Lack of efficacy of streptozocin and doxorubicin in patients with advanced pancreatic endocrine tumors

Background: The combination of streptozocin and doxorubicin has been considered the standard palliative chemotherapy regimen in patients with advanced pancreatic endocrine tumors (PETs). However, a recent review failed to confirm high antitumor activity in patients with advanced PETs. Methods: We retrospectively reviewed the records of 16 consecutive patients who received streptozocin and doxorubicin for advanced PETs at Dana Farber/Partners Cancer Care institutions. Baseline patient characteristics, radiographic response to therapy, treatment-related toxicity, progression-free and overall survival were analyzed. Results: One patient demonstrated an objective partial response to therapy (objective response rate [ORR], 6%; 95% confidence interval [Cl],. 0-18%). Six patients achieved stable disease (38%; 95% Cl. 14-62%) and 9 patients demonstrated disease progression on initial restaging (56%, 95% Cl, 33-77%). The median progression-free survival and overall survival were 3.9 months (95% Cl, 2.8-8.8) and 20.2 months (95% Cl, 9.7-37.4), respectively. Conclusions: In this retrospective cohort, the combination of streptozocin and doxorubicin failed to demonstrate substantial antitumor activity in patients with advanced PET. Our findings underscore the need for new therapeutic options in this patient Population.