Sahu A, et al. - In this retrospective study, researchers evaluated functional imaging response, progression-free and overall survival, and tolerability of capecitabine-temozolomide (CAPTEM) in patients (pts) with metastatic well-differentiated intermediate (WHO grade 2) or high grade (WHO grade 3) neuroendocrine tumors (NETs) treated at Peter MacCallum Cancer Centre between March 2013 and March 2017. From days1 to 14, they administered capecitabine 750 mg/m² orally twice daily (bd) to patients, and temozolomide 100 mg/m² bd was given from days 10 to 14 every 28 days. A median of 6 cycles (range: 2-16) of CAPTEM was received by 32 pts for grade 2 (n=21, 66%) or grade 3 (n=11, 34%), Ki67 <55% (n= 7, 21.9%) or Ki67 ≥55% (n= 4, 12.5 %) NET. First-line treatment with CAPTEM was received by 22%. The two-year overall survival (OS) and median OS of 42% and 24 months, respectively, was noted after a median of 31 months of follow-up. Findings revealed a significant activity of CAPTEM in patients with metastatic grades 2 and 3 NETs. A manageable toxicity profile was displayed by CAPTEM, with nausea (15.6%), thrombocytopaenia (12.5%), and fatigue (9.4%) reported as the most common toxicities. Grade 3 subgroup with Ki67<55% demonstrated progression-free survival benefit.