High-Dose Intravenous Octreotide Is Safe and May Be Superior to Surgery in Managing Severe Postesophagectomy Chylothorax in High-Risk Patients

Bello, Sean O.Z.; Rahamim, J

doi:10.1016/j.athoracsur.2014.08.058

Cited by 18 publications

(22 citation statements)

References 5 publications

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“…In patients with GI NETs who were treated with octreotide LAR at doses >30 mg/month, no severe toxic effects were reported, possibly indicating a favorable safety profile involving a scarcity of severe side effects 130. A patient who had received an esophagectomy developed chylothorax that was satisfactorily managed with high-dose octreotide (0.25 mg three times a day for 2 weeks), this noninvasive choice was proven safe 29…”

Section: Considerations For Expanding the Use Of Octreotide And For Rmentioning

confidence: 99%

“…SSTR binding by octreotide activates the mitogen-activated protein kinase (MAPK) cascade and affects serum levels of GH and IGF1 in patients 26. Octreotide has also been therapeutically used for the management of HIV-associated diarrhea,27 severe diabetic diarrhea,28 chylothorax,29 and congenital hyperinsulinemia (a rare disorder affecting 1/50,000 newborn babies) 30,31…”

Section: Overview Of Current Clinical Use Of Octreotide and Chloroquimentioning

confidence: 99%

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Toward fully exploiting the therapeutic potential of marketed pharmaceuticals: the use of octreotide and chloroquine in oncology

Papanagnou

Georgios

Stivarou

et al. 2018

OTT

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Pleiotropy in biological systems and their targeting allows many pharmaceuticals to be used for multiple therapeutic purposes. Fully exploiting the therapeutic properties of drugs that are already marketed would be highly advantageous. This is especially the case in the field of oncology, where the ineffectiveness of typical anticancer agents is a common issue, while the development of novel anticancer agents is a costly and particularly time-consuming process. Octreotide and chloroquine are two pharmaceuticals that exhibit profound antitumorigenic activities. However, the current therapeutic use of octreotide is restricted primarily to the management of acromegaly and neuroendocrine tumors, both of which are rare medical conditions. Similarly, chloroquine is used mainly for the treatment of malaria, which is designated as a rare disease in Western countries. This limited exploitation contradicts the experimental findings of numerous studies outlining the possible expansion of the use of octreotide to include the treatment of common human malignancies and the repositioning of chloroquine in oncology. Herein, we review the current knowledge on the antitumor function of these two agents stemming from preclinical or clinical experimentation. In addition, we present in silico evidence on octreotide potentially binding to multiple Wnt-pathway components. This will hopefully aid in the design of new efficacious anticancer therapeutic regimens with minimal toxicity, which represents an enormous unmet demand in oncology.

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Section: Considerations For Expanding the Use Of Octreotide And For Rmentioning

confidence: 99%

Section: Overview Of Current Clinical Use Of Octreotide and Chloroquimentioning

confidence: 99%

Toward fully exploiting the therapeutic potential of marketed pharmaceuticals: the use of octreotide and chloroquine in oncology

Papanagnou

Georgios

Stivarou

et al. 2018

OTT

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“…Durch die zusätzliche Gabe von Somatostationanaloga kann hiermit eine Ausheilung in bis zu 80 % der Fälle erreicht werden, je nach Art der Leckage und initialer Drainagenfördermenge [24, 35 -37]. Bei therapierefraktären Verläufen kann auch die Eskalation der Somatostatinanalogatherapie mit intravenöser Hochdosisgabe effektiv sein [38]. Die Indikation zur chirurgischen Intervention besteht bei persistierendem Erguss.…”

Section: Zeitpunkt Der Chirurgischen Interventionunclassified

Prävention und operative Therapie des Chylothorax

2018

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“…A diéta mellett ismert a nyirokáramlás további csök-kentése szomatosztatin-vagy analóg octreotidszerekkel [38][39][40][41][42]. Azonban sem a chylothoraxot, mint javallatot, sem a gyógyszer dózisát, módszerét és időtartamát nem határozták még meg, illetve nem standardizálták prospektív vizsgálatokban.…”

Section: áBraunclassified

A chylothorax modern kezelésének bizonyítékalapú áttekintése

2016

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A chylothorax napjainkban rendszerint műtéti vagy baleseti szövődmény, ritkábban daganat következménye. Prospektív vagy randomizált vizsgálatok hiányában a bizonyítékalapú kezelés személyes tapasztalaton, ideálisan a retrospektív elemzések ismeretében történik. A szerzők célja a chylothorax modern kezelésének áttekintése. A PubMed adatbázist "chylothorax" kulcsszóra szűrték az elmúlt tíz év közleményei között, kiemelve az összehasonlító értéke-léseket. A módszerek és ajánlások kritikai elemzésekor a szerzők együttes 39 éves klinikai tapasztalatukra támaszkod-tak. A konzervatív kezelés sikere az etiológiától függően nagy szórást mutat (3-90%). A non-és szemi-invazív intervenciós eljárások sikerrátája 50-100% közötti. Eredménytelen konzervatív kezeléskor a sebészi kezelés, elsősorban a ductus thoracicus lekötése jelenti a standard terápiát. Ezen beavatkozások sikerességi aránya 64-100% közötti, a morbiditási/mortalitási mutató elérheti a 25%-ot. A kezelést konzervatívan kell megkezdeni, majd egy lépcsőzetes agresszivitású terápia ajánlott, amelyben a beteg állapota és a drénvolumen irányítják a döntéshozatalt. Az intervenciós radiológiai eljárások biztonságosak, sikeresek és helyet kaptak a konzervatív és műtéti megoldások mellett. Orv. Hetil., 2016, 157(2), 43-51. Kulcsszavak: chylothorax, szövődmény, mellkassebészet Review of evidence-based modern treatment for chylothoraxChylothorax is a multi-factorial complication, frequently of an operation or an accident, but rarely of a tumour. In the absence of prospective or randomised studies evidence-based treatment is normally based on personal experience, ideally in the possession of retrospective analyses using the "best practice" method. The aim of the authors was the review the up-to-date chylothorax treatments. They performed the PubMed database's "chylothorax" keyword search of the publications reported in the last ten years. They put emphasis on articles that included a comparative analysis of the various treatment options. During the critical analysis of the methods and recommendations, the authors relied on their own joint experience amounting to 39 years. The results showed that the success of the initial conservative treatment indicates a signifi cant deviation depending on the etiology (3-90%). The success rate of noninvasive or semi-invasive interventions is between 50-100%, again depending on the etiology. The standard surgical treatment following an unsuccessful conservative treatment of an operable patient includes the fi tting of a (thoracoscopic) knot to the ductus thoracicus, pleurodesis, insertion of a permanent chest drain or a pleuroperitoneal shunt. The success rate of these interventions is between 64-100%, with a morbidity index and mortality index exceeding 25%. Conservative treatment should be the fi rst step, which should then be followed by a gradually increased aggressive therapy, during which the decisions should be made according to the patient's condition and the drain volume. Interventional radiology procedures are safe, successful an...

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High-Dose Intravenous Octreotide Is Safe and May Be Superior to Surgery in Managing Severe Postesophagectomy Chylothorax in High-Risk Patients

Cited by 18 publications

References 5 publications

Toward fully exploiting the therapeutic potential of marketed pharmaceuticals: the use of octreotide and chloroquine in oncology

Toward fully exploiting the therapeutic potential of marketed pharmaceuticals: the use of octreotide and chloroquine in oncology

Prävention und operative Therapie des Chylothorax

A chylothorax modern kezelésének bizonyítékalapú áttekintése

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