Interferon-α versus Somatostatin or the Combination of Both in Metastatic Neuroendocrine Gut and Pancreatic Tumours

Faiss, Siegbert; Scherübl, Hans; Riecken, E. O.; Wiedenmann, Bertram

doi:10.1159/000201404

Cited by 15 publications

(10 citation statements)

References 7 publications

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“…However, the results of three randomized clinical trials involving interferon- α and octreotide have mixed results. Two demonstrated increased 5-year survival rate [70] and median survival time [83] in the combination group versus the octreotide-only group, 57% versus 37% and 51 months versus 35 months, respectively; but another trial showed minimal response rates [84]. …”

Section: Nonsurgical Non-liver-directed Therapiesmentioning

confidence: 99%

Treatment of Liver Metastases in Patients with Neuroendocrine Tumors: A Comprehensive Review

Harring

Nguyen

Goss

et al. 2011

International Journal of Hepatology

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Patients diagnosed with Neuroendocrine Tumors (NET) often are also diagnosed with Neuroendocrine Liver Metastases (NLM) during the course of their disease. NLM can cause significant morbidity and mortality, oftentimes much more than compared to patients with NET. Treatment options have been limited in the past, focusing on surgical resections, for which only a minority of patients are candidates. However, developments of new treatment modalities have progressed rapidly and patients with NLM now have significantly more options, including surgical-directed therapies; liver-directed therapies; and nonsurgical, non-liver-directed therapies. This review provides information about the roles of hepatic resection, orthotopic liver resection, radiofrequency ablation, hepatic artery embolization and hepatic artery chemoembolization, hepatic artery radioembolization and selective internal radiation therapy, peptide receptor radionuclide therapy, systemic chemotherapy, biotherapies including somatostatin analogs and interferon-α, vascular endothelial growth factor and mTOR targets, and microRNA-regulated pathways. Given these new options, the clinician can tailor therapy specific to the patient diagnosed with NLM, thereby giving the patient the best possible chance of prolonged survival.

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Section: Nonsurgical Non-liver-directed Therapiesmentioning

confidence: 99%

Treatment of Liver Metastases in Patients with Neuroendocrine Tumors: A Comprehensive Review

Harring

Nguyen

Goss

et al. 2011

International Journal of Hepatology

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“…The compound dramatically ameliorates the debilitating results have been largely confirmed by others [28][29][30]; the usual doses range from 3 to 9 million units of -interferon symptoms from the clinical manifestations of endocrine tumors such as diarrhea and flushing. The success of given as subcutaneous injections 3-7 times a week.…”

Section: Treatment Strategies For Gep Endocrine Tumorsmentioning

confidence: 74%

The Role of Octreotide in the Treatment of Gastroenteropancreatic Endocrine Tumors

Degen

Beglinger²

1999

Digestion

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Gastrointestinal-endocrine pancreatic (GEP) tumors are rare, occurring in less than 1% of the population. They are usually divided into functionally active or nonfunctioning tumors. Functionally active tumors produce a variety of substances (mainly peptides or serotonin). The tumors are classified according to the dominant clinical syndrome that they cause. Surgery is the treatment of choice in patients with GEP tumors and it should always be considered, even if total tumor excision cannot be achieved. Reduction in tumor mass (debulking) may improve the patients symptoms. Medical treatment is used in patients with advanced malignant endocrine tumors. The most important compounds to control symptoms in these patients are somatostatin analogues. Natural somatostatin is produced in different molecular forms and has inhibitory effects on a number of functions. The observation of potent inhibitory effects on various hormone-secreting cells led to the use of somatostatin for symptomatic treatment of peptide-secreting tumors. Natural somatostatin is not suitable for long-term clinical application; therefore, synthetic somatostatin analogues were developed with improved pharmacokinetic characteristics. The best characterized analogue, octreotide, has been successfully applied to patients with functioning GEP tumors. Octreotide can dramatically ameliorate the debilitating symptoms of patients suffering from the clinical manifestations of endocrine tumors such as diarrhea and flushing. The success of octreotide therapy is best reflected in terms of its impact on the patient''s quality of life as defined by the activity to perform normal daily activities.

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“…In one such study in which 68 patients were treated with subcutaneous octreotide alone or in combination with 3 million units of IFNa five times per week, the 5-year overall survival was increased in the combination arm (57 vs 37%) but was not found to be significant (PZ0.13; Kolby et al 2003). Objective response rates in two further RCTs were w7 and 6% respectively (Faiss et al 1996, Arnold et al 2005. All the three RCTs performed to date were underpowered and no statistically significant overall survival data can be determined.…”

Section: Immunological Modulatorsmentioning

confidence: 99%

Hitting the target: where do molecularly targeted therapies fit in the treatment scheduling of neuroendocrine tumours?

Karpathakis¹,

Caplin²,

Thirlwell³

2012

Endocrine-Related Cancer

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Neuroendocrine tumours (NETs) are a rare and heterogeneous group of tumours whose incidence is increasing and their prevalence is now greater than that of any other upper gastrointestinal tumour. Diagnosis can be challenging, and up to 25% of patients present with metastatic disease. Following the recent FDA approval of two new molecularly targeted therapies for the treatment of advanced pancreatic NETs (pNETs), the first in 25 years, we review all systemic therapies and suggest where these newer targeted therapies fit in the treatment schedule for these challenging tumours. Clinical trial data relating to the routine use of sunitinib and everolimus in low–intermediate-grade pNETs are summarised alongside newer molecularly targeted agents undergoing clinical assessment in NETs. We particularly focus on the challenge of optimal scheduling of molecularly targeted treatments around existing systemic and localised treatment such as chemotherapy or radiotargeted therapy. We also discuss application of current evidence to subgroups of patients who have not so far been directly addressed such as those with poorer performance status or patients receiving radical surgery who may benefit from adjuvant treatment.

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Interferon-α versus Somatostatin or the Combination of Both in Metastatic Neuroendocrine Gut and Pancreatic Tumours

Abstract: Neuroendocrine tumours of the gastroenteropancreatic system represent a therapeutic challenge. Current therapeutic strategies will be presented and discussed with especial consideration given to biotherapeutic regimens in metastatic tumour disease.

Cited by 15 publications

References 7 publications

Treatment of Liver Metastases in Patients with Neuroendocrine Tumors: A Comprehensive Review

Treatment of Liver Metastases in Patients with Neuroendocrine Tumors: A Comprehensive Review

The Role of Octreotide in the Treatment of Gastroenteropancreatic Endocrine Tumors

Hitting the target: where do molecularly targeted therapies fit in the treatment scheduling of neuroendocrine tumours?

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