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Second-Line Treatment and Prognostic Factors in Neuroendocrine Carcinoma.

Julien Hadoux 1 Thomas Walter 2, 3, 4 Christina Kanaan Segolene Hescot 5 Vincent Hautefeuille 6 Marine Perrier 7, 8 Igor Tauveron 9 Sandrine Laboureau 10 Christine Do Cao 11 Caroline Pétorin 12 Odile Blanchet 13, 10 Matthieu Faron 14 Emmanuelle Leteurtre 15 Marie-Christine Rousselet 10 Juliette Joubert Zakeyh Aude Marchal 16 Denis Chatelain 17 Clement Beaulaton Valerie Hervieu 18 Catherine Lombard-Bohas 19 Michel Ducreux 20, 21, 1 Jean Yves Scoazec 22 Eric Baudin 1 
Abstract : Neuroendocrine carcinomas (NEC) are aggressive malignant diseases. Etoposide-based rechallenge (EBR) and the prognostic role of Rb status in second-line chemotherapy (2L) have not been studied. The objectives of this study were to report the results of 2L including EBR as well as prognostic factors in a national retrospective multicenter study. NEC patients treated in 2L and further, with tissue samples available were included. Rb status and morphological classification were reviewed centrally. Among the 121 NEC patients (40% female, median age 61) included, there were 73 small cell NEC (60%), 34 large cell NEC (28%) and 14 NEC (not otherwise specified, 12%). Primary sites were lung (39%), gastro-enteropancreatic (36%), other (13%) and unknown (12%). Median Ki-67 index was 80%. Median progression-free survival (PFS) and overall survival (OS) under 2L were 2.1 and 6.2 months, respectively. No difference was observed between patients who received an "Adenocarcinoma-like" or a "Neuroendocrine-like" 2L or according to the Rb status. Thoracic primary was the only adverse prognostic factor for OS. EBR, administered to 31 patients, resulted in a 62% disease control rate with a median PFS and OS of 3.2 and 11.7 months respectively. In the 94 patients with a relapse-free interval ≥q 3 months after first-line platinum-etoposide, median OS was 12 months in patients who received EBR as compared to 5.9 months in patients who did not (p=0.043). EBR could be the best 2L option for patient with initial response to first line platinum-etoposide lasting at least 3 months. Rb status does not provide prognostic information in this setting.
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Soumis le : jeudi 4 août 2022 - 17:57:51
Dernière modification le : mardi 9 août 2022 - 13:58:28



Julien Hadoux, Thomas Walter, Christina Kanaan, Segolene Hescot, Vincent Hautefeuille, et al.. Second-Line Treatment and Prognostic Factors in Neuroendocrine Carcinoma.. Endocrine-Related Cancer, BioScientifica, 2022, pp.ERC-22-0102. ⟨10.1530/ERC-22-0102⟩. ⟨hal-03746086⟩



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