Evidence-based data regarding the role of chemotherapy in the management of gastrointestinal neuroendocrine tumors are scarce, mainly because the results of only small studies are available. Combination chemotherapy with regimens such as cisplatin–etoposide was reported to have activity against gastrointestinal neuroendocrine tumors. However, few studies have documented a good response of gastrointestinal neuroendocrine tumors to second-line chemotherapy.Patients and methods
We studied three patients with unresectable gastrointestinal neuroendocrine tumors who received irinotecan or amrubicin after prior chemotherapy with platinum and etoposide. ResultsThe characteristics of the three patients are shown below. All were men, with a median age of 69 years (range, 62–70). The site of the primary tumor was the stomach in two patients and the esophagus in one. One patient with a gastric neuroendocrine tumor received irinotecan as second-line chemotherapy, and the other received amrubicin as second-line chemotherapy followed by irinotecan as third-line therapy. A partial response was obtained in one patient after two courses of irinotecan, and this patient is now receiving the fifth course of irinotecan. The patient with an esophageal neuroendocrine tumor received amrubicin as second-line chemotherapy, followed by irinotecan as third-line therapy. The second course of irinotecan is now being administered, and response will be evaluated after completion of the second course. Both patients who received amrubicin as second-line therapy had progressive disease after two courses of amrubicin.Conclusions
We described our experience with a case of gastrointestinal neuroendocrine tumor that responded to irinotecan after prior chemotherapy. Irinotecan might be effective against gastrointestinal neuroendocrine tumor. However, further clinical studies are required to confirm currently available evidence.