Somatostatin analogue octreotide and inhibition of tumour growth in metastatic endocrine gastroenteropancreatic tumours.

Arnold, R.; Trautmann, Michael E.; Creutzfeldt, W.; Benning, R; Benning, Mayah; Neuhaus, Christian; Jürgensen, Ralph; Stein, Ken; Schäfer, Heiner; Berthou, Christian; Dennler, H J

doi:10.1136/gut.38.3.430

Cited by 319 publications

(191 citation statements)

References 35 publications

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“…In order to make reliable comparative studies it is important to have a relevant tumour staging system, and possibly also information on the biological behaviour of the tumour disease. I T1-T2 N0 M0 n = 5 Stage II T3 N0 M0 n = 0 Stage III T1-T3 N1 Some investigators have proposed to divide patients into stable or progressive disease after an initial observation period prior to initiation of medical therapy (Arnold et al, 1996). In the present series, with a large proportion of patients with NEC tumours, tumour stage IV was a very strong predictor of poor survival.…”

Section: mentioning

confidence: 59%

Comparison of survival between malignant neuroendocrine tumours of midgut and pancreatic origin

et al. 1999

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Neuroendocrine tumours of the gastrointestinal tract are rare diseases and with the presence of metastases, patients may suffer from disabling symptoms of hormone overproduction. Potentially curative surgery can be performed in patients with localized disease, and sometimes in patients with liver metastases. However, long-term follow-up of the latter patients mostly shows late tumour recurrences (Norton, 1994). Debulking (cytoreductive) surgery can be considered when most of the tumour burden can be excised safely to minimize hormonal symptoms and to facilitate medical therapy (McEntee et al, 1990;Carty et al, 1992;Que et al, 1995). An important question is whether the aggressive treatment of metastatic disease prolongs survival. No randomized studies are available today. Such studies are complicated by the lack of strict surgical treatment protocols running over long periods, the relatively low number of patients and the absence of a TNM (tumour, node, metastases) classification of these tumour types. Many clinical studies, in which debulking surgery and resection rates are discussed, are composed of patients with carcinoids and those with endocrine pancreatic tumours (EPT). However, these two disease entities may include tumours with markedly different biology.In our consecutive series of patients with advanced midgut carcinoids (all with locoregional and hepatic metastases) the estimated overall 5-year survival was 69% after active interventional treatment. The 5-year survival of carcinoid patients with bilobar liver metastases was 63% (cf. Wängberg et al, 1996). These figures are superior to the ones obtained after more conservative treatment. In a consecutive series of 42 patients with metastatic EPT from National Institutes of Health, the 5-year survival of those 17 patients resected for cure was 79% versus 28% in the non-resected group (Carty et al, 1992). Similar results were recently reported from the Mayo Clinic in 74 patients with hepatic metastases from either EPT or carcinoid tumours. The 4-year survival was 85% for one-third of the patients selected for resection versus 65% for the two-thirds non-resected (Que et al, 1995). In a recent French series of 34 patients with neuroendocrine tumours (carcinoids and EPT) and hepatic metastases, the liver resection rate was as high as 50%. Twelve of these 17 patients were operated upon with curative intent (Dousset et al, 1996).The aim of this retrospective study was to compare survival in our consecutive series of patients with malignant EPT with that of patients with advanced midgut carcinoids when subjected to similar treatment principles. Furthermore, EPT were staged according to the TNM classification of pancreatic carcinoma. By doing so, stage IV tumours should be compared with advanced carcinoid tumours with liver metastases.  Patients and treatmentThe 64 consecutive patients with advanced midgut carcinoids were treated during 1987-1997 (cf. Wängberg et al, 1996. All patients underwent primary surgery, removal of the primary tumo...

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Section: mentioning

confidence: 59%

Comparison of survival between malignant neuroendocrine tumours of midgut and pancreatic origin

et al. 1999

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“…Interestingly, stable disease without aggressive therapy was observed in 56% of GEP tumors over a 6 month time frame. Previous studies report the occurrence of spontaneous disease stabilization ranging from 13% of 31 and 26% of 65 evaluable patients (Arnold et al 1996, Madeira et al 1998, Clancy et al 2006. Since tumor slope assessment is not yet standardized in the field of endocrine tumors, a comparison with previous studies is difficult.…”

Section: Discussionmentioning

confidence: 89%

Prognostic factors influencing survival from metastatic (stage IV) gastroenteropancreatic well-differentiated endocrine carcinoma

Durante¹,

Boukheris²,

Dromain³

et al. 2009

Endocrine-Related Cancer

106

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Survival of metastatic gastroenteropancreatic well-differentiated endocrine carcinoma (GEP WDEC) is not well characterized. We evaluated the long-term outcome and prognostic factors for survival in 118 patients with distant metastases from GEP WDEC. Inclusion criteria were 1) pathological review by a single pathologist according to the present WHO criteria, 2) absence of previous therapy apart from surgery, 3) complete morphological evaluation within 3 months including somatostatin receptor scintigraphy, and 4) follow-up at Gustave-Roussy Institute until death or study's end. Clinical, biological marker, and pathological parameters were analyzed in univariate and multivariate statistical models. Survival after the first complete imaging work-up of the metastatic disease was determined using Kaplan-Meier method. Overall, survival for 5 years after the diagnosis of metastatic disease was 54%. In multivariate analysis, age (hazard ratio (HR): 1.05, 95% confidence interval (CI): 1.01-1.08, PZ0.01), the number of liver metastases (HR: 3.4, 95% CI: 1.4-8.3, PZ0.01), tumor slope (HR: 1.1, 95% CI: 1.0-1.1, PZ0.001), and initial surgery (HR: 0.3, 95% CI: 0.1-0.8, PZ0.01) were predictive of survival. Five-year survival was 100%, 91% (95% CI, 51-98%), 62% (95% CI, 37-83%), and 9% (95% CI, 6-32%) when patients had 0, 1, 2, 3 or more poor prognostic features respectively. This study enables the stratification of metastatic GEP WDEC patients into distinct risk groups. These risk categories can be used to tailor therapeutic approaches and also to design and interpret clinical trials.

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“…Evaluation of those 671 articles identified 12 primary clinical trials for inclusion in this review [22][23][24][25][26][27][28][29][30][31][32][33]. Another three articles for inclusion were selected based on the citations of these studies and/or recent reviews [34 -36].…”

Section: Octreotidementioning

confidence: 99%

Antitumor Effects of Somatostatin Analogs in Neuroendocrine Tumors

2012

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Background. For decades, somatostatin analogs (including octreotide and lanreotide) have been indicated for relief of the symptoms of flushing, diarrhea, and wheezing associated with secretory neuroendocrine tumors (NETs). Recently, it has been suggested that somatostatin analogs may provide direct and indirect antitumor effects in secretory and nonsecretory NETs in addition to symptom control in secretory NETs.Methods. A systematic review of MEDLINE was conducted to identify studies that investigated the antitumor effects of octreotide or lanreotide for patients with NETs. Additional studies not published in the peer-reviewed literature were identified by searching online abstracts.Results. In all, 17 octreotide trials and 11 lanreotide trials that included antitumor effects were identified. Partial response rates were between 0% and 31%, and stable disease

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Somatostatin analogue octreotide and inhibition of tumour growth in metastatic endocrine gastroenteropancreatic tumours.

Abstract: Antiproliferative treatment of patients with metastatic endocrine gastroenteropancreatic tumours (GEP) is based mainly on chemotherapeutic protocols whereby drug toxicity is a major handicap. Octreotide is the first choice in the control of hormone mediated symptoms.

Cited by 319 publications

References 35 publications

Comparison of survival between malignant neuroendocrine tumours of midgut and pancreatic origin

Comparison of survival between malignant neuroendocrine tumours of midgut and pancreatic origin

Prognostic factors influencing survival from metastatic (stage IV) gastroenteropancreatic well-differentiated endocrine carcinoma

Antitumor Effects of Somatostatin Analogs in Neuroendocrine Tumors

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