KEY TAKEAWAYS
- The phase II/III trial aimed to evaluate the outcomes of atezolizumab plus chemotherapy in EP-NEC pts as first-line treatment.
- Pts diagnosed with grade III, Ki-67 >20%, poorly differentiated, metastatic EP-NEC, and treated with at least one dose of atezolizumab plus chemotherapy as first-line treatment were selected for analysis.
- The study found that atezolizumab plus chemotherapy as first-line therapy for poorly differentiated metastatic EP-NEC showed efficacy and tolerability, warranting further investigation.
Poorly differentiated extrapulmonary neuroendocrine carcinoma (EP-NEC) is a rare and aggressive cancer with limited treatment options. Studies in small-cell lung cancer suggest that adding the immunotherapy drug atezolizumab to chemotherapy can improve survival, but prospective trials are needed in EP-NEC.
Researchers aimed to evaluate the outcomes of atezolizumab plus chemotherapy in patients(pts) with poorly differentiated extrapulmonary neuroendocrine carcinoma (EP-NEC) as first-line treatment.
The study reviewed pts at the Gastrointestinal Medical Oncology Clinic at Banner-University of Arizona Cancer Center who received at least one dose of atezolizumab. The analysis focused on pts diagnosed with poorly differentiated, metastatic EP-NEC with grade III, Ki-67>20% treated with atezolizumab and chemotherapy as their first-line treatment.
During the specified period, 10 pts received atezolizumab-based therapy. Of these, 6 pts met the analysis criteria, while 4 were excluded for different diagnoses. Among the included pts were 4 females and 2 males, with an average age at diagnosis of 63.8 years. They underwent a median of 7.0 chemotherapy cycles (4 to 17) and received 7.5 atezolizumab doses (6 to 28). The median progression-free survival (PFS) was 7 months (95% CI 5 to *), while the median overall survival (mOS) was 13 months (95% CI 8 to *). The mOS since starting atezolizumab was 12 months (95% CI 8 to *) [*Upper bound of 95% CI cannot be determined.] Among the pts, 83% (5 out of 6) showed a partial response per RECISTv1.1. All pts had MMR-proficient/MSI-stable tumors, with negative PD-L1 expression in 3 pts (PD-L1 status unavailable for 3 pts). There were no hospitalizations related to immunotherapy or chemotherapy. The most common adverse events(AEs) included nausea, diarrhea, and fatigue, 1 patient experienced immune-mediated thyroid dysfunction, successfully managed medically.
The study found that atezolizumab plus chemotherapy as first-line therapy for poorly differentiated metastatic EP-NEC shows efficacy and tolerability, warranting further investigation.
Source: https://ascopubs.org/doi/abs/10.1200/JCO.2023.41.16_suppl.e14619
Clinical Trial: https://www.clinicaltrials.gov/study/NCT05058651
Sakthi Kumar, Toluwalase Talabi, Mahta Mahmoudieh, Daniel Pennington, Kathylynn Saboda, Junaid Arshad, and Aaron James Scott. DOI: 10.1200/JCO.2023.41.16_suppl.e14619 Journal of Clinical Oncology 41, no. 16_suppl (June 01, 2023) e14619-e14619.
