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Doxorubicin and streptozotocin after failed biotherapy of neuroendocrine tumors

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Abstract

Background: Well-differentiated neuroendocrine tumors are treated primarily with somatostatin analogs and interferon-α. It is not clear what therapy should be applied after failed biotherapy. Our aim was to establish whether patients whose tumors rapidly progress under biotherapy may benefit from chemotherapy.

Patients and Methods: In 10 patients with metastatic neuroendocrine tumors (4 foregut, 3 midgut, 1 retroperitoneal, and 2 of unknown origin) streptozotocin and doxorubicin were used as second-line or third-line therapy. Tumor response was assessed by computed tomography of the abdomen and thorax and measurement of tumor secretion products (serum chromogranin A, urinary 5-hydroxyindoleacetic acid).

Results: Three patients showed a radiological response over a mean time of 30 mo (range: 7–67 mo). Median survival after initiation of chemotherapy was 50 mo in patients with a response and 8 mo in non-responders. Three patients developed major side effects (nephrotoxicity, diabetes, and encephalopathy).

Conclusion: Streptozotocin and doxorubicin produce poor response rates in patients with progressive neuroendocrine tumors after failed biotherapy, but may prolong life in those patients who show a tumor response.

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Authors and Affiliations

  1. Department of Medicine I, University of Erlangen-Nuremberg, Ulmenweg 18, 91054, Erlangen, Germany

    Marianne E. Pavel MD & Eckhart G. Hahn

  2. Institute of Diagnostic Radiology, University of Erlangen-Nuremberg, Ulmenweg 18, 91054, Erlangen, Germany

    Ulrich Baum

  3. Klinikum Nordstadt, Internal Medicine, Haltenhoffstrasse 41, 30171, Hannover, Germany

    Johannes Hensen

Authors
  1. Marianne E. Pavel MD
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  2. Ulrich Baum
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  3. Eckhart G. Hahn
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  4. Johannes Hensen
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Correspondence to Marianne E. Pavel MD.

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Pavel, M.E., Baum, U., Hahn, E.G. et al. Doxorubicin and streptozotocin after failed biotherapy of neuroendocrine tumors. Int J Gastrointest Canc 35, 179–185 (2005). https://doi.org/10.1385/IJGC:35:3:179

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