Second-line treatment in patients with advanced extra-pulmonary poorly differentiated neuroendocrine carcinoma: a systematic review and meta-analysis
dc.contributor.author | McNamara, Mairead G | |
dc.contributor.author | Frizziero, Melissa | |
dc.contributor.author | Jacobs, Timothy | |
dc.contributor.author | Lamarca, Angela | |
dc.contributor.author | Hubner, Richard A | |
dc.contributor.author | Valle, Juan W | |
dc.contributor.author | Amir, E. | |
dc.date.accessioned | 2020-06-16T11:03:14Z | |
dc.date.available | 2020-06-16T11:03:14Z | |
dc.date.issued | 2020 | en |
dc.identifier.citation | M. G. McNamara, M. Frizziero, T. Jacobs et al. Second-line treatment in patients with advanced extra-pulmonary poorly differentiated neuroendocrine carcinoma: a systematic review and meta-analysis. Ther Adv Med Oncol. 2020;12:1758835920915299. | en |
dc.identifier.pmid | 32426044 | en |
dc.identifier.doi | 10.1177/1758835920915299 | en |
dc.identifier.uri | http://hdl.handle.net/10541/623024 | |
dc.description.abstract | Background: There is no standard second-line treatment for patients with advanced extra-pulmonary poorly differentiated neuroendocrine carcinoma (EP-PD-NEC). This study explored data evaluating second-line treatment in these patients. Methods: A search of MEDLINE and EMBASE identified studies reporting survival and/or response data for patients with EP-PD-NEC receiving second-line therapy. Association between various factors (age, gender, ECOG performance status, primary tumour location, morphology, Ki-67, treatment and grade 3/4 haematological toxicity) and response rate (RR), progression-free (PFS) and overall survival (OS) were assessed with a mixed effects meta-regression weighted by individual study sample size. Due to a small sample size, associations were reported quantitatively, based on magnitude of beta coefficient rather than statistical significance. Results: Of 83 identified studies, 19 were eligible, including 4 prospective and 15 retrospective studies. Analysis comprised 582 patients, with a median number of 19 patients in each study (range 5-100). Median age was 59 years (range 53-66). Median RR was 18% (range 0-50; 0% for single-agent everolimus, temozolomide, topotecan; 50% with amrubicin), median PFS was 2.5 months (range 1.15-6.0) and median OS was 7.64 months (range 3.2-22.0). Studies with a higher proportion of patients with a Ki-6755% had lower RR (beta = -0.73) and shorter OS (beta = -0.82). Conclusion: Second-line therapy for patients with advanced EP-PD-NEC has limited efficacy and the variety of regimens used is diverse. Ki-67"55% is associated with worse outcomes. Prospective randomised studies are warranted to enable exploration of new treatment strategies." | en |
dc.language.iso | en | en |
dc.relation.url | https://dx.doi.org/10.1177/1758835920915299 | en |
dc.title | Second-line treatment in patients with advanced extra-pulmonary poorly differentiated neuroendocrine carcinoma: a systematic review and meta-analysis | en |
dc.type | Article | en |
dc.contributor.department | Department of Medical Oncology, The Christie NHS Foundation Trust/Division of Cancer Sciences, University of Manchester, Wilmslow Road, Manchester M20 4BX, UK. | en |
dc.identifier.journal | Therapeutic Advances in Medical Oncology | en |
dc.description.note | en] | |
refterms.dateFOA | 2020-06-16T13:23:03Z |