Some Locally-Advanced and Metastatic Pulmonary Carcinoid Tumors Respond to Chemotherapy

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Octreotide has demonstrated promising results vs. a subset of carcinoid tumors.
Octreotide has demonstrated promising results vs. a subset of carcinoid tumors.

Octreotide appears to be promising against a subset of locally advanced and metastatic pulmonary carcinoid tumors, despite a lower overall response rate than those observed for other chemotherapy regimens, report authors of a retrospective review (NET Abstract #C8) presented at the 7th Annual Neuroendocrine Tumors (NET) conference in Nashville, TN. The meeting was organized by the North American Neuroendocrine Tumors Society (NANETS).

“These results support our previous finding that a subset of pulmonary carcinoid tumors are responsive to chemotherapy,” reported lead study author Curtis R. Chong, MD, PhD, of the Dana-Farber Cancer Institute in Boston, MA, and colleagues.

“Eight of 10 patients with octreotide-avid disease treated with an octreotide-based regimen experienced disease control (1 partial response, 7 stable disease) for a median of 18 months (range 6-72 months),” the researchers reported.

Optimal management of locally advanced and metastatic pulmonary carcinoid tumors has not yet been established, the coauthors noted. So they undertook a retrospective review of 300 patients diagnosed with typical and atypical pulmonary carcinoid tumors between 1990 and 2012, to identify outcomes for different subsets of patients.

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“Of evaluable patients, 26 (41%) with stage I-III atypical carcinoid tumors recurred at a median time of 3.7 years (range, 0.4-32 [months]), compared to 3 (1%) patients with typical carcinoid (range, 8-12.3),” Dr. Chong and his colleagues reported.

A total of 39 patients had been treated with chemotherapy, including 30 patients with metastatic disease (27 had atypical carcinoid tumors), they reported. Seven patients (6 with atypical) were treated with adjuvant platinum-etoposide chemoradiotherapy.

“At a median follow-up of 2 years, there were 2 recurrences in the 7 patients receiving adjuvant treatment,” the authors noted.

Among 15 patients treated with octreotide-based chemotherapy regimens, the coauthors reported a 10% response rate (RR), 70% disease control rate (DCR), and a median progression-free survival (PFS) time of 15 months.

Among 13 patients who received etoposide with platinum therapies, RR was 23%, DCR was 69%, and median PFS was 7 months, they reported.

For 14 patients who received temozolomide-based treatments, RR was 14%, DCR was 57%, and median PFS was 10 months.

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