Chemotherapy for locally advanced and metastatic pulmonary carcinoid tumors.

Abstract

OBJECTIVES:

The optimal management of locally advanced and metastatic pulmonary carcinoid tumors remains to be determined.

MATERIALS AND METHODS:

A retrospective review was conducted on patients with typical and atypical pulmonary carcinoid tumors treated at our institutions between 1990 and 2012.

RESULTS:

300 patients were identified with pulmonary carcinoid, (80 patients with atypical carcinoid), of whom 29 presented with metastatic disease (16 atypical). Of evaluable patients, 26 (41%) with stages I-III atypical carcinoid tumors recurred at a median time of 3.7 years (range, 0.4-32), compared to 3 (1%) patients with typical carcinoid (range, 8-12.3). 39 patients were treated with chemotherapy, including 30 patients with metastatic disease (27 atypical), and 7 patients were treated with adjuvant platinum-etoposide chemoradiation (6 atypical, 1 typical, 6 stage IIIA, 1 stage IIB). At a median follow-up of 2 years there were 2 recurrences in the 7 patients receiving adjuvant treatment. Median survival after diagnosis of metastatic disease for patients with atypical pulmonary carcinoid was 3.3 years with a 5-year survival of 24%. Treatment regimens showing efficacy in pulmonary carcinoid include 15 patients treated with octreotide-based therapies (10% response rate (RR), 70% disease control rate (DCR), 15 month median progression-free survival (PFS)), 13 patients treated with etoposide+platinum (23% RR, 69% DCR, 7 month median PFS), and 14 patients treated with temozolomide-based therapies (14% RR, 57% DCR, 10 month median PFS). 8 of 10 patients with octreotide-avid disease treated with an octreotide-based regimen experienced disease control (1 partial response, 7 stable disease) for a median of 18 months (range 6-72 months).

CONCLUSIONS:

These results support our previous finding that a subset of pulmonary carcinoid tumors are responsive to chemotherapy.

• Authors: Curtis R Chong, Lori J Wirth, Mizuki Nishino, Aileen B Chen, Lynette M Sholl, Matthew H Kulke, Ciaran J McNamee, Pasi A Jänne, Bruce E Johnson
• Journal: Lung cancer (Amsterdam, Netherlands) (Lung Cancer) Vol. 86 Issue 2 Pg. 241-6 (Nov 2014) ISSN: 1872-8332 [Electronic] Ireland
• PMID: 25218177 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Topics

• Adult
• Aged
• Aged, 80 and over
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Carcinoid Tumor (diagnosis, drug therapy, mortality, pathology)
• Female
• Humans
• Lung Neoplasms (diagnosis, drug therapy, mortality, pathology)
• Male
• Middle Aged
• Neoplasm Metastasis
• Neoplasm Staging
• Retrospective Studies
• Treatment Outcome
• Young Adult