Post-first-line FOLFOX chemotherapy for grade 3 neuroendocrine carcinoma

J. Hadoux, D. Malka, D. Planchard, J. Y. Scoazec, C. Caramella, J. Guigay, V. Boige, S. Leboulleux, P. Burtin, A. Berdelou, Y. Loriot, P. Duvillard, C. N. Chougnet, D. Déandréis, M. Schlumberger, I. Borget, M. Ducreux, E. Baudin

Research output: Contribution to journalArticlepeer-review

127 Scopus citations


There is no standard for second-line chemotherapy in poorly differentiated grade 3 neuroendocrine carcinoma (G3-NEC) patients. We analyzed the antitumor efficacy of 5-fluorouracil and oxaliplatin (FOLFOX) chemotherapy in this population. A single-center retrospective analysis of consecutive G3-NEC patients treated with FOLFOX chemotherapy after failure of a cisplatinum-based regimen between December 2003 and June 2012 was performed. Progression-free survival (PFS), overall survival (OS), response rate, and safety were assessed according to RECIST 1.1 and NCI.CTC v4 criteria. Twenty consecutive patients were included (seven males and 13 females; median age 55; range 23-87 years) with a performance status of 0-1 in 75% of them. Primary location was gastroenteropancreatic in 12, thoracic in four, other in two, and unknown in two patients. There were 12 (65%) large-cell and 7 (30%) small-cell G3-NEC tumors, and 1 (5%) unknown. All patients had distant metastases. Twelve (60%) patients received FOLFOX as second-line treatment and 8 (40%) as third-line treatment or later and the median number of administered cycles was 6 (range 3-14). The median follow-up was 19 months. Median PFS was 4.5 months. Among the 17 evaluable patients, five partial responses (29%), six stable diseases (35%), and six progressive diseases (35%) were observed. Median OS was 9.9 months. Main Grade 3-4 toxicities were neutropenia (35%), thrombopenia (20%), nausea/vomiting (10%), anemia (10%), and elevated liver transaminases (10%). Our results indicate that the FOLFOX regimen could be considered as a second-line option in poorly differentiated G3-NEC patients after cisplatinum-based first-line treatment but warrant further confirmation in future larger prospective studies.

Original languageEnglish
Pages (from-to)289-298
Number of pages10
JournalEndocrine-Related Cancer
Issue number3
StatePublished - 1 Jun 2015
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2015 Society for Endocrinology.


  • Grade 3
  • Neuroendocrine carcinoma
  • Oxaliplatin
  • Poorly differentiated neuroendocrine tumor
  • Second-line chemotherapy


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