Dr. Krishnamurthi on CAPTEM as Treatment for Neuroendocrine Tumors

Smitha Krishnamurthi, MD, a medical oncologist and associate professor of medicine at University Hospitals Case Medical Center and Case Western Reserve University, discusses a prospective phase II study of capecitabine and temozolomide (CAPTEM) for progressive, moderately, and well-differentiated metastatic neuroendocrine tumors.

Krishnamurthi says neuroendocrine tumors are typically resistant to chemotherapy because they are slow growing. Preclinical data found that giving capecitabine followed by temozolomide depletes thymidine in patients. Thymidine inhibits the ability of cells to repair the damage caused by temozolomide, Krishnamurthi says.

In the phase II prospective study, 28 patients with neuroendocrine tumors were treated with the CAPTEM combination. Of the 12 patients with carcinoid tumors, 5 patients showed a partial or complete response to the therapy. Patients with pituitary tumors and about 33% of patients with pancreatic neuroendocrine tumors also responded to treatment.

Progression-free survival for these patients was close to 2 years, Krishnamurthi says. However, further studies are needed to test the efficacy of CAPTEM in neuroendocrine tumors.