Irinotecan-based chemotherapy in extrapulmonary neuroendocrine carcinomas: survival and safety data from a multicentric Italian experience

Camilla Bardasi, Andrea Spallanzani, Stefania Benatti, Francesca Spada, Alice Laffi, Lorenzo Antonuzzo, Daniele Lavacchi, Riccardo Marconcini, Marco Ferrari, Margherita Rimini, Francesco Caputo, Chiara Santini, Krisida Cerma, Andrea Casadei-Gardini, Kalliopi Andrikou, Massimiliano Salati, Federica Bertolini, Annalisa Fontana, Massimo Dominici, Gabriele LuppiFabio Gelsomino

Research output: Contribution to journalArticlepeer-review


Purpose: Neuroendocrine carcinomas (NECs) are a rare subgroup of neuroendocrine neoplasms that occasionally originate from gastro-entero-pancreatic (GEP) tract. Evidence of the effectiveness of chemotherapy is scarce. Platinum plus Etoposide regimens are currently the standard treatment in first-line, while little data are available on second-line treatments. The aim of this study is to evaluate the efficacy and safety of irinotecan (IRI)-based chemotherapy in a series of extrapulmonary NECs. Methods: Patients with NEC diagnosis treated at University Hospitals of Modena, Florence, Pisa, and European Institute of Oncology of Milan with an IRI-based regimen (FOLFIRI or XELIRI) after progression to a first-line platinum-based therapy were enrolled. Objective responses were assessed according to RECIST criteria. Progression-free survival (PFS) and overall survival (OS) were calculated. Results: Thirty-four patients, 16 males, and 18 females, median age of 59 years (range 32–77), with metastatic NEC were included. Twenty-seven patients had Ki-67 ≥ 55% and four patients Ki-67 of <55% (for three patients data were not available). The median number of treatment cycles of the IRI-based regimen was 7.5 (range 1–16). Six partial responses (17.6%) and 9 stable diseases (26.5%) were observed, with a disease control rate of 44.1%. Median PFS and OS were 4.4 and 5.9 months, respectively. Neutropenia, anemia, and nausea were the only G3–G4 toxicities reported. Conclusions: Despite the relatively small sample size, IRI-based therapy demonstrated to be a valid option for patients with pretreated extrapulmonary NEC.

Original languageEnglish
Publication statusAccepted/In press - 2021


  • Chemotherapy
  • Irinotecan
  • NEC
  • Neuroendocrine carcinoma
  • Second-line treatment
  • Survival

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


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