560 Infusional 5-fluorouracil with alpha interferon as a palliative treatment for patients with symptomatic malignant neuroendocrine tumours

Abstract

Inoperable neuroendocrine tumours are frequently slow growing but occasionally patients can present with rapidly progressive metastatic disease and uncontrolled symptoms. Generally, such patients receive only limited benefit and severe toxicity from chemotherapy regimens. 24 patients with rapidly progressive neuroendocrine tumours were treated with a new regimen of continuous infusional 5FU (200 mg/m 2 /day) given via a Hickman line for 20 weeks and alpha Interferon (5 megaunits 3 × week). Maintenance Interferon at the same dose was continued after the initial 20 week period. Of 15 patients with carcinoid tumours 7 (47%) had an objective tumour response (median duration 20.5 months) and 5 (33%) had stabilisation of their disease for a period of between 3.5–42 months. 3 early deaths occurred, all in patients with very advanced disease. An improvement in symptoms was reported by 10 (67%) patients. 3 (33%) of 9 patients with non-carcinoid tumours had an objective response (duration 2.5-24.5 months) and 5 (55%) had stable disease for 2.5–16 months. Toxicity was modest: 3 patients experienced severe gastrointestinal toxicity, 1 patient had a severe skin reaction and 8 patients had subclinical haematological toxicity. These results, particularly for carcinoid tumours are encouraging. This regimen seems to be less toxic and may provide better response rates and palliation than other chemotherapeutic options.