Surgical management and palliative treatment in bronchial neuroendocrine tumours: A clinical study of 45 patients

Srirajaskanthan, Raj; Toumpanakis, Christos; Karpathakis, Anna; Marelli, Laura; Quigley, Ann‐Marie; Dusmet, Michael; Meyer, Tim; Caplin, Martyn

doi:10.1016/j.lungcan.2008.10.025

Cited by 39 publications

(25 citation statements)

References 31 publications

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“…31 Surgical therapy is the treatment of choice when it is applicable. 32 Adjuvant pre-and postoperative chemotherapy was associated with better outcome in patients with stage I LCNEC. 33 Moreover, Rossi et al demonstrated that adjuvant platinum-etoposide based chemotherapy can be very effective and significantly improves survival in stage I, II and III LCNEC patients.…”

Section: Discussionmentioning

confidence: 98%

Ectopic calcitonin secretion in a woman with large cell neuroendocrine lung carcinoma

Cvijović¹,

Micić²,

Kendereški³

et al. 2013

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ObJEctIVE: serum calcitonin (ct) is a sensitive but not specific marker for medullary thyroid carcinoma (Mtc). there are a large number of conditions that may elevate ct levels. cAsE rEPOrt: Herein we present the case of a 47-year old woman with Hashimoto thyroiditis, goiter, cervical lymphadenopathy and high ct and cEA levels. After surgical extirpation of the lymph node neuroendocrine cancer metastasis was suspected. computed tomography of the chest showed a tumor mass on the right lung. bronchoscopy was performed and pathological and immunohistochemical analysis revealed large cell neuroendocrine lung cancer (LcNEc). After chemotherapy, significant reduction of tumor mass was achieved with a moderate decrease in ct levels in parallel. cONcLUsIONs: We present a female with LcNEc, a condition which is usually observed in older men (7 th decade) and is not associated with ct secretion. Hashimoto thyroiditis is associated with increased incidence of different types of cancers (e.g. thyroid, colon). No reports at present exist on the incidence of lung cancers in patients with thyroid disease.

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Section: Discussionmentioning

confidence: 98%

Ectopic calcitonin secretion in a woman with large cell neuroendocrine lung carcinoma

Cvijović¹,

Micić²,

Kendereški³

et al. 2013

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“…Typical carcinoids arise 3-4 times more frequently than atypical carcinoids, which tend to occur in older patients, are more commonly larger, and more often arise peripherally. They metastasize in 30%250% of cases and have a 5-y survival rate of 40%260% (13). Patients with pulmonary neuroendocrine tumor often present with recurrent pneumonia, cough, hemoptysis, or chest pain.…”

Section: Discussionmentioning

confidence: 99%

A Comparison of ⁶⁸Ga-DOTATATE and ¹⁸F-FDG PET/CT in Pulmonary Neuroendocrine Tumors

Kayani¹,

Conry²,

Groves³

et al. 2009

J Nucl Med

232

124

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Our purpose was to compare the performance of 68 4,7,N9,N$,N%-tetraacetic acid-D-Phe 1 , Tyr 3 -octreotate (DOTATATE), a novel selective somatostatin receptor 2 PET ligand, and 18 F-FDG in the detection of pulmonary neuroendocrine tumors using PET/CT, with correlation of uptake and tumor grade on histology. Methods: The imaging findings of the first 18 consecutive patients (8 men and 10 women) with pulmonary neuroendocrine tumors (11 typical carcinoids, 2 atypical carcinoids, 1 large cell neuroendocrine tumor, 1 small cell neuroendocrine carcinoma, 1 non-small cell lung cancer with neuroendocrine differentiation, and 2 cases of diffuse idiopathic pulmonary neuroendocrine cell hyperplasia) who underwent 68 Ga-DOTATATE and 18 F-FDG PET/CT were reviewed. In all cases, the diagnosis was established on histology. Results: Of 18 patients, 15 had primary tumors (median size, 2.7 cm; range, 0.5-8 cm) and 3 had recurrent tumors. All typical carcinoids showed high uptake of 68 Ga-DOTATATE (maximum standardized uptake value [SUV max ] $ 8.2), but 4 of 11 showed negative or minimal 18 F-FDG uptake (SUV max 5 1.7-2.9). All tumors of higher grade showed high uptake of 18 F-FDG (SUV max $ 11.7), but 3 of 5 showed only minimal accumulation of 68 Ga-DOTATATE (SUV max 5 2.2-2.8). Neither case of diffuse idiopathic pulmonary neuroendocrine cell hyperplasia showed uptake of 68 Ga-DOTATATE or 18 F-FDG. Typical carcinoids showed significantly higher uptake of 68 Ga-DOTATATE and significantly less uptake of 18 F-FDG than did tumors of higher grade (P 5 0.002 and 0.005). There was no instance of falsepositive uptake of 68 Ga-DOTATATE, but there were 3 sites of 18 F-FDG uptake secondary to inflammation. 68 Ga-DOTATATE was superior to 18 F-FDG in discriminating endobronchial tumor from distal collapsed lung (P 5 0.02). Conclusion: Typical bronchial carcinoids showed higher and more selective uptake of 68 Ga-DOTATATE than of 18 F-FDG. Atypical carcinoids and higher grades had less 68 Ga-DOTATATE avidity but were 18 F-FDG-avid.

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“…Our data indeed show that treatment with SOM230 has an inhibitory effect on BC cell viability and secretory activity. Currently employed SRIF analogs, such as octreotide an lanreotide, having affinity mostly for SSTR2 and SSTR5, are know as effective treatment to prolong the time to tumor M C Zatelli et al: Everolimus in bronchial carcinoids www.endocrinology-journals.org progression in patients with functionally active and inactive metastatic midgut neuroendocrine tumors (Rinke et al 2009) and to reduce hormonal secretion also by bronchial endocrine tumors (Rubin et al 1999), whereas antitumor effects of SRIF analogues in lung endocrine tumors are still a matter of discussion (Filosso et al 2002, Srirajaskanthan et al 2009). Therefore, the finding that the new SRIF analog SOM230 (pasireotide) might be effective in controlling BC tumor bulk opens new therapeutic perspectives for patients not responding to other medical treatments.…”

Section: Discussionmentioning

confidence: 99%

Everolimus as a new potential antiproliferative agent in aggressive human bronchial carcinoids

Zatelli¹,

Minoia²,

Martini³

et al. 2010

Endocrine-Related Cancer

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Bronchial carcinoids (BCs) are rare tumors originating from endocrine cells dispersed in the respiratory epithelium. It has been previously demonstrated that everolimus, or RAD001, an mTOR inhibitor, has potent antiproliferative effects in human endocrine tumors. Our aim was to evaluate the possible antiproliferative effects of everolimus in human BCs in primary culture. We collected 24 BCs that were dispersed in primary cultures, treated without or with 1 nM-1 mM everolimus, 10 nM SOM230 (pasireotide, a somatostatin receptor multiligand), and/or 50 nM IGF1. Cell viability was evaluated after 48 h, and chromogranin A (CgA) as well as vascular endothelial growth factor (VEGF) secretion was assessed after 8 h incubation. Somatostatin receptors, mTOR, and AKT expression were investigated by quantitative PCR. We found that in 15 cultures (67.5%), everolimus significantly reduced cell viability (by w30%; P!0.05 versus control), inhibited p70S6K activity (K30%), and blocked IGF1 proliferative effects. Everolimus also significantly reduced CgA (by w20%) and VEGF (by w15%) secretion. Cotreatment with SOM230 did not exert additive effects on cell viability and secretory activity. AKT expression was similar in responder and nonresponder tissues, while mTOR expression was significantly higher in the responder group, which was characterized by higher CgA plasma levels and bigger tumors with higher mitotic index and angiogenesis. Our data demonstrate that everolimus reduces VEGF secretion and cell viability in BCs with a mechanism likely involving IGF1 signaling, suggesting that it might represent a possible medical treatment for BCs.

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Surgical management and palliative treatment in bronchial neuroendocrine tumours: A clinical study of 45 patients

Cited by 39 publications

References 31 publications

Ectopic calcitonin secretion in a woman with large cell neuroendocrine lung carcinoma

Ectopic calcitonin secretion in a woman with large cell neuroendocrine lung carcinoma

A Comparison of ⁶⁸Ga-DOTATATE and ¹⁸F-FDG PET/CT in Pulmonary Neuroendocrine Tumors

Everolimus as a new potential antiproliferative agent in aggressive human bronchial carcinoids

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Surgical management and palliative treatment in bronchial neuroendocrine tumours: A clinical study of 45 patients

Cited by 39 publications

References 31 publications

Ectopic calcitonin secretion in a woman with large cell neuroendocrine lung carcinoma

Ectopic calcitonin secretion in a woman with large cell neuroendocrine lung carcinoma

A Comparison of 68Ga-DOTATATE and 18F-FDG PET/CT in Pulmonary Neuroendocrine Tumors

Everolimus as a new potential antiproliferative agent in aggressive human bronchial carcinoids

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A Comparison of ⁶⁸Ga-DOTATATE and ¹⁸F-FDG PET/CT in Pulmonary Neuroendocrine Tumors