PMID- 27142424
OWN - NLM
STAT- MEDLINE
DCOM- 20171016
LR  - 20181202
IS  - 1479-5876 (Electronic)
IS  - 1479-5876 (Linking)
VI  - 14
IP  - 1
DP  - 2016 May 3
TI  - Metronomic temozolomide as second line treatment for metastatic poorly 
      differentiated pancreatic neuroendocrine carcinoma.
PG  - 113
LID - 10.1186/s12967-016-0857-1 [doi]
LID - 113
AB  - Neuroendocrine Neoplasms (NEN) are a group of heterogeneous malignancies derived 
      from neuroendocrine cell compartment, with different roles in both endocrine and 
      nervous system. Most NETs have gastroentero-pancreatic (GEP) origin, arising in 
      the foregut, midgut, or hindgut. The 2010 WHO classification divides GEP-NETs 
      into two main subgroups, neuroendocrine tumors (NET) and neuroendocrine 
      carcinomas (NEC), according with Ki-67 levels. NET are tumors with low (<20 %) 
      Ki-67 value, and NECs, including small cell lung carcinomas and Merkel Cell 
      carcinomas, are all NETs with high Ki-67 levels (>20 %-G3). Poorly differentiated 
      neuroendocrine carcinomas (NEC) are usually treated with cisplatin-based 
      chemotherapy regimens. Here we present a case of a patient with pancreatic NEC 
      progressing after cisplatin and etoposide, treated with temozolomide as 
      palliative, second line treatment. According with the poor Performance Status 
      (PS = 2) and to reduce the toxicity of the treatment was chosen an intermittent 
      dosing regimen of metronomic temozolomide 
      (75 mg/m(2)/day-one-week-on/on-week-off). MGMT resulted methylated. On July 2014 
      the patient started the treatment. On August 2014 the patient obtained a 
      significant clinical benefit (PS = 0) and the total body CT scan performed on 
      October 2014 showed a RECIST partial response on all the sites of disease. No 
      drug-related side effects were reported by the patient. After 18 months of 
      therapy the treatment continues without significant toxicity, and with further 
      remission of the metastases. Treatment with metronomic "one-week-on/on-week-off" 
      Temozolomide can be considered a good treatment option in patients with poor 
      performance status, affected by pNEC with MGMT methylation.
FAU - De Divitiis, C
AU  - De Divitiis C
AD  - Department of Abdominal Oncology, Istituto Nazionale Tumori, IRCCS-Fondazione "G. 
      Pascale", Naples, Italy.
FAU - von Arx, C
AU  - von Arx C
AD  - Department of Clinical Medicine and Surgery, University of Naples Federico II, 
      Naples, Italy.
FAU - Grimaldi, A M
AU  - Grimaldi AM
AD  - Melanoma, Cancer Immunotherapy, and Innovative Therapy Unit, Istituto Nazionale 
      Tumori, IRCCS-Fondazione "G. Pascale", Naples, Italy.
FAU - Cicala, D
AU  - Cicala D
AD  - Unit of Interventional Neuroradiology, Department of Advanced Biomedical 
      Sciences, "Federico II" University, Naples, Italy.
FAU - Tatangelo, F
AU  - Tatangelo F
AD  - Department of Diagnostic Pathology and Laboratory, Istituto Nazionale Tumori, 
      IRCCS-Fondazione "G. Pascale", Naples, Italy.
FAU - Arcella, A
AU  - Arcella A
AD  - IRCCS Neuromed, Localita Camerelle, Pozzilli-Isernia, Italy.
FAU - Romano, G M
AU  - Romano GM
AD  - Department of Abdominal Oncology, Istituto Nazionale Tumori, IRCCS-Fondazione "G. 
      Pascale", Naples, Italy.
FAU - Simeone, E
AU  - Simeone E
AD  - Melanoma, Cancer Immunotherapy, and Innovative Therapy Unit, Istituto Nazionale 
      Tumori, IRCCS-Fondazione "G. Pascale", Naples, Italy.
FAU - Iaffaioli, R V
AU  - Iaffaioli RV
AD  - Department of Abdominal Oncology, Istituto Nazionale Tumori, IRCCS-Fondazione "G. 
      Pascale", Naples, Italy.
FAU - Ascierto, P A
AU  - Ascierto PA
AD  - Melanoma, Cancer Immunotherapy, and Innovative Therapy Unit, Istituto Nazionale 
      Tumori, IRCCS-Fondazione "G. Pascale", Naples, Italy.
FAU - Tafuto, S
AU  - Tafuto S
AD  - Department of Abdominal Oncology, Istituto Nazionale Tumori, IRCCS-Fondazione "G. 
      Pascale", Naples, Italy. salvatore.tafuto@libero.it.
CN  - European Neuroendocrine Tumor Society (ENETS) Center of 
      Excellence-Multidisciplinary Group for Neuroendocrine Tumors in Naples (Italy)
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20160503
PL  - England
TA  - J Transl Med
JT  - Journal of translational medicine
JID - 101190741
RN  - 7GR28W0FJI (Dacarbazine)
RN  - YF1K15M17Y (Temozolomide)
SB  - IM
MH  - Administration, Metronomic
MH  - Animals
MH  - Carcinoma, Neuroendocrine/diagnostic imaging/*drug therapy/*pathology
MH  - *Cell Differentiation/drug effects
MH  - Dacarbazine/administration & dosage/*analogs & derivatives/therapeutic use
MH  - Female
MH  - Humans
MH  - Middle Aged
MH  - Neoplasm Metastasis
MH  - Pancreatic Neoplasms/diagnostic imaging/*drug therapy/*pathology
MH  - Temozolomide
MH  - Tomography, X-Ray Computed
PMC - PMC4855772
OTO - NOTNLM
OT  - Immunotherapy
OT  - Metronomic treatment
OT  - Neuroendocrine tumors
OT  - Pancreatic neuroendocrine carcinoma
OT  - Second line therapy
OT  - Temozolomide
EDAT- 2016/05/05 06:00
MHDA- 2017/10/17 06:00
PMCR- 2016/05/03
CRDT- 2016/05/05 06:00
PHST- 2015/10/28 00:00 [received]
PHST- 2016/04/10 00:00 [accepted]
PHST- 2016/05/05 06:00 [entrez]
PHST- 2016/05/05 06:00 [pubmed]
PHST- 2017/10/17 06:00 [medline]
PHST- 2016/05/03 00:00 [pmc-release]
AID - 10.1186/s12967-016-0857-1 [pii]
AID - 857 [pii]
AID - 10.1186/s12967-016-0857-1 [doi]
PST - epublish
SO  - J Transl Med. 2016 May 3;14(1):113. doi: 10.1186/s12967-016-0857-1.