{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T14:21:44Z","timestamp":1778768504969,"version":"3.51.4"},"reference-count":34,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Capecitabine plus temozolomide (CAPTEM) improves progression-free survival (PFS) in pancreatic endocrine and neuroendocrine neoplasms (PNENs), yet its real-world effectiveness across other endocrine and neuroendocrine neoplasm (ENEN) subtypes remains uncertain. We conducted a retrospective population-based cohort study including 159 adults with ENENs treated with CAPTEM in Alberta, Canada (2011\u20132021). Patients were stratified by primary tumor site, treatment line, and number of CAPTEM cycles received. Kaplan\u2013Meier methods and Cox proportional hazards models adjusted for age and sex were used to evaluate PFS and overall survival (OS). Compared with pancreatic neuroendocrine neoplasms PNENs, gastrointestinal neuroendocrine neoplasms (GINENs) demonstrated similar PFS and OS. In contrast, pulmonary neuroendocrine neoplasms (PuNENs) and other ENENs (OENENs) were associated with significantly shorter PFS and OS. Use of CAPTEM in the first-line setting was associated with improved PFS (HR 0.56, 95% CI 0.40\u20130.78, p &lt; 0.001) and OS (HR 0.42, 95% CI 0.29\u20130.62, p &lt; 0.001). Receipt of \u22656 treatment cycles was also strongly associated with superior PFS (HR 0.22, 95% CI 0.16\u20130.32, p &lt; 0.001) and OS (HR 0.22, 95% CI 0.14\u20130.34, p &lt; 0.001). CAPTEM shows comparable real-world effectiveness in GINENs and PNENs but appears less effective in PuNENs and other OENEN subtypes. Early initiation and adequate treatment duration are key factors associated with improved survival outcomes.<\/jats:p>","DOI":"10.3390\/curroncol33050289","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T13:04:09Z","timestamp":1778763849000},"page":"289","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Real-World Effectiveness of Capecitabine and Temozolomide Across Endocrine and Neuroendocrine Neoplasm Subtypes (ENENs): A Population-Based Cohort Study from Alberta, Canada (2011\u20132021)"],"prefix":"10.3390","volume":"33","author":[{"given":"Alda","family":"Aleksi","sequence":"first","affiliation":[{"name":"Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada"},{"name":"Department of Medical Oncology, Arthur J.E. Child Comprehensive Cancer Centre, Calgary, AB T2N 5G2, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaiden D.","family":"Jobin","sequence":"additional","affiliation":[{"name":"Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malek B.","family":"Hannouf","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Arthur J.E. Child Comprehensive Cancer Centre, Calgary, AB T2N 5G2, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrik","family":"Husi","sequence":"additional","affiliation":[{"name":"Department of Cellular, Molecular and Microbial Biology, University of Calgary, Calgary, AB T2N 4N1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6288-9625","authenticated-orcid":false,"given":"Heather","family":"Halperin","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chris","family":"White-Gloria","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, University of Calgary, Calgary, AB T2N 4N1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tasnima","family":"Abedin","sequence":"additional","affiliation":[{"name":"Department of Statistics, University of Calgary, Calgary, AB T2N 4N1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dean","family":"Ruether","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Arthur J.E. Child Comprehensive Cancer Centre, Calgary, AB T2N 5G2, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1770","DOI":"10.1038\/s41379-018-0110-y","article-title":"A common classification framework for neuroendocrine neoplasms: An International Agency for Research on Cancer (IARC) and World Health Organization (WHO) expert consensus proposal","volume":"31","author":"Rindi","year":"2018","journal-title":"Mod. Pathol."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Sultana, Q., Kar, J., Verma, A., Sanghvi, S., Kaka, N., Patel, N., Sethi, Y., Chopra, H., Kamal, M.A., and Greig, N.H. (2023). A Comprehensive Review on Neuroendocrine Neoplasms: Presentation, Pathophysiology and Management. J. Clin. 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