(1) Background: GEP-NETs are frequently diagnosed at advanced stage. For well-differentiated somatostatin receptor-positive (SSTR+) NETs, SSA are the preferred first-line therapy. However, in newly diagnosed patients with G2/G3 and a high tumor burden, SSA alone might not be enough; (2) Methods: We conducted a retrospective analysis to assess the effectiveness of combining oxaliplatin–fluoropyrimidine chemotherapy with SSA as an upfront strategy in newly diagnosed metastatic G2/G3 GEP-NET patients treated with oxaliplatin–fluoropyrimidine-based chemotherapy; (3) Results: Between March 2017 and October 2023, 32 pts (19 males, 13 females; M:F = 1.5:1; median age 54 years, range 31–82) were deemed eligible to receive oxaliplatin–fluoropyrimidine chemotherapy in addition to SSA; 14 received XELOX and 18 FOLFOX. After a median follow-up of 26 mo., each patient had completed at least two cycles of chemotherapy. The ORR was 25%, with a median DoR of 21.3 mo. The DCR was 87.5%. Notably, 28.1% of patients experienced tumor shrinkage sufficient for radical surgery on residual tumor lesions, encompassing both primary tumors and metastases; (4) Conclusions: Upfront treatment with the combination of oxaliplatin–fluoropyrimidine and SSA demonstrated effectiveness and safety. This approach may be considered to facilitate conversion surgery in eligible patients.
（1）背景：胃肠胰神经内分泌肿瘤（GEP-NETs）常在晚期确诊。对于分化良好且生长抑素受体阳性（SSTR+）的NETs，生长抑素类似物（SSA）是首选的一线治疗。然而，对于新诊断的G2/G3级且肿瘤负荷较高的患者，单独使用SSA可能不足；（2）方法：我们进行了一项回顾性分析，旨在评估在新诊断的转移性G2/G3级GEP-NET患者中，采用奥沙利铂-氟嘧啶化疗联合SSA作为前期治疗策略的有效性；（3）结果：2017年3月至2023年10月期间，32例患者（男性19例，女性13例；男女比例1.5:1；中位年龄54岁，范围31-82岁）被认为适合在SSA基础上接受奥沙利铂-氟嘧啶化疗；其中14例接受XELOX方案，18例接受FOLFOX方案。中位随访26个月后，所有患者均完成了至少两个周期的化疗。客观缓解率（ORR）为25%，中位缓解持续时间（DoR）为21.3个月。疾病控制率（DCR）为87.5%。值得注意的是，28.1%的患者肿瘤缩小程度足以对残留病灶（包括原发灶和转移灶）进行根治性手术；（4）结论：奥沙利铂-氟嘧啶联合SSA的前期治疗显示出有效性和安全性。对于符合条件的患者，可考虑采用该策略以促进转化手术的实施。
肿瘤(癌症)患者之家