A case report of successful treatment of metastatic gastral neuroendocrine carcinoma to a small-molecule VEGFR-2 tyrosine kinase inhibitor apatinib

Abstract

Context: Neuroendocrine Tumor (NET) is arising from cells throughout the diffuse endocrine system. They comprise a broad family of tumors. Neuroendocrine Carcinoma (NEC) is a poorly differentiated and high-grade type. Advanced NEC has a poor prognosis due to a limited efficacy for chemotherapy and radiotherapy. Case presentation: We present here a 51-year-old Chinese woman initially diagnosed with advanced gastral neuroendocrine carcinoma. She accepted everolimus as the first line treatment, but progression after 1 month. And then she received two different cytotoxic chemotherapy regimens. Unfortunately, the treatment failed. Then, she received apatinib, a novel tyrosine kinase inhibitor of vascular endothelial growth factor receptor-2 that has been used in the treatment of patients with metastatic gastric cancer who progressed with 2 or more chemotherapy regimens. This patient was partially responsive to apatinib with a dose of 500 mg daily. Tolerated drug-related side effects were observed. Conclusion: Our findings indicate that some cases of neuroendocrine carcinoma may be responsive to antiangiogenic agent apatinib. Further large-scale prospective studies are needed to optimize the treatment.