Efficacy and safety of streptozocin-based chemotherapy for gastroenteropancreatic neuroendocrine tumors in Japanese clinical practice

Author:

Murakami Masatoshi1ORCID,Fujimori Nao1,Takamatsu Yu2,Ito Tetsuhide234,Matsumoto Kazuhide1,Kakehashi Shotaro1,Ohno Akihisa1,Teramatsu Katsuhito1,Ueda Keijiro1,Ishigami Kousei56,Ogawa Yoshihiro1

Affiliation:

1. Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University , Fukuoka , Japan

2. Neuroendocrine Tumor Centre, Fukuoka Sanno Hospital , Fukuoka , Japan

3. Department of Gastroenterology , Graduate School of Medical Sciences, , Fukuoka , Japan

4. International University of Health and Welfare , Graduate School of Medical Sciences, , Fukuoka , Japan

5. Department of Clinical Radiology , Graduate School of Medical Sciences, , Fukuoka , Japan

6. Kyushu University , Graduate School of Medical Sciences, , Fukuoka , Japan

Abstract

Abstract Background Streptozocin has been used to treat neuroendocrine tumors in Europe and the USA; however, its actual status in Japan has not been fully clarified owing to the rarity of this disease and the relatively recent approval of streptozocin in Japan. Methods We retrospectively analyzed 53 patients with gastroenteropancreatic neuroendocrine tumors who were treated with streptozocin-based chemotherapy at two Japanese hospitals between January 2004 and June 2023. Results The overall response and disease control rates were 27.7 and 74.5%, respectively, and the median progression-free survival and overall survival were 7.1 and 20.3 months, respectively. Performance status ≥1 showed a significant negative correlation with progression-free survival, and performance status ≥1 and liver tumor burden ≥25% showed a significant negative correlation with overall survival. No significant differences were observed in the treatment response between pancreatic and gastrointestinal neuroendocrine tumors. No treatment-related serious adverse events were observed; however, 87.7% of patients expressed a decrease in the estimated glomerular filtration rate, which negatively correlated with the duration of streptozocin treatment (r = 0.43, P = 0.0020). In the streptozocin re-administration group (n = 5), no differences were found in efficacy between the initial and second streptozocin treatments. Conclusions Although streptozocin is a safe, streptozocin-induced renal dysfunction is a dilemma in streptozocin responders. Streptozocin may benefit patients with gastroenteropancreatic neuroendocrine tumors, especially those with a good performance status; however, in some cases, planned streptozocin withdrawal or switching to other drugs should be considered.

Funder

JSPS KAKENHI

Clinical Research Promotion Foundation

Publisher

Oxford University Press (OUP)

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