Amrubicin Monotherapy in Patients with Platinum-Refractory Metastatic Neuroendocrine Carcinoma and Mixed Adenoneuroendocrine Carcinoma of the Gastrointestinal Tract

Colorectal mixed adenoneuroendocrine carcinoma (MANEC), which acts like an aggressive tumor, is a rare clinical manifestation on which only a limited amount of literature exists. Surgical resection by regional lymphadenectomy is considered as the only curative treatment for colorectal MANEC, and adjuvant chemotherapy or radiotherapy is recommended because of its high recurrence rate. Colorectal MANEC is frequently diagnosed at an advanced stage, when it is unresectable, and chemotherapy plays a central role in its treatment. Pathological confirmation of the target lesion component is critical for regimen selection. If the lesion comprises an adenocarcinomatous component, a regimen for colorectal adenocarcinoma should be administered. For lesions comprising mainly a neuroendocrine carcinomatous component, cisplatin combined with etoposide or irinotecan has proven to be clinically appropriate. Everolimus, a mechanistic target of rapamycin pathway inhibitor, also improves survival. Sunitinib malate, another molecular targeting agent, is effective for treating neuroendocrine carcinoma; however, the evidence on its effectiveness for treating gastrointestinal neuroendocrine carcinoma is insufficient.

Download Full-text

PS02.193: A CASE OF LARGE CELL NEUROENDOCRINE CARCINOMA OF THE ESOPHAGOGASTRIC JUNCTION

Diseases of the Esophagus ◽

10.1093/dote/doy089.ps02.193 ◽

2018 ◽

Vol 31 (Supplement_1) ◽

pp. 176-177

Author(s):

Takuo Takehana ◽

Kazuhiro Yamamoto ◽

Shunsuke Kawai

Keyword(s):

Gastrointestinal Tract ◽

Tumor Cells ◽

Neuroendocrine Carcinoma ◽

Esophagogastric Junction ◽

Large Cell ◽

Large Cell Neuroendocrine Carcinoma ◽

Nuclear Bodies ◽

Upper Gastrointestinal Tract ◽

Positive Staining ◽

Upper Gastrointestinal

Abstract Background The frequency of occurrence of neuroendocrine carcinoma (NEC) in the upper gastrointestinal tract is low, and especially large cell neuroendocrine carcinoma (LCNEC) is extremely rare disease. We report a case of LCNEC of the esophagogastric junction with relapse-free survival in 1 year and 3 months after surgical treatment. Methods An 81 - year—old Japanese man was referred to our hospital because of a semicircular ulcerative lesion in the esophagogastric junction (EGJ) by esophagogastroduodenoscopy of routine medical checkup. Biopsy from the lesion showed proliferation of tumor cells with clear nuclear bodies and irregular nuclei. Immunohistochemistry (IHC) demonstrated weakly positive staining of AE1/AE3, and CD3, CD20, S-100 and HMB 45 were negative. Computed tomography (CT) revealed a thickened wall of the EGJ and a lymphadenopathy of the cardiac node without any metastases to other organs. The patient was diagnosed with carcinoma in EJG, Stage III T3N1M0. We performed thoracoscopic esophagectomy with two-filed lymphadenectomy. Results Macroscopically, the ulcerative tumor measured 55 × 50mm invaded to the adventitia and was approximately centered in the EGJ. Histologically, the tumor cells showed large nuclei with highly frequent mitoses. IHC revealed that tumor was LCNEC positive for synaptophysin. One lymph node metastasis was found among 39 dissected lymph nodes. Finally, the pathological stage was T3N1M0, IIIA. On postoperative day 7, we performed the drainage for intra-abdominal abscess. He was discharged on postoperative day 44. Adjuvant chemotherapy was not performed, because the patient refused it. He was well and had no evidence of recurrence 15 months after surgery. Conclusion LCNECs of the esophagus or stomach are very rare but highly malignant tumors. It is expected that the number of reports of LCNEC in the upper gastrointestinal tract will increase. It is necessary to collect information on more cases to improve prognosis and to establish appropriate treatment guidelines. Disclosure All authors have declared no conflicts of interest.

Download Full-text

Amrubicin therapy for platinum-refractory extrapulmonary neuroendocrine carcinoma: Retrospective single-center analysis

Annals of Oncology ◽

10.1093/annonc/mdv472.28 ◽

2015 ◽

Vol 26 ◽

pp. vii112 ◽

Cited By ~ 1

Author(s):

Yukako Hattori ◽

Hirotaka Takasaki ◽

Yasufumi Ishiyama ◽

Jun Aoki ◽

Ayumi Numata ◽

...

Keyword(s):

Neuroendocrine Carcinoma ◽

Single Center ◽

Platinum Refractory

Download Full-text

Comparison of Survival and Patterns of Recurrence in Gastric Neuroendocrine Carcinoma, Mixed Adenoneuroendocrine Carcinoma, and Adenocarcinoma

JAMA Network Open ◽

10.1001/jamanetworkopen.2021.14180 ◽

2021 ◽

Vol 4 (7) ◽

pp. e2114180

Author(s):

Jianxian Lin ◽

Yajun Zhao ◽

Yanbing Zhou ◽

Yantao Tian ◽

Qingliang He ◽

...

Keyword(s):

Neuroendocrine Carcinoma ◽

Mixed Adenoneuroendocrine Carcinoma ◽

Gastric Neuroendocrine Carcinoma ◽

Patterns Of Recurrence

Download Full-text

High-grade neuroendocrine carcinoma of the gastrointestinal tract: A retrospective study.

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.15_suppl.e15152 ◽

2014 ◽

Vol 32 (15_suppl) ◽

pp. e15152-e15152

Author(s):

Ashish V. Chintakuntlawar ◽

Thomas C. Smyrk ◽

Steven R. Alberts

Keyword(s):

Retrospective Study ◽

Gastrointestinal Tract ◽

Neuroendocrine Carcinoma ◽

High Grade

Download Full-text

Amrubicin monotherapy for patients with platinum-refractory gastroenteropancreatic neuroendocrine carcinoma.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.3_suppl.328 ◽

2015 ◽

Vol 33 (3_suppl) ◽

pp. 328-328

Author(s):

Takayuki Ando ◽

Ayumu Hosokawa ◽

Hiroki Yoshita ◽

Akira Ueda ◽

Shinya Kajiura ◽

...

Keyword(s):

Partial Response ◽

Neuroendocrine Carcinoma ◽

Progression Free Survival ◽

Median Number ◽

Line Treatment ◽

First Line ◽

Ki 67 ◽

Platinum Based Chemotherapy ◽

Platinum Refractory ◽

First Line Treatment

328 Background: Patients with gastroenteropancreatic neuroendocrine carcinoma (NEC) have a poor prognosis. Platinum-based combination chemotherapy is commonly used as first-line treatment; however, because studies on salvage chemotherapy are limited, its role remains unknown. This study aimed to analyze the efficacy and safety of amrubicin monotherapy in patients with platinum-refractory gastroenteropancreatic NEC. Methods: Among 22 patients with advanced gastroenteropancreatic NEC, 10 received amrubicin monotherapy between September 2006 and May 2014 after failure of platinum-based chemotherapy. The efficacy and toxicity of the treatment were analyzed retrospectively. Results: Eight males and two females ((median age, 67 years (range, 52–78)) received platinum-based chemotherapy, including cisplatin plus irinotecan (n = 7, 70%), cisplatin plus etoposide (n = 2, 20%), and carboplatin plus etoposide (n = 1, 10%) before amrubicin therapy. A total of 30 cycles of amrubicin was administered in 10 patients, with a median number of cycles per patients was 2.5 (range, 1-7). Median progression-free survival (PFS) and overall survival after amrubicin therapy were 2.6 and 5.0 months, respectively. Two patients had partial response (20% response rate), and their PFS were 6.2 months and 6.3 months, respectively. Two patients with partial response had characteristics of NEC with a high Ki-67 index (99% and 89%, respectively) and had received cisplatin and irinotecan as first-line treatment. Grade 3–4 neutropenia and anemia were observed in four (40%) and five (50%) patients, and they were manageable in all cases by careful monitoring of myelosuppression and appropriate dose reduction of amrubicin. Conclusions: Amrubicin monotherapy appears to be potentially active and well-tolerated for platinum-refractory gastroenteropancreatic NEC.

Download Full-text