1
|
Merola E, Pascher A, Rinke A, Bartsch DK, Zerbi A, Nappo G, Carnaghi C, Ciola M, McNamara MG, Zandee W, Bertani E, Marcucci S, Modica R, Grützmann R, Fazio N, de Herder W, Valle JW, Gress TM, Delle Fave G, de Pretis G, Perren A, Wiedenmann B, Pavel ME. ASO Visual Abstract: Radical Resection in Enteropancreatic Neuroendocrine Tumors-Recurrence-Free Survival Rate and Definition of a Risk Score for Recurrence. Ann Surg Oncol 2022; 29:5580-5581. [PMID: 35789310 DOI: 10.1245/s10434-022-12049-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 06/09/2022] [Indexed: 11/18/2022]
Affiliation(s)
- E Merola
- Division of Endocrinology, Department of Medicine 1, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany.
- Department of Gastroenterology, Santa Chiara Hospital, Largo Medaglie D'Oro 9, Azienda Provinciale per i Servizi Sanitari (APSS), 38122, Trento, Italy.
| | - A Pascher
- Department of Surgery, Charité Universitätsmedizin, Berlin, Germany
- Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsklinikum Münster, Münster, Germany
| | - A Rinke
- Department of Gastroenterology, University Hospital Gießen and Marburg, Marburg, Germany
| | - D K Bartsch
- Department of Visceral, Thoracic and Vascular Surgery, Philipps-University Marburg, Marburg, Germany
| | - A Zerbi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - G Nappo
- IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - C Carnaghi
- Oncology Unit, Bolzano Central Hospital, Bolzano, Italy
| | - M Ciola
- Department of Surgery, Bolzano Central Hospital, Bolzano, Italy
| | - M G McNamara
- Division of Cancer Sciences, University of Manchester/Department of Medical Oncology, Christie NHS Foundation Trust, Manchester, UK
| | - W Zandee
- Department of Internal Medicine, Sector of Endocrinology, Erasmus MC, Rotterdam, The Netherlands
- Division of Endocrinology, Department of Internal Medicine, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - E Bertani
- Division of Gastrointestinal Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - S Marcucci
- Department of Surgery 2, Santa Chiara Hospital, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | - R Modica
- Endocrinology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - R Grützmann
- Department of Surgery, University Medical Center Erlangen, Erlangen, Germany
| | - N Fazio
- Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumours, European Institute of Oncology IEO, IRCCS, Milan, Italy
| | - W de Herder
- Department of Internal Medicine, Sector of Endocrinology, Erasmus MC, Rotterdam, The Netherlands
| | - J W Valle
- Division of Cancer Sciences, University of Manchester/Department of Medical Oncology, Christie NHS Foundation Trust, Manchester, UK
| | - T M Gress
- Department of Gastroenterology, University Hospital Gießen and Marburg, Marburg, Germany
| | - G Delle Fave
- Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumours, European Institute of Oncology IEO, IRCCS, Milan, Italy
- Department of Gastroenterology, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - G de Pretis
- Department of Gastroenterology, Santa Chiara Hospital, Largo Medaglie D'Oro 9, Azienda Provinciale per i Servizi Sanitari (APSS), 38122, Trento, Italy
| | - A Perren
- Institute of Pathology, University of Bern, Bern, Switzerland
| | - B Wiedenmann
- Department of Hepatology and Gastroenterology, Campus Virchow-Klinikum, Charité Universitätsmedizin, Berlin, Germany
| | - M E Pavel
- Division of Endocrinology, Department of Medicine 1, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
- Department of Gastroenterology, Santa Chiara Hospital, Largo Medaglie D'Oro 9, Azienda Provinciale per i Servizi Sanitari (APSS), 38122, Trento, Italy
| |
Collapse
|
2
|
Affiliation(s)
- W de Herder
- Department of Internal Medicine, Sector of Endocrinology, Rg520, Erasmus MC, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.
| |
Collapse
|
3
|
Merola E, Pascher A, Rinke A, Bartsch DK, Zerbi A, Nappo G, Carnaghi C, Ciola M, McNamara MG, Zandee W, Bertani E, Marcucci S, Modica R, Grützmann R, Fazio N, de Herder W, Valle JW, Gress TM, Fave GD, de Pretis G, Perren A, Wiedenmann B, Pavel ME. Radical Resection in Entero-Pancreatic Neuroendocrine Tumors: Recurrence-Free Survival Rate and Definition of a Risk Score for Recurrence. Ann Surg Oncol 2022; 29:5568-5577. [PMID: 35583694 DOI: 10.1245/s10434-022-11837-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 04/11/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Surgery with radical intent is the only potentially curative option for entero-pancreatic neuroendocrine tumors (EP-NETs) but many patients develop recurrence even after many years. The subset of patients at high risk of disease recurrence has not been clearly defined to date. OBJECTIVE The aim of this retrospective study was to define, in a series of completely resected EP-NETs, the recurrence-free survival (RFS) rate and a risk score for disease recurrence. PATIENTS AND METHODS This was a multicenter retrospective analysis of sporadic pancreatic NETs (PanNETs) or small intestine NETs (SiNETs) [G1/G2] that underwent R0/R1 surgery (years 2000-2016) with at least a 24-month follow-up. Survival analysis was performed using the Kaplan-Meier method and risk factor analysis was performed using the Cox regression model. RESULTS Overall, 441 patients (224 PanNETs and 217 SiNETs) were included, with a median Ki67 of 2% in tumor tissue and 8.2% stage IV disease. Median RFS was 101 months (5-year rate 67.9%). The derived prognostic score defined by multivariable analysis included prognostic parameters, such as TNM stage, lymph node ratio, margin status, and grading. The score distinguished three risk categories with a significantly different RFS (p < 0.01). CONCLUSIONS Approximately 30% of patients with EP-NETs recurred within 5 years after radical surgery. Risk factors for recurrence were disease stage, lymph node ratio, margin status, and grading. The definition of risk categories may help in selecting patients who might benefit from adjuvant treatments and more intensive follow-up programs.
Collapse
Affiliation(s)
- E Merola
- Department of Medicine 1, Division of Endocrinology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany. .,Department of Gastroenterology, Santa Chiara Hospital, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy.
| | - A Pascher
- Department of Surgery, Charité Universitätsmedizin, Berlin, Germany.,Klinik für Allgemein, Viszeral- und Transplantationschirurgie, Universitätsklinikum Münster, Münster, Germany
| | - A Rinke
- Department of Gastroenterology, University Hospital Gießen and Marburg, Marburg, Germany
| | - D K Bartsch
- Department of Visceral, Thoracic and Vascular Surgery, Philipps-University Marburg, Marburg, Germany
| | - A Zerbi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.,IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - G Nappo
- IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - C Carnaghi
- Oncology Unit, Bolzano Central Hospital, Bolzano, Italy
| | - M Ciola
- Department of Surgery, Bolzano Central Hospital, Bolzano, Italy
| | - M G McNamara
- Division of Cancer Sciences, University of Manchester, Manchester, UK.,Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - W Zandee
- Department of Internal Medicine, Sector of Endocrinology, Erasmus MC, Rotterdam, The Netherlands.,Department of Internal Medicine, Division of Endocrinology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - E Bertani
- Division of Gastrointestinal Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - S Marcucci
- Department of Surgery 2, Santa Chiara Hospital, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | - R Modica
- Department of Clinical Medicine and Surgery, Endocrinology Unit, University Federico II, Naples, Italy
| | - R Grützmann
- Department of Surgery, University Medical Center Erlangen, Erlangen, Germany
| | - N Fazio
- Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumours, European Institute of Oncology IEO, IRCCS, Milan, Italy
| | - W de Herder
- Department of Internal Medicine, Sector of Endocrinology, Erasmus MC, Rotterdam, The Netherlands
| | - J W Valle
- Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - T M Gress
- Department of Gastroenterology, University Hospital Gießen and Marburg, Marburg, Germany
| | - G Delle Fave
- Department of Gastroenterology, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - G de Pretis
- Department of Gastroenterology, Santa Chiara Hospital, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | - A Perren
- Institute of Pathology, University of Bern, Bern, Switzerland
| | - B Wiedenmann
- Department of Hepatology and Gastroenterology, Campus Virchow-Klinikum, Charité Universitätsmedizin, Berlin, Germany
| | - M E Pavel
- Department of Medicine 1, Division of Endocrinology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany.,Department of Hepatology and Gastroenterology, Campus Virchow-Klinikum, Charité Universitätsmedizin, Berlin, Germany
| |
Collapse
|
4
|
Burggraaf B, Pouw N, Arroyo SF, van Vark-van der Zee L, van de Geijn G, Birnie E, Huisbrink J, van der Zwan E, Mulder M, Rensen P, de Herder W, Cabezas MC. Reduced Fasting And Postprandial Triglyceride Levels By Alirocumab In Male Diabetes Patients On Intensive Insulin Treatment By Improved Chylomicron Metabolism. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
5
|
Jonkers YMH, Claessen SMH, Perren A, Schmitt AM, Hofland LJ, de Herder W, de Krijger RR, Verhofstad AAJ, Hermus AR, Kummer JA, Skogseid B, Volante M, Voogd AC, Ramaekers FCS, Speel EJM. DNA copy number status is a powerful predictor of poor survival in endocrine pancreatic tumor patients. Endocr Relat Cancer 2007; 14:769-79. [PMID: 17914106 DOI: 10.1677/erc-07-0111] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The clinical behavior of endocrine pancreatic tumors (EPTs) is difficult to predict in the absence of metastases or invasion to adjacent organs. Several markers have been indicated as potential predictors of metastatic disease, such as tumor size > or =2 cm, Ki67 proliferative index > or =2%, cytokeratin (CK) 19 status, and recently in insulinomas, chromosomal instability (CIN). The goal of this study was to evaluate the value of these markers, and in particular of the CIN, to predict tumor recurrence or progression and tumor-specific death, using a series of 47 insulinomas and 24 non-insulinoma EPTs. From these EPT cases, a genomic profile has been generated and follow-up data have been obtained. The proliferative index has been determined in 68 tumors and a CK19 expression pattern in 50 tumors. Results are statistically analyzed using Kaplan-Meier plots and the log-rank statistic. General CIN, as well as specific chromosomal alterations such as 3p and 6q loss and 12q gain, turned out to be the most powerful indicators for poor tumor-free survival (P< or =0.0004) and tumor-specific death (P< or =0.0113) in insulinomas. The CIN, chromosome 7q gain, and a proliferative index > or =2% were reliable in predicting a poor tumor-free survival in non-insulinoma EPTs (P< or =0.0181, whereas CK19 expression was the most optimal predictor of tumor-specific death in these tumors. In conclusion, DNA copy number status is the most sensitive and efficient marker of adverse clinical outcome in insulinomas and of potential interest in non-insulinoma EPTs. As a consequence, this marker should be considered as a prognosticator to improve clinical diagnosis, most practically as a simple multi-target test.
Collapse
Affiliation(s)
- Y M H Jonkers
- Department of Molecular Cell Biology (Box 17), Research Institute for Growth and Development (GROW), University of Maastricht, PO Box 616, 6200 MD Maastricht, The Netherlands.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
6
|
Kvols L, Glusman JE, Hahn EA, Wang E, Öberg K, Anthony L, O’Dorisio TM, de Herder W, Darby CH, Wiedenmann, G. B. The effects of pasireotide (SOM230) on health-related quality of life in patients with metastatic carcinoid tumors refractory or resistant to octreotide LAR. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.4558] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4558 Background: Pasireotide is a novel multi-ligand somatostatin analogue with high affinity binding for four of the five somatostatin receptor subtypes (sst1,2,3 and sst5). This Phase II clinical trial showed that pasireotide is effective in controlling the symptoms of diarrhea and flushing in 27% of patients with metastatic carcinoid tumors refractory or resistant to octreotide LAR. The impact of pasireotide therapy on health-related quality of life (HRQL) was also evaluated. Methods: Patients in this open-label, multicenter study initially received pasireotide 300 μg sc bid which was escalated to a maximum dose of 1,200 μg sc bid until clinical response was achieved. Data are reported for the Functional Assessment of Chronic Illness Therapy-Diarrhea (FACIT-D) instrument. FACIT-D comprises the Functional Assessment of Cancer Therapy-General (FACT-G) score, which measures physical, social, emotional and functional well-being, plus a symptom-specific sub-scale which measures HRQL specific to diarrhea. FACIT-D baseline assessment was obtained on day 1 immediately before dosing, and then monthly thereafter. FACIT-D sub-scale and total scores at baseline and after 1, 2, and 3 months of pasireotide treatment are described by categories of clinical response. Results: 45 patients (mean age 61 years; range 40–83) received treatment, and 44 were eligible for the efficacy and HRQL analyses. Functional well-being scores, symptom-specific scores and total FACIT-D scores of non-responders tended to be lower at baseline and during treatment than those of responders. The three sub-scale and summary FACIT-D scores exhibited relatively stable mean HRQL scores and similar patterns of variability in clinical responders and non- responders through the third month of pasireotide treatment. Conclusions: HRQL was stable during treatment with pasireotide in patients with advanced metastatic disease refractory or resistant to octreotide LAR. Additional work in HRQL study design and evaluation of HRQL endpoints in patients with carcinoid disease is indicated, and will further improve our understanding of quality of life in patients with this disease. [Table: see text]
Collapse
Affiliation(s)
- L. Kvols
- H Lee Moffitt Cancer Center & Research Institute, Tampa, FL; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Feinberg School of Medicine, Chicago, IL; University Hospital, Uppsala, Sweden; Louisiana State University Medical Center, New Orleans, LA; University of Iowa, Iowa City, IA; Erasmus Medical Center, Rotterdam, The Netherlands; Universitatsklinikum Charité-Virchow-Klinikum, Berlin, Germany; and the Pasireotide Carcinoid Study Group
| | - J. E. Glusman
- H Lee Moffitt Cancer Center & Research Institute, Tampa, FL; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Feinberg School of Medicine, Chicago, IL; University Hospital, Uppsala, Sweden; Louisiana State University Medical Center, New Orleans, LA; University of Iowa, Iowa City, IA; Erasmus Medical Center, Rotterdam, The Netherlands; Universitatsklinikum Charité-Virchow-Klinikum, Berlin, Germany; and the Pasireotide Carcinoid Study Group
| | - E. A. Hahn
- H Lee Moffitt Cancer Center & Research Institute, Tampa, FL; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Feinberg School of Medicine, Chicago, IL; University Hospital, Uppsala, Sweden; Louisiana State University Medical Center, New Orleans, LA; University of Iowa, Iowa City, IA; Erasmus Medical Center, Rotterdam, The Netherlands; Universitatsklinikum Charité-Virchow-Klinikum, Berlin, Germany; and the Pasireotide Carcinoid Study Group
| | - E. Wang
- H Lee Moffitt Cancer Center & Research Institute, Tampa, FL; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Feinberg School of Medicine, Chicago, IL; University Hospital, Uppsala, Sweden; Louisiana State University Medical Center, New Orleans, LA; University of Iowa, Iowa City, IA; Erasmus Medical Center, Rotterdam, The Netherlands; Universitatsklinikum Charité-Virchow-Klinikum, Berlin, Germany; and the Pasireotide Carcinoid Study Group
| | - K. Öberg
- H Lee Moffitt Cancer Center & Research Institute, Tampa, FL; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Feinberg School of Medicine, Chicago, IL; University Hospital, Uppsala, Sweden; Louisiana State University Medical Center, New Orleans, LA; University of Iowa, Iowa City, IA; Erasmus Medical Center, Rotterdam, The Netherlands; Universitatsklinikum Charité-Virchow-Klinikum, Berlin, Germany; and the Pasireotide Carcinoid Study Group
| | - L. Anthony
- H Lee Moffitt Cancer Center & Research Institute, Tampa, FL; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Feinberg School of Medicine, Chicago, IL; University Hospital, Uppsala, Sweden; Louisiana State University Medical Center, New Orleans, LA; University of Iowa, Iowa City, IA; Erasmus Medical Center, Rotterdam, The Netherlands; Universitatsklinikum Charité-Virchow-Klinikum, Berlin, Germany; and the Pasireotide Carcinoid Study Group
| | - T. M. O’Dorisio
- H Lee Moffitt Cancer Center & Research Institute, Tampa, FL; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Feinberg School of Medicine, Chicago, IL; University Hospital, Uppsala, Sweden; Louisiana State University Medical Center, New Orleans, LA; University of Iowa, Iowa City, IA; Erasmus Medical Center, Rotterdam, The Netherlands; Universitatsklinikum Charité-Virchow-Klinikum, Berlin, Germany; and the Pasireotide Carcinoid Study Group
| | - W. de Herder
- H Lee Moffitt Cancer Center & Research Institute, Tampa, FL; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Feinberg School of Medicine, Chicago, IL; University Hospital, Uppsala, Sweden; Louisiana State University Medical Center, New Orleans, LA; University of Iowa, Iowa City, IA; Erasmus Medical Center, Rotterdam, The Netherlands; Universitatsklinikum Charité-Virchow-Klinikum, Berlin, Germany; and the Pasireotide Carcinoid Study Group
| | - C. H. Darby
- H Lee Moffitt Cancer Center & Research Institute, Tampa, FL; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Feinberg School of Medicine, Chicago, IL; University Hospital, Uppsala, Sweden; Louisiana State University Medical Center, New Orleans, LA; University of Iowa, Iowa City, IA; Erasmus Medical Center, Rotterdam, The Netherlands; Universitatsklinikum Charité-Virchow-Klinikum, Berlin, Germany; and the Pasireotide Carcinoid Study Group
| | - B. Wiedenmann, G.
- H Lee Moffitt Cancer Center & Research Institute, Tampa, FL; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Feinberg School of Medicine, Chicago, IL; University Hospital, Uppsala, Sweden; Louisiana State University Medical Center, New Orleans, LA; University of Iowa, Iowa City, IA; Erasmus Medical Center, Rotterdam, The Netherlands; Universitatsklinikum Charité-Virchow-Klinikum, Berlin, Germany; and the Pasireotide Carcinoid Study Group
| |
Collapse
|
7
|
Kvols L, Oberg K, de Herder W, Anthony L, Glusman J, Tran LL, Wiedenmann B. Early data on the efficacy and safety of the novel multi-ligand somatostatin analog, SOM230, in patients with metastatic carcinoid tumors refractory or resistant to octreotide LAR. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.8024] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- L. Kvols
- H Lee Moffitt Cancer Ctr & Rsrch Inst, Tampa, FL; Univ Hosp, Uppsala, Sweden; Erasmus Medcl Ctr, Rotterdam, The Netherlands; Louisiana State Univ Medcl Ctr, New Orleans, LA; Novartis Pharmaceuticals Corp, East Hanover, NJ; Univklin Charité-Virchow-Klinikum, Berlin, Germany
| | - K. Oberg
- H Lee Moffitt Cancer Ctr & Rsrch Inst, Tampa, FL; Univ Hosp, Uppsala, Sweden; Erasmus Medcl Ctr, Rotterdam, The Netherlands; Louisiana State Univ Medcl Ctr, New Orleans, LA; Novartis Pharmaceuticals Corp, East Hanover, NJ; Univklin Charité-Virchow-Klinikum, Berlin, Germany
| | - W. de Herder
- H Lee Moffitt Cancer Ctr & Rsrch Inst, Tampa, FL; Univ Hosp, Uppsala, Sweden; Erasmus Medcl Ctr, Rotterdam, The Netherlands; Louisiana State Univ Medcl Ctr, New Orleans, LA; Novartis Pharmaceuticals Corp, East Hanover, NJ; Univklin Charité-Virchow-Klinikum, Berlin, Germany
| | - L. Anthony
- H Lee Moffitt Cancer Ctr & Rsrch Inst, Tampa, FL; Univ Hosp, Uppsala, Sweden; Erasmus Medcl Ctr, Rotterdam, The Netherlands; Louisiana State Univ Medcl Ctr, New Orleans, LA; Novartis Pharmaceuticals Corp, East Hanover, NJ; Univklin Charité-Virchow-Klinikum, Berlin, Germany
| | - J. Glusman
- H Lee Moffitt Cancer Ctr & Rsrch Inst, Tampa, FL; Univ Hosp, Uppsala, Sweden; Erasmus Medcl Ctr, Rotterdam, The Netherlands; Louisiana State Univ Medcl Ctr, New Orleans, LA; Novartis Pharmaceuticals Corp, East Hanover, NJ; Univklin Charité-Virchow-Klinikum, Berlin, Germany
| | - L.-L. Tran
- H Lee Moffitt Cancer Ctr & Rsrch Inst, Tampa, FL; Univ Hosp, Uppsala, Sweden; Erasmus Medcl Ctr, Rotterdam, The Netherlands; Louisiana State Univ Medcl Ctr, New Orleans, LA; Novartis Pharmaceuticals Corp, East Hanover, NJ; Univklin Charité-Virchow-Klinikum, Berlin, Germany
| | - B. Wiedenmann
- H Lee Moffitt Cancer Ctr & Rsrch Inst, Tampa, FL; Univ Hosp, Uppsala, Sweden; Erasmus Medcl Ctr, Rotterdam, The Netherlands; Louisiana State Univ Medcl Ctr, New Orleans, LA; Novartis Pharmaceuticals Corp, East Hanover, NJ; Univklin Charité-Virchow-Klinikum, Berlin, Germany
| |
Collapse
|
8
|
Hofland LJ, van der Hoek J, Feelders R, van der Lely AJ, de Herder W, Lamberts SWJ. Pre-clinical and clinical experiences with novel somatostatin ligands: advantages, disadvantages and new prospects. J Endocrinol Invest 2005; 28:36-42. [PMID: 16625843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
Since the cloning and characterization of the five human somatostatin receptor (SSTR) subtypes, our understanding of the expression and functional role of the five SSTR subtypes in human (neuro-)endocrine tumors has increased significantly. The majority of human (neuro-)endocrine tumors express multiple SSTR. GH-secreting pituitary adenomas preferentially express SSTR2 and SSTR5, prolactinomas SSTR1 and SSTR5, and corticotroph adenomas express SSTR2 (low number) and predominantly SSTR5s. In addition, gastroenteropancreatic (GEP) neuroendocrine tumors frequently express multiple SSTR as well, with SSTR2 being expressed at the highest level. Treatment with the current generation of octapeptide somatostatin-analogs, e.g. octreotide and lanreotide, normalizes circulating GH- and IGF-I levels in approximately 60-70% of acromegalic patients, thereby remaining about one-third of patients uncontrolled. In patients with GEP neuroendocrine tumors, both somatostatin-analogs effectively suppress the production of bioactive peptides and hormones by the tumor cells, resulting in an important improvement of the related clinical symptomatology. However, a considerable proportion of patients experience an escape from treatment within months to several years. Altogether, the current generation of somatostatin analogs are effective medical tools in the treatment of acromegalic patients and of patients with neuroendocrine GEP tumors, but there is certainly a need for novel somatostatin analogs. In recent years, a significant number of novel somatostatin-ligands has been developed. These ligands include SSTR selective-, bi-specific, universal, as well as chimeric dopamine (DA)-somatostatin ligands. In vitro studies using human pituitary adenoma cells demonstrate a more profound inhibition of GH, PRL and ACTH secretion by somatostatin-analogs targeting both SSTR2s and SSTR5s, compared with SSTR2-preferential somatostatin-analogs. This likely reflects the SSTR subtype expression pattern in the adenoma cells. A first proof-of-concept trial with the more universal somatostatin-ligand SOM230 in 12 acromegalic patients shows that a single dose of SOM230 is effective in suppressing circulating GH concentrations in a significant larger number of patients compared with octreotide. In animal models, SOM230 has a better effect on GH and IGF-I level with less signs of tachyphylaxis compared with octreotide. Depending on the SSTR expression pattern on neuroendocrine GEP tumors, somatostatin-analogs targeting multiple SSTRs may play a future role in the more long-term control of patients with neuroendocrine GEP tumors. The first clinical trial comparing octreotide and SOM230 is ongoing. However, every advantage has its disadvantage. Targeting multiple SSTR potentially induces more adverse effects as well. Especially, glucose homeostasis might induce new problems in the long-term use of universal ligands.
Collapse
Affiliation(s)
- L J Hofland
- Department of Internal Medicine, Section Endocrinology, Erasmus MC, Rotterdam, The Netherlands.
| | | | | | | | | | | |
Collapse
|
9
|
Oberg K, Kvols L, Caplin M, Delle Fave G, de Herder W, Rindi G, Ruszniewski P, Woltering EA, Wiedenmann B. Consensus report on the use of somatostatin analogs for the management of neuroendocrine tumors of the gastroenteropancreatic system. Ann Oncol 2004; 15:966-73. [PMID: 15151956 DOI: 10.1093/annonc/mdh216] [Citation(s) in RCA: 351] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
This consensus report gives a detailed description of the use of somatostatin analogs in the management of neuroendocrine tumors of the gastroenteropancreatic system. As background information we have outlined critical aspects of the pathology, the use of tumor markers, a definition of functional and non-functional digestive neuroendocrine tumors, different imaging modalities, surgical considerations, liver embolization and the use of cytotoxic drugs as well as interferon. Included in the report is an overview of somatostatin, somatostatin analogs and its receptor expression in different neuroendocrine tumors. It will also define the binding affinities of different somatostatin analogs to the five different subtypes of somatostatin receptor. We compare the efficacy of octreotide and lanreotide in reducing diarrhea and flushing. Side-effects are described and we provide practical information on somatostatin analog treatment.
Collapse
Affiliation(s)
- K Oberg
- Department of Endocrine Oncology, University Hospital, Uppsala, Sweden.
| | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Siccama R, Balk A, de Herder W, van Domburg R, Vantrimpont P, van Gelder T. Amiodarone therapy before heart transplantation as a predictor of thyroid dysfunction after heart transplantation. J Heart Lung Transplant 2002. [DOI: 10.1016/s1053-2498(01)00561-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
|
11
|
Affiliation(s)
- P Petrossians
- Department of Endocrinology, University Hospital, Liege, Belgium
| | | | | | | | | | | |
Collapse
|