Inhibition of Metabolic Activity in Papillary Thyroid Carcinoma by a Somatostatin Analogue

Abstract

Two patients with widely metastatic papillary thyroid cancer demonstrated progressive growth of diffuse pulmonary lesions. One patient had no apparent response to high doses of 131I and the other hand no 131I uptake. 111In-pentetreotide scans revealed that many of the metastatic lesions expressed somatostatin receptors. The baseline metabolic activity and three-dimensional volume of the lesions were determined by 18F-fluoro-de-oxyglucose positron emission tomography (FDG-PET). After 3 or 4 months of octreotide (Sandostatin LAR Depot; Novartis Pharmaceutical, East Hanover, NJ) therapy, repeat FDG-PET scans revealed reductions in tumor volume and decreases in the standard uptake values of FDG. We conclude that octreotide therapy can change the biological activity of metastatic thyroid cancer lesions that exhibit somatostatin receptors.

Is There a Role for Sandostatin Treatment in Patients with Progressive Thyroid Cancer and Iodine-Negative But Somatostatin-Receptor–Positive Metastases?

“…have proven its usefulness in this scenario for local tumor control and stabilization of the disease provided that lesions are positive in the SSTR scintigraphy. Some of the data show that this approach might be a treatment option with adequate dosimetric approaches for optimal calculation of the individual doses (4,(14)(15)(16).…”

“…Zatelli and Uberti (16) demonstrated that their results indicate that sstr-2 agonists inhibit cell proliferation in the human medullary thyroid cracinoma cell lines. As mentioned above, there have been reports that SST receptors are also expressed in nonmedullary thyroid cancer (2,4,(8)(9)(10)(11)14,(17)(18)(19)(20)(21)(22). SST and its analogues have provided contradictory results in the diagnosis and treatment of thyroid cancer.…”

“…SST and its analogues have provided contradictory results in the diagnosis and treatment of thyroid cancer. Robbins et al (14) concluded that the activation of SST receptors might reduce proliferation, metabolic activity, and possibly induce redifferentiation. They explored two patients (one case unresponsive to 131 I, the other not demonstrating 131 I uptake) using 3-to 4-month course of octreotide.…”

“…Robbins et al (14) hypothesized that SST receptors may be expressed in poorly differentiated papillary cancers and that their activation may reduce proliferation, metabolic activity, and possibly induce redifferentiation.…”

Somatostatin receptor expression in thyroid disease

“…This has been shown in a wide range of neuroendocrine tumours including thyroid Hurtle cell, papillary and medullary cell carcinomas and is licensed for the treatment of acromegaly and gastroentero‐pancreatic neuroendocrine tumours (Robbins et al . ; Ahlman et al . ; Reubi ).…”