10.6084/m9.figshare.8869499.v1 deMestier L. deMestier L. Walter T. Walter T. Evrard C. Evrard C. deBoissieu P. deBoissieu P. Hentic O. Hentic O. Cros J. Cros J. Tougeron D. Tougeron D. Lombard-Bohas C. Lombard-Bohas C. Rebours V. Rebours V. Hammel P. Hammel P. Ruszniewski P. Ruszniewski P. Supplementary Material for: Temozolomide Alone or Combined with Capecitabine for the Treatment of Advanced Pancreatic Neuroendocrine Tumor Karger Publishers 2019 Neuroendocrine tumor Metastases Chemotherapy Temozolomide Capecitabine Pancreas 2019-07-15 08:12:52 Dataset https://karger.figshare.com/articles/dataset/Supplementary_Material_for_Temozolomide_Alone_or_Combined_with_Capecitabine_for_the_Treatment_of_Advanced_Pancreatic_Neuroendocrine_Tumor/8869499 <b><i>Background:</i></b> The combination of capecitabine (CAP) with temozolomide (TEM) chemotherapy in advanced pancreatic neuroendocrine tumors (PanNET) relies on limited evidence. We compared TEM-CAP to TEM alone in patients with advanced PanNET. <b><i>Methods:</i></b> Consecutive patients with advanced PanNET treated with TEM or TEM-CAP between 2004 and 2017 in three expert centers were included. Progression-free survival (PFS), tolerance, tumor response, and overall survival were compared between the two groups. Propensity-based analyses were performed to reduce confounding bias due to the nonrandomized setting. <b><i>Results:</i></b> TEM and TEM-CAP were administered to 38 patients and 100 patients, respectively, with a median age of 58 years. The patients in the TEM group more often had hormonal syndromes (<i>p</i> = 0.03), a longer median delay to diagnosis (<i>p</i> = 0.001), and a higher number of pretreatment lines (<i>p</i> < 0.001). The performance status was 0 in 58% versus 65% of the patients, and tumor’s median Ki-67 index was 8% versus 11%, respectively. Tolerance was similar, except that there were more cases of asthenia in the TEM group (<i>p</i> = 0.017) and more cases of hand-foot syndrome in the TEM-CAP group (<i>p</i> = 0.025). The objective response rate was 34% versus 51% (<i>p</i> = 0.088). The raw median PFS was similar with TEM and with TEM-CAP (21.4 vs. 19.8 months, <i>p</i> = 0.84). Although CAP tended to decrease the risk of progression in Cox multivariate analysis (HR 0.65, <i>p</i> = 0.12), it had no effect after adjustment for the propensity score (HR 1.06, <i>p</i> = 0.80). <b><i>Conclusions:</i></b> TEM-CAP might not prolong PFS but might achieve a higher response rate than TEM alone. Hence, TEM-CAP might be preferred when tumor shrinkage is the main therapeutic objective. Otherwise, TEM might be adequate for patients with an impaired performance status or in case of extrahepatic metastases.