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- W2789687047 abstract "Advanced NET tumor grade portends poorer disease control with both systemic and liver-directed therapies. An integrated treatment protocol combining capecitibine-temozolomide with yttrium-90 radioembolization (CapTemY90) for patients with liver-dominant grade 2 metastases was designed in the hopes of achieving synergistic improvement in liver disease control with no more than additive toxicities. This report describes the feasibility and safety of this integrated loco-systemic regimen. The NET Tumor Board identified patients with unresectable Grade 2 neuroendocrine tumor liver-dominant metastases without contraindications to radioembolization or to CapTem. Initial therapy consisted of capecitabine 600 mg/m2 twice daily for 14 days and temozolomide 150-200 mg/m2 in two divided doses on Days 10-14, with 14 days between cycles. Once the patient had completed one cycle of CapTem with tolerable toxicity and undergone simulation angiography demonstrating eligibility for Y-90 radioembolization, the dominant lobe was radioembolized on Day 7 of the 2nd cycle of CapTem. For patients with bilobar disease, the other lobe was treated on Day 7 of the 3rd or 4th cycle. Clinical assessment was performed monthly and imaging every 3 months. 19/21 patients completed the prescribed therapy. Two did not have the planned second lobe radioembolization due to post-embolization toxicities. Adverse events were as expected for each therapy alone, including thrombocytopenia, fatigue, nausea, and post-embolization pain and hepatic dysfunction. ORR was 74% in the liver and 55% for extrahepatic tumor. Median PFS was not reached at a mean follow-up of 27 months. PFS at three years was 67%, with 74% progression-free in the liver. CapTemY90 is a feasible and safe integrated therapeutic regimen for intermediate-grade liver-dominant NETs. Toxicities were additive. Oncologic outcomes suggest synergy and provided the basis for design of a multicenter Phase 2 trial." @default.
- W2789687047 created "2018-03-29" @default.
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- W2789687047 date "2018-04-01" @default.
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- W2789687047 title "3:36 PM Abstract No. 265 Safety and feasibility of integrating yttrium-90 radioembolization with capecitabine-temozolomide for grade 2 liver-dominant metastatic neuroendocrine tumors (CapTemY90): final report" @default.
- W2789687047 doi "https://doi.org/10.1016/j.jvir.2018.01.296" @default.
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