Hepatic artery embolization in advanced neuroendocrine tumors: Efficacy and long‐term outcomes

Pericleous, Marinos; Caplin, Martyn; Tsochatzis, Emmanuel; Yu, Dominic; Morgan-Rowe, Luke; Toumpanakis, Christos

doi:10.1111/ajco.12438

Cited by 46 publications

(55 citation statements)

References 40 publications

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“…targeted agents are used for cases with a moderate tumor burden and/or slow-growing tumors, and cytotoxic chemotherapeutic agents are used for cases with a high tumor burden and/or aggressive tumors. Numerous studies have reported the efficacy and safety of TA(C)E in patients with NETs presenting with liver metastasis [11][12][13][14][15][16][17][18][19] , however, there have been no randomized controlled trials to confirm the survival benefit of TA(C)E, and the positioning of TA(C)E in the treatment of NETs has not yet been clarified in guidelines [20][21][22] . In the current study, the response rate was 56% and the disease control rate was 96%.…”

Section: Discussionmentioning

confidence: 99%

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Transarterial (Chemo)Embolization for Liver Metastases in Patients with Neuroendocrine Tumors

Okuyama

Ikeda²,

Takahashi³

et al. 2017

Oncology

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Objective: The aim of this study was to evaluate the safety and efficacy of transarterial (chemo)embolization [TA(C)E] for the control of liver metastasis in patients with neuroendocrine tumors (NETs). Methods: In this retrospective study, we enrolled 43 patients with metastatic NETs who had been treated with TA(C)E between December 1999 and June 2013 at the National Cancer Center Hospital, Tokyo or the National Cancer Center Hospital East, Kashiwa. We assessed tumor response, time to treatment failure (TTF), overall survival (OS), and frequency of adverse events in these patients, and attempted to identify predictors of TTF. Results: The site of the primary tumor was the pancreas in 29 patients (67%), the gastrointestinal tract in 11 patients (26%), and unknown in 3 patients (7%). Response rate, disease control rate, median TTF, and median OS were 56%, 96%, 24.7 months, and 86.1 months, respectively. No significant predictors of TTF could be identified. While 3 patients developed serious adverse events (including liver abscess in 2 patients and acute renal failure in 1 patient), the adverse events were well tolerated in all other patients. Conclusion: TA(C)E appears to be effective and feasible for controlling the liver metastases in patients with NETs.

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Section: Discussionmentioning

confidence: 99%

“…Reported median time to progression (TTP)/PFS and median OS from previous studies are 4-36 and 9-80 months, respectively [11][12][13][14][15][16][17][18][19] ( Table 6 ). TTF in this study was comparable to previous reports, while OS was more favorable compared to previous reports.…”

Section: Discussionmentioning

confidence: 99%

Transarterial (Chemo)Embolization for Liver Metastases in Patients with Neuroendocrine Tumors

Okuyama

Ikeda²,

Takahashi³

et al. 2017

Oncology

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“…This approach has been particularly considered in patients with hepatic symptoms or refractory malignant F-NET syndromes[17, 20, 21, •22, 68, 71]. In general TACE/TAE result in a symptomatic response in 50–100% of patients and numerous series as well as case reports have documented their control of symptoms in patients with both carcinoid syndrome and F-pNET syndromes[17, 20, 21, •22, 68, 71, 72, •73, 74, 75, •76, 77, •78]. …”

Section: Summary Of Recent Advances/controversies In Management Ofmentioning

confidence: 99%

“…Both studies and case reports have reported the successful use in patients with carcinoid syndrome of the control of the symptoms of the hormone-excess state by using: everolimus[•38]; PRRT[•56, 57, 66, 95, •96, •148]; liver-directed therapies including TACE/TAE[70, 72, •73, 77, 95, 98, 149]; radioembolization[70, 150, 151]; RFA[80, 81, 83, 95, 152]; by increasing the dosage of octreotide/Lanreotide in refractory cases[94, 97, 153–155]; use of cytoreductive surgery[23, 95, 156–160]; use of 131 I-MIBG[95, 105, 106, 108, 110, •161, 162–164]; with the use of the tryptophan hydroxylase inhibitor, Telotristat[108, 113, 114, ••116, •117, 118, 119] and with pasireotide in octreotide resistant cases[•122]. …”

Section: Summary Of Recent Advances In Management Of Specific Hormmentioning

confidence: 99%

Treatment of symptomatic neuroendocrine tumor syndromes: recent advances and controversies

Ito¹,

Lee²,

Jensen³

2016

Expert Opinion on Pharmacotherapy

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Introduction Neuroendocrine tumors(NETs), once thought rare, are increasing in frequency in most countries and receiving increasing-attention. NETs present two-treatment problems. A proportion is functional, hormone-excess-state(F-NET), each of which must be treated. Recently, there are many advances, well-covered in reviews/consensus papers on imaging-NETs;new, novel anti-tumor treatments and understanding their pathogenesis. However, little attention has been paid to advances in the treatment of the hormone-excess-state. These advances are usually reported in case-series, and case-reports with few large studies. In this paper these advances are reviewed. Areas covered Advances in the last 5-years are concentrated on, but a review up to 10-years was performed. PubMed and other databases(Cochrane, etc) were searched for F-NET-syndromes including carcinoid-syndrome, as well as meeting-abstracts on NETs. All advances that controlled hormone-excess-states or facilitated-control were covered. These include new medical-therapies[serotonin-synthesis inhibitors(telotristat), Pasireotide, new agents for treating ACTHomas], increased dosing with conventional therapies(octreotide-LAR, Lanreotide-Autogel), mTor inhibitors(everolimus), Tyrosine-kinase inhibitors(sunitinib), cytoreductive surgery, liver-directed therapies(embolization, chemoembolization, radioembolization, RFA), peptide radio-receptor-therapy(PRRT) and 131I-MIBG, ablation of primary F-NETs. Expert Opinion Although many of the newer therapies controlling the hormone-excess-states in F-NETs are reported in relatively few patients, all the approaches show promise. Their description also generates some controversies/unresolved areas, such as the order of these new treatments, their longterm-efficacy, and effectiveness of combinations which may require large, controlled studies.

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“…Установлено, что эффективность их применения зависит от степени злокачественности НЭО, количества и размера метастатических очагов, объема опухолевого поражения печени [25]. Большинство исследователей [26] сходятся во мнении об отсутствии достоверных различий применения ХЭПА и ЭПА, что ставит под сомнение необходимость рутиного использования цитостатических препаратов у больных c НЭО с низким потенциалом злокачественности. По-прежнему отсутствует единое мнение исследователей о сроках начала, кратности и оптимальной методике эндоваскулярных вмешательств.…”

Section: оригинальные статьиunclassified

Possibilities of treating patients with generalized neuroendocrine tumors

Лысанюк¹,

Майстренко²,

Romashchenko³

et al. 2018

Onkol. Z. im. P.A. Gercena

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Цель исследования-уточнить рациональную тактику лечения больных с генерализованными нейроэндокринными опухолями (НЭО) желудочно-кишечного тракта и поджелудочной железы, позволяющую увеличить продолжительность и качество жизни пациентов. Материал и методы. Изучены результаты обследования и лечения 63 больных с генерализованными НЭО желудочно-кишечного тракта и поджелудочной железы. Комплексное лечение проведено 32 (50,8%) больным, лекарственная терапия в качестве единственного метода лечения-31 (49,2%) пациенту. Результаты. Установлено, что комплексное лечение по сравнению с лекарственной терапией обеспечило увеличение выживаемости больных с НЭО G1-G2 в 2 раза (с 29,9 до 60 мес) и нейроэндокринной карциномой (НЭК) G3 в 2,9 раза (с 10,1 до 28,5 мес). Определены неблагоприятные прогностические факторы течения заболевания, которыми являются: 1) локализация первичной опухоли в поджелудочной железе; 2) метастатическое поражение печени III типа; 3) наличие НЭК G3; 4) проведение лекарственной терапии в качестве единственного вида лечения (р<0,05). Заключение. Лечение больных с генерализованными НЭО необходимо проводить в специализированных медицинских центрах, имеющих возможность реализации мультидисциплинарного подхода, позволяющего достоверно увеличить продолжительность и качество жизни пациентов. Ключевые слова: нейроэндокринная опухоль, нейроэндокринная карцинома, комплексное лечение.

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Hepatic artery embolization in advanced neuroendocrine tumors: Efficacy and long‐term outcomes

Cited by 46 publications

References 40 publications

Transarterial (Chemo)Embolization for Liver Metastases in Patients with Neuroendocrine Tumors

Transarterial (Chemo)Embolization for Liver Metastases in Patients with Neuroendocrine Tumors

Treatment of symptomatic neuroendocrine tumor syndromes: recent advances and controversies

Possibilities of treating patients with generalized neuroendocrine tumors

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