{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T10:12:57Z","timestamp":1791972777831,"version":"4.3.4"},"reference-count":32,"publisher":"Harborside Press, LLC","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,1]]},"abstract":"Background:<\/jats:bold> The capecitabine\/temozolomide (CAPTEM) regimen has significant activity in advanced neuroendocrine tumors (NETs). Questions exist regarding activity in pancreatic versus nonpancreatic NETs, risk of opportunistic infections, long-term myelotoxicity, and safety of prolonged treatment duration. Analysis of large patient cohorts is needed for the evaluation of rare toxicities and assessment of risk factors. Methods:<\/jats:bold> We conducted a retrospective study of all patients with advanced NETs seen at Moffitt Cancer Center between January 2008 and June 2019 who received treatment with CAPTEM. Results:<\/jats:bold> A total of 462 patients were eligible. The objective radiographic response rate was 46%, and the disease control rate was 81%. Median progression-free survival (PFS) was 18 months (95% CI, 14.0\u201321.9 months) and median overall survival was 51 months (95% CI, 42.8\u201359.2 months): 62 months in well-differentiated NETs versus 14 months in poorly differentiated neuroendocrine carcinomas (P<\/jats:italic><.0001). Patients with primary pancreatic tumors had the highest partial response rates and longest median PFS. Incidences of grade 4 thrombocytopenia and neutropenia were 7% and 3%, respectively, and substantially higher in women than men (P<\/jats:italic>=.02 and P<\/jats:italic>=.004, respectively). Only 1 case (0.2%) of suspected Pneumocystis<\/jats:italic> pneumonia (PCP) was observed in a patient receiving corticosteroids. Three patients developed myelodysplastic disease, all of whom had received prior peptide receptor radiotherapy (PRRT). There were no acute treatment-related deaths; 1 patient died 2 months after a thrombocytopenic bleed. Conclusions:<\/jats:bold> The CAPTEM regimen is exceptionally safe. Efficacy is particularly robust in well-differentiated pancreatic NETs. Severe myelotoxicity is rare; the risk of grade 4 cytopenias is significantly increased in women, and therefore sex-based dosing should be considered. There were no cases of myelodysplastic syndromes, except among patients who had received PRRT, a known risk factor. The risk of PCP is negligible.<\/jats:p>","DOI":"10.6004\/jnccn.2021.7017","type":"journal-article","created":{"date-parts":[[2021,10,13]],"date-time":"2021-10-13T19:55:30Z","timestamp":1634154930000},"page":"29-36","source":"Crossref","is-referenced-by-count":41,"title":["Efficacy and Toxicity Analysis of Capecitabine and Temozolomide in Neuroendocrine Neoplasms"],"prefix":"10.6004","volume":"20","author":[{"given":"Taymeyah","family":"Al-Toubah","sequence":"first","affiliation":[{"name":"1Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleonora","family":"Pelle","sequence":"additional","affiliation":[{"name":"1Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiffany","family":"Valone","sequence":"additional","affiliation":[{"name":"1Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mintallah","family":"Haider","sequence":"additional","affiliation":[{"name":"1Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan R.","family":"Strosberg","sequence":"additional","affiliation":[{"name":"1Department of Gastrointestinal Oncology, H. 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