Eine Analyse der Wirksamkeit und Sicherheit von Dacarbazin bei Patienten mit fortgeschrittenen metastasierten neuroendokrinen Tumoren

The aim of this study was to evaluate the efficiency and toxicity of a low dose dacarbazine regimen (650mg/m²) in patients with advanced, highly differentiated neuroendocrine neoplasms. 75 patients with neuroendocrine tumors predominantly of pancreatic origin were retrospectively examined at the Department of Internal Medicine at the University Hospital in Marburg. The period between 1992 and 2013 had been under survey. All subjects had been intravenously administered with a cycle of 650mg/m² dacarbazine. Objective response rate according to RECIST 1.1 and progression-free survival were determined as endpoints. Results showed that 27% of all patients had an objective response under low dose dacarbazine treatment which lasted progression-free a median of 24 months. In the subgroup of patients with pancreatic neuroendocrine neoplasms even 32% had a partial remission with a median progression-free survival of 27 months, while the clinical benefit was 66%. An univariate analysis was used to assess prognostic markers of the progression-free survival. It showed that a radiological response and a decrease of initially enhanced chromogranin A in the serum during treatment increased progression-free survival significantly. Most common adverse events in treatment were nausea and grade 1 vomiting, only one grade 3 event had been documented. In contrast to the standard therapy, like combinations of streptozocin and temozolomide, the low dose monotherapy with dacarbazine was effective and tolerable in the treatment of neuroendocrine neoplasms. It demonstrated a good outcome in our collective with predominantly pre-treated patients and thus it is a valid therapeutic option as second-line or third-line therapy.