Endocrine Abstracts

Approximately 230 new patients with GEP-NEN are referred annually to the centre. Prevalence of GEP-NEN is increasing due to the availability of 2nd, 3rd or 4th line treatments. Oral chemotherapy is being used with increasing frequency in this setting. The NEN Team wished to explore the outcomes of patients treated with temozolomide singe agent and temozolomide/capecitabine during the previous 5 years and compare the findings with current literature. 18 patients were included in the analysis and were Grade 1 - 3 NEN. 7 had pancreatic NEN [pNEN] (G1 x1, G2 x 2 G3 x 5), 5 had small bowel NEN (G1 x 1, G2 x 3, I x UK), 3 were gastric ( G1 x 1, G2 x 1 G3 x 1) and 3 others (G3 gallbladder, G2 appendix, UK colon). Age range was 47 - 79, median 68. 11 patients were pre treated with somatostatin analogue, 3 with IV chemotherapy and 4 had temozolomide/capecitabine as first line therapy. The best response was in pancreatic NEN. Mean PFS was 239 days (range 28 - 1458). Toxicity was generally mild, i.e., G2 haematological or gastro-intestinal. 6 patients (33%) died after 1 cycle. 1 - brain haemorrhage, 1- stroke and 1 due to COVID. 3 died due to disease progression prior to receiving cycle 2. 1 of those also had G3 haematological toxicity. Median follow up was 235 days (range 25 - one patient remaining on follow up). The best response was in pancreatic NEN which is consistent with current literature. PFS with temozolomide/capecitabine combination is greater in both small bowel and pNEN which is similar to this cohort. It is acknowledged this is a very small sample. The team will continue to analyse the data with a longitudinal approach to gain more robust data particularly as numbers treated continue to rise. As small bowel NEN and pNET are heterogenic more valid data may be obtained by analysing these as separate entities.