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Pancreatic Neoplasms: HELP
Articles by Salvatore Tafuto
Based on 8 articles published since 2010
(Why 8 articles?)
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Between 2010 and 2020, S. Tafuto wrote the following 8 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Review Gemcitabine mono-therapy versus gemcitabine plus targeted therapy in advanced pancreatic cancer: a meta-analysis of randomized phase III trials. 2017

Ottaiano, Alessandro / Capozzi, Monica / De Divitiis, Chiara / De Stefano, Alfonso / Botti, Gerardo / Avallone, Antonio / Tafuto, Salvatore. ·a Department of Abdominal Oncology , Istituto Nazionale Tumori di Napoli "G. Pascale" IRCCS, National Cancer Institute , Naples , Italy. · b Pathology Unit , Istituto Nazionale Tumori di Napoli "G. Pascale" IRCCS, National Cancer Institute , Naples , Italy. ·Acta Oncol · Pubmed #28256961.

ABSTRACT: BACKGROUND: Prognosis of advanced pancreatic cancer is dismal and the novel targeted therapies, albeit successfully used to treat many advanced tumors, have shown modest results. We performed a meta-analysis in order to quantify the effect size on survival of adding targeted therapy to single agent gemcitabine. METHODS: Randomized phase III trials comparing gemcitabine mono-therapy versus gemcitabine plus a targeted agent in first-line treatment of advanced pancreatic cancer designed on survival as primary outcome were selected. Search was done through Medline and the registry of the NIH. Keywords used for searching were 'pancreas', 'pancreatic', 'gemcitabine'. Study quality was assessed with MERGE criteria. Findings were depicted in classical Forest plots. Publication bias was evaluated by the construction of funnel plot. RESULTS: Nine studies met the meta-analysis inclusion criteria including 4564 patients. The target therapies were: erlotinib, cetuximab, rigosertib, elpamotide, bevacizumab, aflibercept, axitinib, masitinib and ganitumab. There was no statistically significant heterogeneity among the nine trials (p = 0.77). The hazard ratio (HR) of the pooled analysis was 0.998 (CI 95%: 0.932-1.068). Subgroup meta-analysis was also performed in anti-EGFR and anti-angiogenesis trials: the pooled HR were 0.94 (CI 95%: 0.705-1.175) and 1.055 (CI 95%: 0.913-1.197), respectively. CONCLUSIONS: The present meta-analysis does not show significant improvements in survival for targeted drugs in advanced pancreatic cancer. The possible reason of these results could be linked to the biology of pancreatic cancer as well as to the absence of predictive factors.

2 Review Antiangiogenic Therapy in Pancreatic Neuroendocrine Tumors. 2016

Capozzi, Monica / VON Arx, Claudia / DE Divitiis, Chiara / Ottaiano, Alessandro / Tatangelo, Fabiana / Romano, Giovanni Maria / Tafuto, Salvatore / Anonymous780886. ·Department of Abdominal Oncology, Division of Medical Oncology, National Cancer Institute IRCCS "G. Pascale Foundation", Naples, Italy m.capozzi@istitutotumori.na.it. · Department of Clinical Medicine and Surgery, University Federico II of Naples, Naples, Italy. · Department of Abdominal Oncology, Division of Medical Oncology, National Cancer Institute IRCCS "G. Pascale Foundation", Naples, Italy. · Department of Diagnostic Pathology and Laboratory, National Cancer Institute IRCCS "G. Pascale Foundation", Naples, Italy. · Department of Abdominal Oncology, Division of Surgical Oncology, National Cancer Institute IRCCS "G. Pascale Foundation", Naples, Italy. ·Anticancer Res · Pubmed #27798861.

ABSTRACT: In recent years, many progresses have been pursued in the management of advanced pancreatic neuroendocrine tumor (pNET); most of them were prompted by increasing knowledge of biology of these neoplasms, including the identification of promising biological targets for therapy. PNETs belong to a group of rare neoplastic diseases. They originate from neuroendocrine system cells and are very heterogeneous regarding anatomic localization and aggressiveness. Recently, many efforts have been particularly focused on the identification of pathologic pathways and innovative drugs in order to treat patients with unresectable, metastatic disease, in progressive well-differentiated pNETs. Chemotherapy remains the mainstay of treatment of poorly-differentiated pNETs. The positive results obtained by sunitinib, a multi-targeted tyrosine kinase receptor inhibitor of vascular endothelial growth factor receptor (VEGFR) 1-3, platelet-derived growth factor receptor (PDGFR), c-kit, RET, colony stimulating factor-1 receptor (CSF-1R) and Fms-like tyrosine kinase 3 (FLT3), with direct antitumor and antiangiogenic effects, have highlighted the importance of tumor angiogenesis inhibition in controlling these tumors. Angiogenesis is a crucial process during tumor progression and plays a key role in development of metastasis. The role of angiogenesis in the malignant spread of pNET cells is finally supported by in vivo studies conducted on the RIP1-Tag2 mouse model. In this mini-review, we focus on the two pharmaceuticals that have given the most interesting results in clinical trials: bevacizumab and sunitinib. These drugs are changing the management of advanced pNETs.

3 Review Electrochemotherapy as a new approach on pancreatic cancer and on liver metastases. 2015

Tafuto, Salvatore / von Arx, Claudia / De Divitiis, Chiara / Maura, Claire Tracey / Palaia, Raffaele / Albino, Vittorio / Fusco, Roberta / Membrini, Massimo / Petrillo, Antonella / Granata, Vincenza / Izzo, Francesco / Anonymous6340834. ·Department of Abdominal Oncology, Division of Medical Oncology, NCI "Fondazione G. Pascale", Naples, Italy. Electronic address: s.tafuto@istitutotumori.na.it. · Department of Clinical Medicine and Surgery, University Federico II of Naples, Naples, Italy. Electronic address: claudia.vonarx@gmail.com. · Department of Abdominal Oncology, Division of Medical Oncology, NCI "Fondazione G. Pascale", Naples, Italy. Electronic address: chiaradedivitiis@yahoo.com. · Department of Abdominal Oncology, Division of Medical Oncology, NCI "Fondazione G. Pascale", Naples, Italy. Electronic address: mauratraceydebellis@alice.it. · Department of Abdominal Oncology, Division of Surgical Oncology, NCI "Fondazione G. Pascale", Naples, Italy. Electronic address: r.palaia@istitutotumori.na.it. · Department of Abdominal Oncology, Division of Surgical Oncology, NCI "Fondazione G. Pascale", Naples, Italy. Electronic address: v.albino@istitutotumori.na.it. · Department of Diagnostic Imaging, NCI of Naples, "Fondazione G. Pascale", Naples, Italy. Electronic address: r.fusco@istitutotumori.na.it. · Department of Abdominal Oncology, Division of Medical Oncology, NCI "Fondazione G. Pascale", Naples, Italy. Electronic address: massimo.membrini@gmail.com. · Department of Diagnostic Imaging, NCI of Naples, "Fondazione G. Pascale", Naples, Italy. Electronic address: a.petrillo@istitutotumori.na.it. · Department of Diagnostic Imaging, NCI of Naples, "Fondazione G. Pascale", Naples, Italy. Electronic address: cinzia.granata80@libero.it. · Department of Abdominal Oncology, Division of Surgical Oncology, NCI "Fondazione G. Pascale", Naples, Italy. Electronic address: f.izzo@istitutotumori.na.it. ·Int J Surg · Pubmed #26123385.

ABSTRACT: Electrochemotherapy is a local non-thermal treatment for cancer ablation. Currently, many studies and case report have investigated the differences in effectiveness of electrochemotherapy with respect to tumor type, chemotherapeutic drug, and route of drug administration. ESOPE trial validated standard operating procedures [SOP] for ECT using the Cliniporator device and demonstrated that ECT is a simple, highly efficacious, and cost-effective treatment of cutaneous and subcutaneous nodules from different primary tumors for cutaneous or superficial lesions. This review has the purpose to summarize current knowledge about clinical effectiveness of electrochemotherapy and future prospects regarding its use on pancreatic cancer and liver metastasis not only.

4 Review Everolimus and pancreatic neuroendocrine tumors (PNETs): Activity, resistance and how to overcome it. 2015

Capozzi, Monica / Caterina, Ieranò / De Divitiis, Chiara / von Arx, Claudia / Maiolino, Piera / Tatangelo, Fabiana / Cavalcanti, Ernesta / Di Girolamo, Elena / Iaffaioli, Rosario Vincenzo / Scala, Stefania / Tafuto, Salvatore / Anonymous6330834. ·Pharmacy Unit, Istituto Nazionale Tumori, IRCCS - Fondazione G. Pascale, Naples, Italy. · Molecular Immunology and Immuneregulation Section, Functional Genomic Unit, Istituto Nazionale Tumori, IRCCS - Fondazione G. Pascale, Naples, Italy. · Department of Abdominal Oncology, Division of Medical Oncology, NCI "Fondazione G. Pascale", Naples, Italy. · Department of Clinical Medicine and Surgery, University Federico II of Naples, Naples, Italy. · Department of Diagnostic Pathology and Laboratory, Istituto Nazionale Tumori, IRCCS - Fondazione G. Pascale, Naples, Italy. · Endoscopy Unit, Istituto Nazionale Tumori, IRCCS - Fondazione G. Pascale, Naples, Italy. · Department of Abdominal Oncology, Division of Medical Oncology, NCI "Fondazione G. Pascale", Naples, Italy. Electronic address: s.tafuto@istitutotumori.na.it. ·Int J Surg · Pubmed #26123382.

ABSTRACT: Neuroendocrine tumors (NET) are rare malignancies, with the most common site of origin being from the gastrointestinal tract, particularly the pancreas, small bowel and appendix. Pancreatic neuroendocrine tumors (PNETs) can be functional, hormone secreting tumors, and can have distinctive symptoms leading to the diagnosis. In contrast nonfunctional tumors, the majority of PNETs, usually present later either incidentally or due to tumor bulk symptoms. Currently Everolimus, an inhibitor of mammalian target of rapamycin (mTOR), is the most promising drug for patients with unresectable, metastatic disease, in progressive well-differentiated PNETs and many studies are ongoing to demonstrate its effects on the other neuroendocrine histotipes. Food and Drug Administration (FDA) and European Medicines Agency (EMA) registered Everolimus in advanced/metastatic breast cancer, in advanced/metastatic renal cell carcinoma and in well/moderately differentiated pancreatic neuroendocrine tumors. Nevertheless only a subset of patients respond to the therapy due to the development of drug resistance. Thus the powerful Everolimus antitumor activity have prompted extensive efforts to overcome drug resistance and to maximize clinical benefit. In this review we aim to summarize current knowledge on mechanisms of Everolimus and other mTOR inhibitors molecules resistance with the intent to overcome it.

5 Review Gastrointestinal non colorectal cancer. Do elderly patients need a specific management? 2013

Silvestro, Lucrezia / Nasti, Guglielmo / Ottaiano, Alessandro / Montano, Massimo / Casaretti, Rossana / Avallone, Antonio / Berretta, Massimiliano / Romano, Carmela / Cassata, Antonio / Tafuto, Salvatore / Iaffaioli, Rosario Vincenzo. ·Department of Abdominal Oncology, National Cancer Institute "G. Pascale"- Via M.Semmola, 80131 Naples, Italy. l.silvestro@istitutotumori.na.it. ·Anticancer Agents Med Chem · Pubmed #24102272.

ABSTRACT: BACKGROUND: Elderly patients (65 years and over) develop often, sometimes predominantly , esophageal, gastro esophageal junction, gastric and pancreatic cancer (gastrointestinal non colorectal cancer). Most clinical trials exclude elderly patients from accrual considering aging a potential risk factor. In fact an elderly patient can develop greater toxicity than a younger patient from oncologic treatments (chemotherapy, radiotherapy, target therapies) due to a worse function of vital organs. METHODS: We analyzed the current scientific literature, searching articles since 1990, about gastrointestinal non colorectal cancer in elderly patients, to establish if they need a specific management, different from younger patients. RESULTS: Data from analyzed studies, both gastro esophageal and pancreatic cancer, are contradictory. In some reports elderly patients don't seem to bring greater toxicity than younger. Other trials consider that dose-adjustment to renal function is need in elderly patients, but these trials are very few. Other trials may include several biases such as accrual of "only fit" elderly patients. CONCLUSIONS: It is very important in elderly patients with higher risk of toxicity, to distinguish the aim of cancer treatment: is it curative or palliative? Furthermore, in this type of patients the most important target is probably maintaining the quality of life especially in gastric and pancreatic cancer that often started as advanced disease. For these valuation chronological age alone is not sufficient. Another very important factor in elderly cancer patients is the geriatric assessment including not only age but also functional, social and mental status.

6 Article Metformin Use Is Associated With Longer Progression-Free Survival of Patients With Diabetes and Pancreatic Neuroendocrine Tumors Receiving Everolimus and/or Somatostatin Analogues. 2018

Pusceddu, Sara / Vernieri, Claudio / Di Maio, Massimo / Marconcini, Riccardo / Spada, Francesca / Massironi, Sara / Ibrahim, Toni / Brizzi, Maria Pia / Campana, Davide / Faggiano, Antongiulio / Giuffrida, Dario / Rinzivillo, Maria / Cingarlini, Sara / Aroldi, Francesca / Antonuzzo, Lorenzo / Berardi, Rossana / Catena, Laura / De Divitiis, Chiara / Ermacora, Paola / Perfetti, Vittorio / Fontana, Annalisa / Razzore, Paola / Carnaghi, Carlo / Davì, Maria Vittoria / Cauchi, Carolina / Duro, Marilina / Ricci, Sergio / Fazio, Nicola / Cavalcoli, Federica / Bongiovanni, Alberto / La Salvia, Anna / Brighi, Nicole / Colao, Annamaria / Puliafito, Ivana / Panzuto, Francesco / Ortolani, Silvia / Zaniboni, Alberto / Di Costanzo, Francesco / Torniai, Mariangela / Bajetta, Emilio / Tafuto, Salvatore / Garattini, Silvio Ken / Femia, Daniela / Prinzi, Natalie / Concas, Laura / Lo Russo, Giuseppe / Milione, Massimo / Giacomelli, Luca / Buzzoni, Roberto / Delle Fave, Gianfranco / Mazzaferro, Vincenzo / de Braud, Filippo. ·Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, ENETS Center of Excellence, Milan, Italy. Electronic address: sara.pusceddu@istitutotumori.mi.it. · Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, ENETS Center of Excellence, Milan, Italy; Fondazione Istituto FIRC di Oncologia Molecolare (IFOM), Milan, Italy. · Dipartimento di Oncologia, Università degli Studi di Torino, A. O. Ordine Mauriziano, Turin, Italy. · Dipartimento di Oncologia, Santa Chiara Hospital, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy. · IEO - Istituto Europeo di Oncologia, ENETS Center of Excellence, Milan, Italy. · Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy. · Centro di Osteoncologia e Tumori Rari, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy. · Azienda Ospedaliera Universitaria San Luigi Gonzaga, Orbassano, Italy. · Policlinico Sant'Orsola Malpighi, Bologna, Italy. · Unità di chirurgia tiroidea e paratiroidea, Istituto Nazionale per lo studio e la cura dei tumori "Fondazione G. Pascale" - IRCCS, Naples, Italy. · IOM- Istituto Oncologico del Mediterraneo, Catania, Italy. · Azienda Ospedaliera Universitaria Sant'Andrea, ENETS Center of Excellence, Rome, Italy. · Azienda Ospedaliera Universitaria, Verona, Italy. · Fondazione Poliambulanza, Brescia, Italy. · A. O. U. Careggi, Firenze, Italy. · Azienda Ospedaliero Universitaria Ospedali Riuniti, Ancona, Italy. · Policlinico di Monza, Monza, Italy. · IRCCS Fondazione Pascale, ENETS Center of Excellence, Naples, Italy. · Azienda Ospedaliero Universitaria Santa Maria della Misericordia, Udine, Italy. · Fondazione IRCCS Policlinico San Matteo, SC oncologia, Pavia, Italy. · Policlinico di Modena, Italy. · Unit of Endocrinology, Ospedale Mauriziano, Torino, Italy. · Istituto Clinico Humanitas, Rozzano, ENETS Center of Excellence, Italy. · Ospedale Policlinico Borgo Roma, Verona, Italy. · Ospedale S Croce e Carle, Cuneo, Italy. · Ospedale Valduce Como, Italy. · Endocrinology Section, Department of Clinical Medicine and Surgery, "Federico II" University of Naples, Italy. · Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, ENETS Center of Excellence, Milan, Italy. · Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, ENETS Center of Excellence, Milan, Italy; Medical-Surgical Science and Traslational Medicine Departement, Sapienza University, Rome, Italy. · Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Italy. · Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, ENETS Center of Excellence, Milan, Italy; Universita' degli Studi di Milano, Milan, Italy. ·Gastroenterology · Pubmed #29655834.

ABSTRACT: BACKGROUND & AIMS: Metformin seems to have anticancer effects. However, it is not clear whether use of glycemia and metformin affect outcomes of patients with advanced pancreatic neuroendocrine tumors (pNETs). We investigated the association between glycemia and progression-free survival (PFS) of patients with pNETs treated with everolimus and/or somatostatin analogues, as well as the association between metformin use and PFS time. METHODS: We performed a retrospective analysis of 445 patients with advanced pNET treated at 24 medical centers in Italy from 1999 through 2015. Data on levels of glycemia were collected at time of diagnosis of pNET, before treatment initiation, and during treatment with everolimus (with or without somatostatin analogues), octreotide, or lanreotide. Diabetes was defined as prior or current use of glycemia control medication and/or fasting plasma glucose level ≥ 126 mg/dL, hemoglobin A1c ≥ 6.5% (48 mmol/L), or a random sample of plasma glucose ≥ 200 mg/dL (11.1 mmol/L), with reported classic symptoms of hyperglycemia or hyperglycemic crisis. Patients were assigned to groups based on diagnosis of diabetes before or during antitumor therapy. PFS was compared between patients with vs without diabetes. Among patients with diabetes, the association between metformin use and PFS was assessed. We performed sensitivity and landmark analyses to exclude patients who developed diabetes while receiving cancer treatment and to exclude a potential immortal time bias related to metformin intake. RESULTS: PFS was significantly longer in patients with diabetes (median, 32.0 months) than without diabetes (median, 15.1 months) (hazard ratio for patients with vs without diabetes, 0.63; 95% confidence interval, 0.50-0.80; P = .0002). PFS of patients treated with metformin was significantly longer (median PFS, 44.2 months) than for patients without diabetes (hazard ratio for survival of patients with diabetes receiving metformin vs without diabetes, 0.45; 95% confidence interval, 0.32-0.62; P < .00001) and longer than for patients with diabetes receiving other treatments (median PFS, 20.8 months; hazard ratio, 0.49; 95% confidence interval, 0.34-0.69; P < .0001). In multivariable analysis, adjusted for other factors associated with outcomes, metformin was associated with longer PFS but level of glycemia was not. Metformin was associated with increased PFS of patients receiving somatostatin analogues and in those receiving everolimus, with or without somatostatin analogues. Sensitivity and landmark analyses produced similar results. CONCLUSIONS: In a retrospective study of patients with pNETs, we found a significant association between metformin use and longer PFS.

7 Article Nab-Paclitaxel and Gemcitabine in Advanced Pancreatic Cancer: The One-year Experience of the National Cancer Institute of Naples. 2017

Ottaiano, Alessandro / Capozzi, Monica / DE Divitiis, Chiara / VON Arx, Claudia / DI Girolamo, Elena / Nasti, Guglielmo / Cavalcanti, Ernesta / Tatangelo, Fabiana / Romano, Giovanni / Avallone, Antonio / Tafuto, Salvatore. ·Department of Abdominal Oncology, Istituto Nazionale, Tumori di Napoli "G. Pascale" IRCCS, National Cancer Institute, Naples, Italy ale.otto@libero.it. · Department of Abdominal Oncology, Istituto Nazionale, Tumori di Napoli "G. Pascale" IRCCS, National Cancer Institute, Naples, Italy. · ENETS Center of Excellence, Multidisciplinary Group for Neuroendocrine Tumors in Naples, Naples, Italy. · Units of Endoscopy, Istituto Nazionale Tumori di Napoli "G. Pascale" IRCCS, National Cancer Institute, Naples, Italy. · Laboratory Unit, Istituto Nazionale Tumori di Napoli "G. Pascale" IRCCS, National Cancer Institute, Naples, Italy. · Pathology Unit of the Department of Diagnostic Pathology and Laboratory, Istituto Nazionale Tumori di Napoli "G. Pascale" IRCCS, National Cancer Institute, Naples, Italy. · Department of Abdominal Surgery, Istituto Nazionale, Tumori di Napoli "G. Pascale" IRCCS, National Cancer Institute, Naples, Italy. ·Anticancer Res · Pubmed #28373469.

ABSTRACT: BACKGROUND: Pancreas adenocarcinoma is the sixth cause of cancer-related death worldwide with an increasing mortality in the Western countries. Recently, the association between nab-paclitaxel (nab-P) and gemcitabine (GEM) has significantly improved progression-free and overall survival. PATIENTS AND METHODS: Patients affected by metastatic pancreas adenocarcinoma were treated at the Department of Abdominal Oncology of the National Cancer Institute of Naples from July 2015 to July 2016 with nab-P at 125 mg per square meter of body-surface area followed by GEM at 1,000 mg per square meter on days 1, 8 and 15 every 4 weeks. Computed tomography (CT) was performed every three months of therapy. Toxicity was graded with National Cancer Institute-Common Toxicity Criteria (NCI-CTC) v4.0. Objective responses were evaluated with Response Evaluation Criteria in Solid Tumors (RECIST). Analysis of time-to-progression is only descriptive. Pain was evaluated with a visual analogue scale (VAS). RESULTS: Twenty-three patients were treated. Median age was 67 years (range=45-81); 8 patients were ≥70 years old. Performance status (PS) Eastern Cooperative Oncology Group (ECOG) was 2 in 8 patients, 1 in 10 and 0 in 5. Twelve patients presented with diffuse hepatic metastases, 4 with carcinosis, 7 with more than one organ involvement. Nab-P was reduced at 100 mg per square meter in all patients. The most common G3/G4 adverse events were neutropenia (13.0% G4, 8.6% G3; none was febrile), neuropathy (30.4% G3) and asthenia (G3 17.3%). The disease control rate was 43.4% (partial response+stable disease (PR+SD) 10/23). The median time-to-progression was 7.9 months (95% confidence interval (CI)=5.8-11.2). After three months of therapy the PS improved in 14 patients, as well as pain in 18 patients. CONCLUSION: We present an experience with nab-P and GEM association in a series with poor PS and highly metastatic disease relatively to a previous randomized study. The schedule is feasible, with nab-P at 100 mg per square meter achieving a good disease control rate, as well as a clinical benefit.

8 Article Metronomic temozolomide as second line treatment for metastatic poorly differentiated pancreatic neuroendocrine carcinoma. 2016

De Divitiis, C / von Arx, C / Grimaldi, A M / Cicala, D / Tatangelo, F / Arcella, A / Romano, G M / Simeone, E / Iaffaioli, R V / Ascierto, P A / Tafuto, S / Anonymous5600866. ·Department of Abdominal Oncology, Istituto Nazionale Tumori, IRCCS-Fondazione "G. Pascale", Naples, Italy. · Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy. · Melanoma, Cancer Immunotherapy, and Innovative Therapy Unit, Istituto Nazionale Tumori, IRCCS-Fondazione "G. Pascale", Naples, Italy. · Unit of Interventional Neuroradiology, Department of Advanced Biomedical Sciences, "Federico II" University, Naples, Italy. · Department of Diagnostic Pathology and Laboratory, Istituto Nazionale Tumori, IRCCS-Fondazione "G. Pascale", Naples, Italy. · IRCCS Neuromed, Località Camerelle, Pozzilli-Isernia, Italy. · Department of Abdominal Oncology, Istituto Nazionale Tumori, IRCCS-Fondazione "G. Pascale", Naples, Italy. salvatore.tafuto@libero.it. ·J Transl Med · Pubmed #27142424.

ABSTRACT: Neuroendocrine Neoplasms (NEN) are a group of heterogeneous malignancies derived from neuroendocrine cell compartment, with different roles in both endocrine and nervous system. Most NETs have gastroentero-pancreatic (GEP) origin, arising in the foregut, midgut, or hindgut. The 2010 WHO classification divides GEP-NETs into two main subgroups, neuroendocrine tumors (NET) and neuroendocrine carcinomas (NEC), according with Ki-67 levels. NET are tumors with low (<20 %) Ki-67 value, and NECs, including small cell lung carcinomas and Merkel Cell carcinomas, are all NETs with high Ki-67 levels (>20 %-G3). Poorly differentiated neuroendocrine carcinomas (NEC) are usually treated with cisplatin-based chemotherapy regimens. Here we present a case of a patient with pancreatic NEC progressing after cisplatin and etoposide, treated with temozolomide as palliative, second line treatment. According with the poor Performance Status (PS = 2) and to reduce the toxicity of the treatment was chosen an intermittent dosing regimen of metronomic temozolomide (75 mg/m(2)/day-one-week-on/on-week-off). MGMT resulted methylated. On July 2014 the patient started the treatment. On August 2014 the patient obtained a significant clinical benefit (PS = 0) and the total body CT scan performed on October 2014 showed a RECIST partial response on all the sites of disease. No drug-related side effects were reported by the patient. After 18 months of therapy the treatment continues without significant toxicity, and with further remission of the metastases. Treatment with metronomic "one-week-on/on-week-off" Temozolomide can be considered a good treatment option in patients with poor performance status, affected by pNEC with MGMT methylation.