= 7) was 7. WHO PS 2 (< 0.0001). The individuals

= 7) was 7. WHO PS 2 (< 0.0001). The individuals in WHO PS 0-1 received a median of 3 courses of TMZ (range 1C12) versus 1 course (1C3) in PS 2 patients. Patients with a Ki-67 index 50% had a significantly shorter median survival of 2.7 months compared to 10.9 months in patients with Ki-67 index <50%, (< 0.0001) (Figure 1). There were no statistical differences when comparing survival times in CgA positive versus CgA negative patients, and CgA positive Mouse monoclonal to CD32.4AI3 reacts with an low affinity receptor for aggregated IgG (FcgRII), 40 kD. CD32 molecule is expressed on B cells, monocytes, granulocytes and platelets. This clone also cross-reacts with monocytes, granulocytes and subset of peripheral blood lymphocytes of non-human primates.The reactivity on leukocyte populations is similar to that Obs versus CgA negative/weakly positive patients, respectively. Comparing SRS positive versus SRS negative patients and patients with buy 827022-32-2 positive SRS (>liver uptake) versus SRS < liver uptake, respectively, showed no statistical significant influence of SRS position on success. There have been no treatment-related fatalities. buy 827022-32-2 One affected person (4%) experienced quality 3 leucopenia and two individuals (7%) got quality 4 thrombocytopenia. None of the patients had febrile neutropenia. Emesis was well controlled on the standard prophylactic antiemetic therapy. Figure 1 Kaplan-Meier survival curves for patients with Ki-67 index <50% versus 50%. 4. Discussion The specific aims of our retrospective study were to elucidate and evaluate the efficacy and tolerability of monotherapy with TMZ as second and third line treatment after platin-based chemotherapy in patients with NECs (WHO G3). Usually these patients have a very poor prognosis with a short-term survival. In our material, none of the 28 patients had objective response (CR + PR) to treatment, but a disease control rate of 38%. The OS and PFS after start of TMZ treatment were 3.5 months and 2.4 months, respectively. The first report on second and third line TMZ-based chemotherapy in 25 patients with NECs after progression on first line chemotherapy buy 827022-32-2 (cisplatin/etoposide or docetaxel and doxorubicin) [5] showed overall response rate of 33% and disease stabilization in 38% of the patients. The median PFS was 6 months and the median OS was 22 months. The patients were treated with TMZ alone (= 5) or in combination with capecitabine (= 19) of which a subgroup also had bevacizumab (= 7). Adding capecitabine and bevacizumab to TMZ did not seem to have any additional effect. However, the number of patients in each group was small [5], which may hide a beneficial effect of combined therapy. These data are indicative of a promising effect of TMZ in NECs; however, data is probably not much like our research because of variations in selecting individuals. We discovered a median Ki-67 proliferation index of 50% inside our individuals, whereas half from the cohort in the additional study [5] got a Ki-67 at 20C30%, which might take into account the difference in today's outcomes. Although not apparent in the latest study [5], we'd a high addition (21%) of individuals with PS 2, which might affect the full total outcomes. TMZ and capecitabine-based regimes are connected with fairly high tumor response prices in individuals with well or reasonably differentiated pancreatic NENs (G1 and G2) [4, 6, 7]. We demonstrated a tendency towards much longer median overall success for individuals with major pancreatic NECs (7.0 months) versus individuals with nonpancreatic NECs (2.9 months) following receiving TMZ as monotherapy. The PFS was 3.three months versus 1.9 months, respectively. Although different NEN populations, the email address details are supported with a stage 2 research of 29 individuals (28 well-differentiated neuroendocrine tumors and one badly differentiated neuroendocrine carcinoma) treated with TMZ and thalidomide [8]. The record demonstrated radiologic response rate of 25%therapy appeared to be most active among metastatic pancreatic NENs with a response rate of 45% buy 827022-32-2 [8]. The use of TMZ with capecitabine as first line therapy for pancreatic NENs G1 + G2 has been reported with a response rate of 70% [6]. If these data are consistent and confirmed, TMZ-based chemotherapy regimens with relatively mild toxicity may develop into a future second line or even first line option in these patients. The role of the nuclear antigen Ki-67 as a prognostic indicator and a surrogate marker for a therapeutic buy 827022-32-2 response is still a matter of debate. A review from 2008 [9].

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