Ünal, ÇaglarAzizy, AbdulmünirKarabulut, SenemTaştekin, DidemAkyıldız, ArifYaşar, SerkanYalçın, ŞuayibÇoban, EyupEvrensel, TürkkanKalkan, ZiyaOruç, ZeynepDerin, SumeyraTurna, Zeynep HandeBayram, DoganKos, Fahriye TugbaŞendur, Mehmet Ali NihatSever, NadiyeErcelep, ÖezlemSeyyar, MustafaKefeli, UmutUygun, KazimÖzcelik, MelikeÖn, SercanŞanli, Ulus AliCanaslan, KubraUnek, İlkay TubaYucel, Kadriye BirÖzdemir, NuriyeYazici, OzanGuzel, Halil GokselSalim, Derya KivrakGoksu, Sema SezginTatli, Ali MuratOrdu, ÇetinSelvi, OguzhanŞakin, AbdullahBuyukbayram, Mehmet EminDursun, BenguÜrun, YukselArak, HaciAgdas, GozdeUgrakli, MuzafferHendem, EnginEryilmaz, Melek KarakurtBilgin, BurakTopcu, AtakanŞimsek, MelihBuyuksimsek, MahmutAkay, BusraErdal, Gülçin ŞahingözKaratas, FatihAlan, ÖzkanÇaglayan, MelekKahvecioglu, Fatma AkdagDemirci, AysePaksoy, NailÇetin, BulentGümüş, MahmutAk, NaziyeAydinalp, YaseminPaydaş, SemraGuven, Deniz CanKılıçkap, SaadettinSağlam, Sezer2024-12-042024-12-042023-09-071083-7159https://doi.org/10.1093/oncolo/oyad257https://academic.oup.com/oncolo/article/28/10/875/7263101?login=truehttps://hdl.handle.net/11452/48890Introduction: This study aims to report the efficacy and safety of capecitabine plus temozolomide (CAPTEM) across different lines of treatment in patients with metastatic neuroendocrine tumors (NETs).Methods: We conducted a multicenter retrospective study analyzing the data of 308 patients with metastatic NETs treated with CAPTEM between 2010 and 2022 in 34 different hospitals across various regions of Turkey.Results: The median follow-up time was 41.0 months (range: 1.7-212.1), and the median age was 53 years (range: 22-79). Our results across the entire patient cohort showed a median progression-free survival (PFS) of 10.6 months and a median overall survival (OS) of 60.4 months. First-line CAPTEM treatment appeared more effective, with a median PFS of 16.1 months and a median OS of 105.8 months (median PFS 16.1, 7.9, and 9.6 months in first-, second-and =third-line respectively, P = .01; with median OS values of 105.8, 47.2, and 24.1 months, respectively, P = .003) In terms of ORR, the first-line treatment again performed better, resulting in an ORR of 54.7% compared to 33.3% and 30.0% in the second and third or higher lines, respectively (P < .001). Grade 3-4 side effects occurred only in 22.5% of the patients, leading to a discontinuation rate of 9.5%. Despite the differences in outcomes based on treatment line, we did not observe a significant difference in terms of side effects between the first and subsequent lines of treatment.Conclusions and Relevance: The substantial superior outcomes in patients receiving first-line CAPTEM treatment highlight its potential as an effective treatment strategy for patients with metastatic NET.eninfo:eu-repo/semantics/openAccessMedical-managementPrognostic-factorsNeoplasmsMethyltransferaseGuidelinesDiagnosisCaptemMgmtCapecitabineCaptemNeuroendocrine neoplasiaNeuroendocrine tumorsTemozolomideOncologyArticle001063354900001875884281010.1093/oncolo/oyad257