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Media type:
E-Article
Title:
Long-term treatment with streptozocin/5-fluorouracil chemotherapy in patients with metastatic pancreatic neuroendocrine tumors : Case series
:
Case series
Description:
<jats:title>Abstract</jats:title>
<jats:sec>
<jats:title>Rationale:</jats:title>
<jats:p>Pancreatic neuroendocrine tumors (pNETs) are rare entities representing 1% to 3% of all malignant pancreatic neoplasms. Current guidelines recommend a combination of streptozocin (STZ) and 5-fluorouracil (5-FU) for patients with metastatic well-differentiated pNETs requiring systemic therapy. The highest median progression-free survival rate reported in previous studies for this combination was 23 months (95% confidence interval 14.5–31.5). However, it remains unclear for how long this regimen can be safely administered.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Patient concerns:</jats:title>
<jats:p>We report about 3 therapy-naïve patients with metastatic G2 (Ki67 10%–15%) pNETs treated with STZ/5-FU, that achieved sustained disease control for longer than 36 months.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Diagnosis:</jats:title>
<jats:p>Metastatic, well-differentiated G2 pNETs</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Interventions:</jats:title>
<jats:p>Systemic chemotherapy with STZ/5-FU was administered until the disease progressed. In 1 case showing a mixed response, selected metastases of increasing size were additionally treated with surgery and brachytherapy.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Outcomes:</jats:title>
<jats:p>In our 3 patients with metastatic G2 pNETs, STZ/5-FU induced long-term disease control over 44, 42, and 95 months, respectively. No side effects that led to treatment discontinuation were observed.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Lessons:</jats:title>
<jats:p>In patients with metastatic G2 pNETs achieving disease control, STZ/5-FU can be safely administered.</jats:p>
</jats:sec>