Safety review: Dose optimization of somatostatin analogs in patients with acromegaly and neuroendocrine tumors

Ludlam, W.H.; Anthony, Lowell

doi:10.1007/s12325-011-0062-9

Cited by 38 publications

(15 citation statements)

References 56 publications

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“…These results support the role of SSAs, both as preoperative and adjuvant therapy. The development of gallstones, the potentially most important side effect that may occur in approximately 10% of the cases, 31,32 was observed in two patients. Nevertheless, SSA therapy was generally well tolerated, 23,24 a finding that has also been observed in acromegalic patients with long-term SSA therapy.…”

Section: Discussionmentioning

confidence: 98%

A long‐term follow‐up study of eighteen patients with thyrotrophin‐secreting pituitary adenomas

Varsseveld

Bisschop

Biermasz

et al. 2013

Clinical Endocrinology

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Our results demonstrate that patients with TSH-omas, who often present with large macroadenomas with extrasellar extension, have an excellent response to SSA therapy. Because the results of surgery and radiotherapy are disappointing, primary medical therapy may be considered in virtually all patients, except in case of optic chiasm compression, especially in those harbouring large adenomas with parasellar extension.

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Section: Discussionmentioning

confidence: 98%

A long‐term follow‐up study of eighteen patients with thyrotrophin‐secreting pituitary adenomas

Varsseveld

Bisschop

Biermasz

et al. 2013

Clinical Endocrinology

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“…15 Escalation of the SSA doses has been shown to improve biochemical control in patients resistant to conventional doses 9,10,13 while demonstrating a similar tolerability profile. 16 We analyzed retrospectively, in an unselected population of Romanian patients with acromegaly assessed in a single center, the efficacy of SSA treatment and the effect of progressive increase of SSA doses in patients not surgically treated as compared to patients treated with SSA after pituitary surgery.…”

Section: Introductionmentioning

confidence: 99%

Beneficial effect of dose escalation and surgical debulking in patients with acromegaly treated with somatostatin analogs in a Romanian tertiary care center

Gheorghiu

Găloiu

Vintila

et al. 2016

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BACKgROUND: somatostatin analogs (ssA) are now considered standard therapy for acromegaly, as primary or adjunctive treatment after pituitary surgery. OBJeCTIve: To evaluate the efficacy of ssA and the effect of dose escalation in non-operated patients with acromegaly as compared to patients treated after pituitary surgery in a Romanian tertiary care center. DesIgN: Retrospective study of 73 consecutively evaluated patients with acromegaly treated with ssA, divided into 2 groups: 11 patients (4M/7f, 21-62 years) with primary treatment and 62 patients (22M/40f, 21-68 years) treated after surgery. They received Octreotide LAR 20-30 mg i.m./28 days or Lanreotide sR 30 mg i.m./14/10/7 days. Random serum growth hormone (GH) was measured using IRMA, sensitivity 0.2-0.01 μg/L IGF-1 was measured using different assays and compared with ULN for age and sex. RESULTS: Overall, random GH ≤2.5 μg/L was attained in 39 patients (53.4%) and optimal GH ≤1 ng/mL) in 30 patients (41%), while normal IGF-1 was recorded in 22/72 patients (30.5%). The final random GH ≤2.5 μg/L was achieved in 27.2% of non-operated patients (3/11) as compared with 58% (36/62) of patients treated medically after pituitary surgery, p<0.05. escalation of doses of ssA applied in 43 patients improved the number of controlled patients by 5 (12.1%, p=0.059) and the number of optimally controlled patients by 9.7%. Of the 8 patients who switched from Lanreotide to Octreotide, 2 patients achieved gh normalization. CONCLUsION: The rate of biochemical control via ssA treatment in patients with acromegaly could be improved by rise of the ssA dose or by debulking surgery. Occasionally, substituting one ssA for another may be of benefit.

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“…The side effect profile is similar to octreotide. Octreotide LAR with 20–90 mg/month and lanreotide slow release with 60–120 mg/month dosage studies, including acromegalic patients and neuroendocrine tumors, provided palliation of symptoms, and significant toxicity related to increasing dose was not observed 13. In studies comparing the efficacy of these two forms in patients with acromegaly, controversial results have been obtained 14–16.…”

Section: Pharmacology Of Long-acting Somatostatin Analogsmentioning

confidence: 99%

A review of the use of somatostatin analogs in oncology

Keskin¹,

Yalçın²

2013

OTT

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Somatostatin is a neuropeptide produced by paracrine cells that are located throughout the gastrointestinal tract, lung, and pancreas, and is also found in various locations of the nervous system. It exerts neural control over many physiological functions including inhibition of gastrointestinal endocrine secretion through its receptors. Potent and biologically stable analogs of somatostatin have been developed. These somatostatin analogs show different efficacy on different receptors, and receptors are varyingly concentrated in specific tissues. Antitumor and antisecretory effects of somatostatin analogs in cancer have been shown in several in vivo and in vitro studies. However, these activities have not always yielded into clinically relevant patient outcome benefit. Somatostatin analogs are of clinical benefit in treating symptoms of ectopic hormone secretion (adrenocorticotropic hormone, growth hormone-releasing hormone) in lung cancer, without inducing a significant tumor response. They have also been shown to induce a statistically significant decrease in bone pain and increase in Karnofsky performance status in patients with metastatic prostate cancer. Somatostatin analogs alone or in combination with other agents have only limited antitumoral effect in breast cancer. In gastrointestinal cancers, studies have not shown an objective tumor response to somatostatin analogs except in endocrine tumors of the liver with symptomatic and biochemical improvement. In neuroendocrine tumors of the gastrointestinal system and pancreas, very high symptomatic and biochemical response rates have been achieved with somatostatin analogs. Antiproliferative activity has been clearly shown in metastatic midgut neuroendocrine tumors.

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Safety review: Dose optimization of somatostatin analogs in patients with acromegaly and neuroendocrine tumors

Cited by 38 publications

References 56 publications

A long‐term follow‐up study of eighteen patients with thyrotrophin‐secreting pituitary adenomas

A long‐term follow‐up study of eighteen patients with thyrotrophin‐secreting pituitary adenomas

Beneficial effect of dose escalation and surgical debulking in patients with acromegaly treated with somatostatin analogs in a Romanian tertiary care center

A review of the use of somatostatin analogs in oncology

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