{"doi":"10.1155/2019/9032753","title":"CAPTEM in Metastatic Well-Differentiated Intermediate to High Grade Neuroendocrine Tumors: A Single Centre Experience","abstract":"<jats:p><jats:italic>Introduction</jats:italic>. Capecitabine-temozolomide (CAPTEM) has significant activity in patients (pts) with metastatic low grade pancreatic neuroendocrine tumors (NETs). However, there is limited data regarding its activity in pts with metastatic well-differentiated intermediate and high grade pancreatic and nonpancreatic NETs. The objective of this study was to assess the functional imaging response, survival, and tolerability of CAPTEM in this population.<jats:italic>Methods</jats:italic>. A retrospective audit of pts with metastatic well-differentiated intermediate (WHO grade 2) or high grade (WHO grade 3) NETs treated at Peter MacCallum Cancer Centre between March 2013 and March 2017. Pts received capecitabine 750 mg/m<jats:sup>2</jats:sup>orally twice daily (bd) from days1 to 14 and temozolomide 100 mg/m<jats:sup>2</jats:sup>bd from days 10 to 14 every 28 days. Data regarding functional imaging response, progression-free and overall survival, and toxicities was collected.<jats:italic>Results</jats:italic>. Thirty-two pts received a median of 6 cycles (range: 2-16) of CAPTEM for grade 2 (n=21, 66%) or grade 3 (n=11, 34%), Ki67 &lt;55% (n= 7, 21.9%) or Ki67 ≥55% (n= 4, 12.5 %) NET. Primary site included gastroenteropancreatic (n= 17, 53%), lung (n= 12, 37.5%), and unknown origin (n = 3, 9.4%). Twenty-two percent received CAPTEM as first-line therapy. After a median of 31 months of follow-up, the two-year overall survival (OS) was 42%, with a median OS of 24 months. There was a trend towards improved median progression-free survival (PFS) in pts with low grade 3 (Ki67&lt;55%) versus high grade 3 (Ki67 ≥55%) NETs (15 vs 4 months, p= 0.11). Ten (31.3%) experienced grade 3/4 toxicity, with nausea (15.6%), thrombocytopaenia (12.5%), and fatigue (9.4%) the most common toxicities reported.<jats:italic>Conclusion</jats:italic>. CAPTEM has significant activity in patients with metastatic grades 2 and 3 NETs with manageable toxicity. The PFS benefit observed in the grade 3 subgroup with Ki67&lt;55% warrants further evaluation in a larger randomized trial.</jats:p>","journal":"Journal of Oncology","year":2019,"id":619738,"datarank":0.5676284450877392,"base_score":3.784189633918261,"endowment":3.784189633918261,"self_citation_contribution":0.5676284450877392,"citation_network_contribution":0.0,"self_endowment_contribution":0.5676284450877392,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":43,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1204028,"name":"Michael Jefford","orcid":"0000-0002-8792-7807","position":1,"is_corresponding":false},{"id":1599518,"name":"Julia Lai-Kwon","orcid":null,"position":2,"is_corresponding":false},{"id":1599519,"name":"Alesha Thai","orcid":null,"position":3,"is_corresponding":false},{"id":640314,"name":"Rodney J. Hicks","orcid":"0000-0002-0758-0824","position":4,"is_corresponding":false},{"id":1599520,"name":"Michael Michael","orcid":null,"position":5,"is_corresponding":false},{"id":801155,"name":"Arvind Sahu","orcid":"0000-0003-1664-2422","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"CAPTEM in Metastatic Well-Differentiated Intermediate to High Grade Neuroendocrine Tumors: A Single Centre Experience","abstract":"<jats:p><jats:italic>Introduction</jats:italic>. Capecitabine-temozolomide (CAPTEM) has significant activity in patients (pts) with metastatic low grade pancreatic neuroendocrine tumors (NETs). However, there is limited data regarding its activity in pts with metastatic well-differentiated intermediate and high grade pancreatic and nonpancreatic NETs. The objective of this study was to assess the functional imaging response, survival, and tolerability of CAPTEM in this population.<jats:italic>Methods</jats:italic>. A retrospective audit of pts with metastatic well-differentiated intermediate (WHO grade 2) or high grade (WHO grade 3) NETs treated at Peter MacCallum Cancer Centre between March 2013 and March 2017. Pts received capecitabine 750 mg/m<jats:sup>2</jats:sup>orally twice daily (bd) from days1 to 14 and temozolomide 100 mg/m<jats:sup>2</jats:sup>bd from days 10 to 14 every 28 days. Data regarding functional imaging response, progression-free and overall survival, and toxicities was collected.<jats:italic>Results</jats:italic>. Thirty-two pts received a median of 6 cycles (range: 2-16) of CAPTEM for grade 2 (n=21, 66%) or grade 3 (n=11, 34%), Ki67 &lt;55% (n= 7, 21.9%) or Ki67 ≥55% (n= 4, 12.5 %) NET. Primary site included gastroenteropancreatic (n= 17, 53%), lung (n= 12, 37.5%), and unknown origin (n = 3, 9.4%). Twenty-two percent received CAPTEM as first-line therapy. After a median of 31 months of follow-up, the two-year overall survival (OS) was 42%, with a median OS of 24 months. There was a trend towards improved median progression-free survival (PFS) in pts with low grade 3 (Ki67&lt;55%) versus high grade 3 (Ki67 ≥55%) NETs (15 vs 4 months, p= 0.11). Ten (31.3%) experienced grade 3/4 toxicity, with nausea (15.6%), thrombocytopaenia (12.5%), and fatigue (9.4%) the most common toxicities reported.<jats:italic>Conclusion</jats:italic>. CAPTEM has significant activity in patients with metastatic grades 2 and 3 NETs with manageable toxicity. The PFS benefit observed in the grade 3 subgroup with Ki67&lt;55% warrants further evaluation in a larger randomized trial.</jats:p>","is_dataset_classified":null,"base_score":3.784189633918261,"endowment":3.784189633918261,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"30915122","pmcid":"PMC6402194","openalex_id":"https://openalex.org/W2916128021","authors":[],"funders":[],"total_grants":0,"fwci":4.5478,"citation_percentile":0.953472,"influential_citations":0,"citation_trend":[{"year":2017,"count":1},{"year":2019,"count":3},{"year":2020,"count":8},{"year":2021,"count":12},{"year":2022,"count":8},{"year":2023,"count":4},{"year":2024,"count":4},{"year":2025,"count":2},{"year":2026,"count":1}],"oa_status":"hybrid","license":"cc-by","oa_locations":[{"url":"https://downloads.hindawi.com/journals/jo/2019/9032753.pdf","host_type":"journal"},{"url":"https://downloads.hindawi.com/journals/jo/2019/9032753.pdf","host_type":"publisher"},{"url":"http://downloads.hindawi.com/journals/jo/2019/9032753.pdf","host_type":"publisher"},{"url":"http://downloads.hindawi.com/journals/jo/2019/9032753.xml","host_type":"publisher"},{"url":"https://doi.org/10.1155/2019/9032753","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/30915122","host_type":"repository"},{"url":"http://hdl.handle.net/11343/247210","host_type":"repository"},{"url":"https://doaj.org/article/8834dd70097a436ba5d52e0a9d01c7a5","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/6402194","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC6402194","host_type":"Europe_PMC"},{"url":"https://europepmc.org/articles/PMC6402194?pdf=render","host_type":"Europe_PMC"}],"fields_of_study":["Neuroendocrine Tumor Research Advances","Pancreatic and Hepatic Oncology Research","Lung Cancer Research Studies"],"mesh_terms":[],"keywords":["Medicine","Neuroendocrine tumors","Oncology","Internal medicine"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[{"name":"doi"}],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-03T08:17:54.017537Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}