Selected chemotherapy trials in metastatic carcinoid tumors

Phase II trials
Regimen	Number of patients*	Tumor response rate, percent	Median overall survival, months	Reference
Dacarbazine	56	16	20	Bukowski R; 1994
Dacarbazine (second-line)	61	8	11.9	Sun W; 2005
Etoposide	17	12	NR	Kelsen D; 1987
Paclitaxel^¶	24^Δ	8	18	Ansell S; 2001
Docetaxel	21	0	24	Kulke M; 2004
Gemcitabine	18^◊	0	11.5	Kulke M; 2004
Capecitabine	19	0	36.5	Medley L; 2011
Streptozocin + fluorouracil + doxorubicin + cyclophosphamide	56	30	10.8	Bukowski R; 1987
Streptozocin + fluorouracil + cyclophosphamide	9	22	10.8	Bukowski R; 1987
Streptozocin + fluorouracil + cisplatin	33	25	31.5^§	Turner N; 2010
Temozolomide + thalidomide	15	7	NR	Kulke M; 2006
Gemcitabine + oxaliplatin	18 (previously treated^¥)	17	23.4	Cassier P; 2009
Randomized trials
Regimen	Number of patients*	Tumor response rate, percent	Median overall survival, months	Reference
Streptozocin + cyclophosphamide versus Streptozocin + fluorouracil	47 42	26* 33*	12.5 11.2	Moertel C; 1979
Doxorubicin versus Streptozocin + fluorouracil	81 80	21 22	11.1 14.9	Engstrom P; 1984
Doxorubicin + fluorouracil versus Streptozocin + fluorouracil	88 88	16 16	15.7 24.3 (p = 0.03)	Sun W; 2005

NR: not reported.
* Response rates included both radiographic tumor regression and reduction urinary 5-HIAA levels.
¶ Patients also received granulocyte-colony-stimulating factor.
Δ Includes patients with carcinoid (n = 14), pancreatic islet cell (n = 9), and anaplastic (n = 1) neuroendocrine tumors.
◊ Includes patients with carcinoid (n = 9), pancreatic (n = 7), and pheochromoctyoma (n = 2) neuroendocrine tumors.
§ Response rate is for nonpancreatic neuroendocrine tumors in a combined series with 47 pancreatic neuroendocrine tumors. Median survival is for the entire group.
¥ Includes patients with well differentiated neuroendocrine carcinoma, not otherwise specified.

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Selected chemotherapy trials in metastatic carcinoid tumors