Objective. Patients with gastroenteropancreatic
neuroendocrine carcinoma (NEC) have a poor prognosis.
Platinum-based
combination chemotherapy is commonly used as first-line treatment; however, the role of salvage
chemotherapy remains unknown. This study aimed to analyze the efficacy and safety of
amrubicin monotherapy in patients with
platinum-refractory gastroenteropancreatic NEC. Methods. Among 22 patients with advanced gastroenteropancreatic NEC, 10 received
amrubicin monotherapy between September 2007 and May 2014 after failure of
platinum-based
chemotherapy. The efficacy and toxicity of the treatment were analyzed retrospectively. Results. Eight males and two females (median age, 67 years (range, 52-78)) received
platinum-based
chemotherapy, including
cisplatin plus
irinotecan (n = 7, 70%),
cisplatin plus
etoposide (n = 2, 20%), and
carboplatin plus
etoposide (n = 1, 10%) before
amrubicin therapy. Median progression-free survival and overall survival after
amrubicin therapy were 2.6 and 5.0 months, respectively. Two patients had partial response (20% response rate), and their PFS were 6.2 months and 6.3 months, respectively. Furthermore, NEC with response for
amrubicin had characteristics with a high Ki-67 index and receipt of prior
chemotherapy with
cisplatin and
irinotecan. Grade 3-4
neutropenia and
anemia were observed in four and five patients, respectively. Conclusion.
Amrubicin monotherapy appears to be potentially active and well-tolerated for
platinum-refractory gastroenteropancreatic NEC.