评估了药物的毒性和生存率。患者的中位年龄为55岁（4名男性，2名女性，6名患者中有1名患有功能性肿瘤）。Ki 67指数的中位数为45%（范围20-80）。6例患者中有4例患者的靶向治疗与生长抑素类似物联合（每月30 mg Sandostatine LAR）。毒性（急性和晚期）是可管理的，没有毒性需要停止治疗。所有患者在15个月的治疗期间均无进展生存，诊断后总生存期超过2年。尽管这是一个选定患者的小队列，但我们得出结论，舒尼替尼或依维莫司是可行和安全的，并且作为PD pNEC的一线治疗具有令人鼓舞的疗效结果。(C)2016 S. Karger AG，巴塞尔
Poorly differentiated pancreatic neuroendocrine carcinoma (PD pNECs) is a rare disease that has a poor prognosis and is treated with systemic chemotherapy as the standard of care. We present 6 cases of chemo-naive patients diagnosed with PD pNECs who refused systemic chemotherapy and received targeted therapies with sunitinib (37.5 mg/day, 5 patients) or the mammalian target of rapamycin (mTOR) inhibitor everolimus (10 mg/day, 1 patient) as the first-line treatment. We evaluated the drugs' toxicities and survival. The median age of the patients was 55 years (4 males, 2 females, functioning tumor in 1 of 6 patients). The median of the Ki67 index was 45% (range 20-80). Targeted therapies were combined with somatostatin analogues in 4 of 6 patients (30 mg Sandostatine LAR monthly). Toxicities (acute and late) were manageable and no toxicities necessitated cessation of treatment. All patients had progression-free survival during the 15-month treatment and an overall survival of more than 2 years after diagnosis. Even though this is a small cohort of selected patients, we conclude that sunitinib or everolimus are both feasible and safe and have encouraging results of efficacy as first-line therapies for PD pNEC. (C) 2016 S. Karger AG, Basel