ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Cancer Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1595151
Predictive Factors for Efficacy of Oxaliplatin Based Chemotherapy in Advanced Well-Differentiated Neuroendocrine Tumors: An Observational Cohort Study and Meta-Analysis
Provisionally accepted
- Qilu Hospital, Shandong University, Jinan, China
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Background: Oxaliplatin based chemotherapy (OX-CT) has shown promising antitumor activity in advanced well-differentiated neuroendocrine tumors (WD-NETs). However, no meta-analysis has been conducted to explore the factors associated with ORR and PFS of OX-CT, and data are still limited in Chinese cohort.We performed a retrospective cohort study with advanced WD-NETs who received OX-CT. Also, we conducted a systematic review and performed a meta-analysis to explore factors associated with ORR and PFS.Results: 27 patients were included, with 21 receiving OX-CT as first line. 18 were of pancreas origin and the median Ki67 was 30%. The ORR and DCR were 29.6% and 81.5%.The median PFS was 9.3 months (95%CI: 4.6~14.0) and OS was not reached. A ki67 >10% predicted higher ORR (36.4 % vs 0.0%, p=0.28) and better PFS (10.0m vs 2.1m, p=0.06).Patients with hepatic tumor burden ≤25% had a similar ORR (33.3 % vs 22.2%, p=0.68), but a trend of longer PFS (10.2m vs 4.7m, p=0.21) than those >25%. Both ORR and PFS were independent of MGMT status. 962 patients were included in the systemic review. The pooled ORR (28.2%, p=0.84) and DCR (82.9%, p=0.85) were comparable with this cohort.No difference was observed between GEMOX and FOLFOX/CAPOX in both ORR (23.9% vs 29.6%, p=0.19) and PFS (10.5m vs 11.8m, p=0.69). Enhanced ORR was seen in pNETs than epNETs (36.8% vs 16.7%, p<0.001), also in G3 NETs than G1-2 NETs (45.5% vs 24.7%, p<0.001). The pooled median PFS and OS were 10.8months (95%CI: 8.8-12.8) and 30.4months (95%CI: 24.8-35.9).Oxaliplatin-based chemotherapy could be a good option for advanced WD-NETs with high ki67 index and pancreatic origin.
Keywords: Well-differentiated neuroendocrine tumors, oxaliplatin, Pancreatic, Ki67 index, MGMT, hepatic tumor burden
Received: 18 Mar 2025; Accepted: 21 Apr 2025.
Copyright: © 2025 Wang, Wang, Chu, Li and Hao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jing Hao, Qilu Hospital, Shandong University, Jinan, China
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