Patients With Carcinoid Syndrome Exhibit Symptoms of Aggressive Impulse Dysregulation

Russo, Sascha; Boon, Jim C.; Kema, Ido P.; Willemse, Pax H.B.; Boer, Johan A. den; Korf, Jakob; Vries, Elisabeth G.E. de

doi:10.1097/00006842-200405000-00022

Cited by 5 publications

(6 citation statements)

References 17 publications

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“…Autoimmune phenomena were also noted such as development of autoimmune thyroiditis, systemic lupus erythematosus syndrome with antinuclear factors, and parietal cell antibodies with pernicious anemia 50,52 . Depression and weight loss are other side effects of IFN‐α that may occur during the course of treatment in up to 50% of the patients in older studies and limit its use 54 . Autoimmune related hypothyroidism may be a contributing factor to fatigue.…”

Section: Methodsmentioning

confidence: 99%

“…50,52 Depression and weight loss are other side effects of IFN-α that may occur during the course of treatment in up to 50% of the patients in older studies and limit its use. 54 Autoimmune related hypothyroidism may be a contributing factor to fatigue. In case of psychiatric disorders and severe autoimmune diseases, IFN-α is contraindicated.…”

Section: Interferon-αmentioning

confidence: 99%

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Efficacy, safety and unmet needs of evolving medical treatments for carcinoid syndrome

Koumarianou

Daskalakis

Tsoli

et al. 2022

J Neuroendocrinology

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This review reports on the currently available medical treatment options for the control of symptoms due to carcinoid syndrome in patients with neuroendocrine tumors. The efficacy and adverse events (AEs) of approved drugs such as somatostatin analogues (SSA), telotristat ethyl (TE) and interferon-alpha, are reviewed. Somatostatin analogues remain the standard treatment of carcinoid syndrome based on the high expression of somatostatin receptors and the resulting inhibition of secretion of bioactive compounds; their use is associated with relatively mild AEs, involving mainly the gastrointestinal system, and being usually transient. Although dose escalation of SSA remains an unapproved option, it is clinically implemented to alleviate symptoms in refractory carcinoid syndrome and supported by the most recent guidelines. The side effects associated with the increased dose are in general mild and consistent with standard dose of SSA. Telotristat ethyl, an oral inhibitor of tryptophan hydroxylase, the rate-limiting enzyme in serotonin biosynthesis, represents a rather novel innovative treatment option in patients with carcinoid syndrome suffering from diarrhea and complements the standard therapy of SSA. Given the low toxicity profile, TE may be considered an early add-on treatment to SSA in patients with uncontrolled carcinoid syndrome. However, further prolonged follow-up of patients treated with TE may be needed to exclude potential AEs, such as liver toxicity or depressed mood, in patients with long-term treatment. Interferon alpha is a cytokine with direct inhibitory effect on hormone secretion and tumor cell proliferation and an approved therapy in carcinoid syndrome but is associated with significant AEs in the majority of the patients requiring frequently dose reduction. The finding of a more favorable tolerability of pegylated interferon needs to be confirmed in a prospective study.

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Section: Methodsmentioning

confidence: 99%

Section: Interferon-αmentioning

confidence: 99%

Efficacy, safety and unmet needs of evolving medical treatments for carcinoid syndrome

Koumarianou

Daskalakis

Tsoli

et al. 2022

J Neuroendocrinology

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“…Several studies have already documented high rates of neuropsychiatric symptoms in patients with NETs. In particular, depression, anxiety and difficulty in impulse control have been described in 20%–50%, 35% and 75% of NET patients, respectively 23‐28 . Moreover, NET patients have been shown to score considerably worse than healthy subjects in terms of HRQoL 29…”

Section: Discussionmentioning

confidence: 99%

The psychological impact of COVID‐19 pandemic on patients with neuroendocrine tumors: Between resilience and vulnerability

Lauricella

Cives

Bracigliano

et al. 2021

J Neuroendocrinology

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The COVID-19 pandemic has added another layer of complexity to the fears of patients with neuroendocrine tumors (NETs). Little is known regarding the psychological impact of the COVID-19 outbreak on patients with gastroenteropancreatic or bronchopulmonary (BP) NETs. We longitudinally surveyed the mental symptoms and concerns of NET patients during the plateau phase of the first (W1) and second epidemic waves (W2) in Italy. Seven specific constructs (depression, anxiety, stress, health-related quality of life, NET-related quality of life, patient-physician relationship, psychological distress) were investigated using validated screening instruments,

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“…Previous studies suggest that NEN is positively associated with psychiatric disorder symptoms, such as depression, anxiety, or psychosis (9)(10)(11). In addition, it is well-known that psychiatric disease is a master contributor to suicides (12).…”

Section: Introductionmentioning

confidence: 99%

Development and Validation of a Score for Screening Suicide of Patients With Neuroendocrine Neoplasms

Shang

Zechner

et al. 2021

Front. Psychiatry

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Background: If the diagnosis of neuroendocrine neoplasm (NEN) increases the risk of patients to commit suicide has not been investigated so far. Identifying NEN patients at risk to commit suicide is important to increase their life quality and life expectancy.Methods and findings: Cancer cases were extracted from the Surveillance, Epidemiology, and End Results program and were divided into the NEN and the non-NEN cohorts. Subsequently, the NEN patients were randomly split into a training data set and a validation data set. Analyzing the training data set, we developed a score for assessing the risk to commit suicide for patients with NEN. In addition, we validated the score using the validation data set and evaluated, if this score could also be applied to other cancer entities by using the test data set, a non-NEN cohort. The odds ratio (OR) of suicide between NEN and non-NEN patients was determined. Moreover, the performance of a score was evaluated by the receiver operating characteristic curve and the area under the curve (AUC). Compared to non-NEN, NEN significantly increased the risk of suicide to 1.8-fold (NEN vs. non-NEN; OR, 1.832; P < 0.001). In addition, we observed that age, gender, race, marital status, tumor stage, histologic grade, surgery, and chemotherapy were associated with suicide among NEN patients; and a synthesized score based on these factors could significantly distinguish suicide individuals from non-suicide individuals in the training data set (AUC, 0.829; P < 0.001) and in the validation data set (AUC, 0.735; P < 0.001). This score also had a good performance when it was assessed by the test data set (AUC, 0.690; P < 0.001). This demonstrates that the score might also be applicable to other cancer entities.Conclusions: This population-based study suggests that NEN patients have a higher risk of suicide than non-NEN patients. In addition, this study provided a score, which can identify NEN patients at high-risk of committing suicide. Thus, this score in combination with current screening and prevention strategies for suicide may improve life quality and life expectancy of NEN patients.

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Patients With Carcinoid Syndrome Exhibit Symptoms of Aggressive Impulse Dysregulation

Cited by 5 publications

References 17 publications

Efficacy, safety and unmet needs of evolving medical treatments for carcinoid syndrome

Efficacy, safety and unmet needs of evolving medical treatments for carcinoid syndrome

The psychological impact of COVID‐19 pandemic on patients with neuroendocrine tumors: Between resilience and vulnerability

Development and Validation of a Score for Screening Suicide of Patients With Neuroendocrine Neoplasms

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