A PHASE-II TRIAL OF CARBOPLATIN IN PATIENTS WITH ADVANCED APUD TUMORS

Background. Chemotherapy remains inadequate for patients with carcinoi d tumors, islet cell tumors, and medullary carcinomas of the thyroid. Carboplatin has shown activity in oat cell carcinoma of the lung, anot her tumor of neuroectodermal origin. Methods. Forty-two patients with advanced APUD tumors (20 carcinoid tumors, 9 islet cell carcinomas, 5 medullary carcinomas of the thyroid, and 9 neuroendocrine tumors of un known primary site) were treated with carboplatin in a Phase II study. Results. Carboplatin was inactive in carcinoid and islet cell tumors, with 0 of 20 and 0 of 9 patients responding, respectively. Of the 41 total patients evaluable for response, only 2 (5%) achieved a partial response. Both of these responding patients had neuroendocrine tumors of unknown primary site. No complete responses were seen. Toxicities w ere those previously noted with carboplatin, with myelosuppression, pa rticularly thrombocytopenia, being dose limiting.Conclusions. Carbopla tin is inactive in carcinoid tumors and did not show evidence of activ ity in islet cell tumors. Further investigations are needed to identif y active agents in the treatment of neuroendocrine malignancies.