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, 6) , Clement Beaulaton , Valerie Hervieu (18) , Catherine Lombard-Bohas (19) , Michel Ducreux (20, 21, 1) , Jean Yves Scoazec (22) , Eric Baudin (1)

1 Département de médecine oncologique [Gustave Roussy]
2 CBIO - Centre de Bioinformatique
3 Cancer et génome: Bioinformatique, biostatistiques et épidémiologie d'un système complexe
4 PSL - Université Paris sciences et lettres
5 Institut Curie [Paris]
6 CHU Amiens-Picardie
7 Laboratoire de Virologie [CHU Saint-Antoine]
8 SU FM - Sorbonne Université - Faculté de Médecine
9 GReD - Génétique, Reproduction et Développement
10 CHU Angers - Centre Hospitalier Universitaire d'Angers
11 CHU Lille
12 Service de Chirurgie Digestive et Hépatobiliaire [CHU Clermont-Ferrand]
13 Centre de Ressources Biologiques [CHU Angers]
14 CESP - Centre de recherche en épidémiologie et santé des populations
15 CANTHER - Cancer Heterogeneity, Plasticity and Resistance to Therapies - UMR 9020 - U 1277
16 Hôpital universitaire Robert Debré [Reims]
17 CHIMERE - CHirurgie, IMagerie et REgénération tissulaire de l’extrémité céphalique - Caractérisation morphologique et fonctionnelle - UR UPJV 7516
18 HCL - Hospices Civils de Lyon
19 Hôpital Edouard Herriot [CHU - HCL]
20 UNICANCER
21 IGR - Institut Gustave Roussy
22 Département de biologie et pathologie médicales [Gustave Roussy]

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.

Domaines: Médecine humaine et pathologie

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