Efficacy of Capecitabine and Temozolomide Regimen in Neuroendocrine Tumors: Data From the Turkish Oncology Group
Çağlar Ünal, Abdulmunir Azizy, Senem Karabulut, Didem Taştekin, Arif Akyıldız, Serkan Yaşar, Şuayib Yalçın, Eyüp Çoban, Türkkan Evrensel, Ziya Kalkan, Zeynep Oruç, Sümeyra Derin, Hande Turna, Bayram Doğan, Fahriye Tuğba Köş, Mehmet Ali Nihat Şendur, Nadiye Sever, Özlem Erçelep, Mustafa Seyyar, Umut Kefeli, Kazım Uygun, Melike Özçelik, Sercan Ön, Ulus Ali Şanlı, Kübra Canaslan, İlkay Tuba Ünek, Kadriye Bır Yucel, Nuriye Özdemir, Ozan Yazıcı, Halil Göksel Güzel, Derya Kıvrak Salim, Sema Sezgin Göksu, Ali Murat Tatlı, Çetın Ordu, Oğuzhan Selvi, Abdullah Sakin, Mehmet Emin Büyükbayram, Bengü Dursun, Yüksel Ürün, Hacı Arak, Gözde Ağdaş, Muzaffer Uğraklı, Engin Hendem, Melek Karakurt Eryılmaz, Burak Bi̇lgi̇n, Atakan Topçu, Melih Şimşek, Mahmut Büyükşimşek, Büşra Akay, Gülçin Şahingöz Erdal, Fatih Karataş, Özkan Alan, Melek Çağlayan, Fatma Akdag Kahvecioglu, Ayşe Demirci, Nail Paksoy, Bülent Çetin, Mahmut Gümüş, Naziye Ak, Yasemin Aydınalp, Semra Paydaş, Deniz Can Güven, Saadettin Kılıçkap, Sezer Sağlam
Abstract
INTRODUCTION: This study aims to report the efficacy and safety of capecitabine plus temozolomide (CAPTEM) across different lines of treatment in patients with metastatic neuroendocrine tumors (NETs). METHODS: We conducted a multicenter retrospective study analyzing the data of 308 patients with metastatic NETs treated with CAPTEM between 2010 and 2022 in 34 different hospitals across various regions of Turkey. RESULTS: The median follow-up time was 41.0 months (range: 1.7-212.1), and the median age was 53 years (range: 22-79). Our results across the entire patient cohort showed a median progression-free survival (PFS) of 10.6 months and a median overall survival (OS) of 60.4 months. First-line CAPTEM treatment appeared more effective, with a median PFS of 16.1 months and a median OS of 105.8 months (median PFS 16.1, 7.9, and 9.6 months in first-, second- and ≥third-line respectively, P = .01; with median OS values of 105.8, 47.2, and 24.1 months, respectively, P = .003) In terms of ORR, the first-line treatment again performed better, resulting in an ORR of 54.7% compared to 33.3% and 30.0% in the second and third or higher lines, respectively (P < .001). Grade 3-4 side effects occurred only in 22.5% of the patients, leading to a discontinuation rate of 9.5%. Despite the differences in outcomes based on treatment line, we did not observe a significant difference in terms of side effects between the first and subsequent lines of treatment. CONCLUSIONS AND RELEVANCE: The substantial superior outcomes in patients receiving first-line CAPTEM treatment highlight its potential as an effective treatment strategy for patients with metastatic NET.