Nonconventional Doses of Somatostatin Analogs in Patients With Progressing Well-Differentiated Neuroendocrine Tumor

Faggiano, Antongiulio; Brighi, Nicole; Tafuto, Salvatore; Ibrahim, Toni; Brizzi, Maria Pia; Pusceddu, Sara; Albertelli, Manuela; Massironi, Sara; Panzuto, Francesco; Badalamenti, Giuseppe; Riccardi, Ferdinando; Butturini, Giovanni; Gelsomino, Fabio; Divitiis, Chiara De; Modica, Roberta; Bongiovanni, Alberto; Salvia, Anna La; Torchio, Martina; Colao, Annamaria; Ferone, Diego; Campana, Davide

doi:10.1210/clinem/dgz035

Cited by 36 publications

(30 citation statements)

References 23 publications

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“…Treatment with non-conventional doses was safe and well tolerated. Side effects were: G1-2 worsening of serum glucose level control (19 events), G1 diarrhea (16 events), G1 fatigue (3 events), and G3 cholelithiasis (two events) [116].…”

Section: Antiproliferative Effects In Gep-netsmentioning

confidence: 99%

Somatostatin Analogs in Clinical Practice: A Review

Gomes-Porras

Cárdenas-Salas

Álvarez-Escolá

2020

IJMS

158

136

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Somatostatin analogs are an invaluable therapeutic option in the diagnosis and treatment of somatotropinomas, thyrotropinomas, and functioning and non-functioning gastroenteropancreatic neuroendocrine tumors. They should also be considered an effective and safe therapeutic alternative to corticotropinomas, gonadotropinomas, and prolactinomas resistant to dopamine agonists. Somatostatin analogs have also shown to be useful in the treatment of other endocrine diseases (congenital hyperinsulinism, Graves' orbitopathy, diabetic retinopathy, diabetic macular edema), non-endocrine tumors (breast, colon, prostate, lung, and hepatocellular), and digestive diseases (chronic refractory diarrhea, hepatorenal polycystosis, gastrointestinal hemorrhage, dumping syndrome, and intestinal fistula).

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Section: Antiproliferative Effects In Gep-netsmentioning

confidence: 99%

Somatostatin Analogs in Clinical Practice: A Review

Gomes-Porras

Cárdenas-Salas

Álvarez-Escolá

2020

IJMS

158

136

View full text Add to dashboard Cite

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“…According to current guidelines, treatment with either octreotide or lanreotide is recommended as the initial first-line treatment in patients with CS (Table 5) [1]. If treatment with the standard dose is not effective, high-dose SSA therapy can be administered [57][58][59]. Tryptophan Hydroxylase Inhibitors: Telotristat, an oral inhibitor of tryptophan hydroxylase, has been investigated in TELESTAR and TELECAST phase III studies (Table 5) [72].…”

Section: Diarrhea Associated With Carcinoid Syndrome or Other Hormonamentioning

confidence: 99%

Section: Management Options and Treatment Strategiesmentioning

confidence: 99%

Differential Diagnosis and Management of Diarrhea in Patients with Neuroendocrine Tumors

Pusceddu

Rossi

Torchio

et al. 2020

JCM

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Diarrhea is a recurrent symptom in patients with neuroendocrine tumors (NETs) and can represent different etiologies; thus, differential diagnosis is challenging. This paper distinguishes the different causes of chronic diarrhea in patients with gastroenteropancreatic NETs, with the aim to identify the most appropriate therapeutic approach. Underlying causes of diarrhea can be multifactorial, including not only diarrhea that is related to specific hormonal hypersecretory syndromes, but also diarrhea that is secondary to the following: extensive surgery which can cause pancreatic exocrine insufficiency or short bowel syndrome, treatment with somatostatin analogs or other antineoplastic agents, and bile acid malabsorption. After initial management of diarrhea with general treatments (dietary modification, use of antidiarrheals), a proper differential diagnosis is necessary to treat patients with specific etiology-driven therapeutic approaches, such as somatostatin analogs, pancreatic enzyme replacement therapy, and tryptophan hydroxylase inhibitors. In conclusion, NETs should be considered in the differential diagnosis of patients suffering from chronic diarrhea, after the exclusion of more common etiologies. Furthermore, physicians should keep in mind that several different etiologies might be responsible for diarrhea occurrence in NET patients. A prompt diagnosis of the actual cause of diarrhea is necessary to guide the treatment and a multidisciplinary approach is mandatory.

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“…High-dose SSA therapy may be considered as a potentially safer alternative to PRRT, targeted therapy, or chemotherapy in patients with progressive well-differentiated GEP NENs ( 22 ).…”

Section: (Vi) Specific Recommendations For the Management Of Nens Durmentioning

confidence: 99%

ENDOCRINOLOGY IN THE TIME OF COVID-19: Clinical management of neuroendocrine neoplasms (NENs)

Casey

Valk

Schalin‐Jäntti

et al. 2020

European Journal of Endocrinology

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In viral pandemics, most specifically Covid-19, many patients with neuroendocrine neoplasms (NENs), including phaeochromocytomas, paragangliomas and medullary thyroid carcinoma, may develop Covid-19 in a mild or severe form, or be concerned about the influence of viral infection relative to their anti-tumoral therapy. In general, newly-presenting patients should be assessed, and patients recently receiving chemotherapy, targeted therapy or radionuclide therapy, or showing tumour growth, should be closely followed. For previously diagnosed patients, who have indolent disease, some delay in routine follow-up or treatment may not be problematic. However, patients developing acute secretory syndromes due to functional neuroendocrine neoplasms (such as of the pancreas, intestine or lung), phaeochromocytomas and paragangliomas, will require prompt treatment. Patients with life-threatening Covid-19-related symptoms should be urgently treated and long-term anti-tumoral treatments may be temporarily delayed. In patients with especially aggressive NENs, a careful judgement should be made regarding the severity of any Covid-19 illness, tumour grade, and the immunosuppressant effects of any planned chemotherapy, immunotherapy, targeted therapy or related treatment. In other cases, especially patients with completely resected NENs, or who are under surveillance for a genetic disorder, a telephone or delayed consultation may be in order, balancing the risk of a delay against that of the possible development of Covid-19.

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Nonconventional Doses of Somatostatin Analogs in Patients With Progressing Well-Differentiated Neuroendocrine Tumor

Cited by 36 publications

References 23 publications

Somatostatin Analogs in Clinical Practice: A Review

Somatostatin Analogs in Clinical Practice: A Review

Differential Diagnosis and Management of Diarrhea in Patients with Neuroendocrine Tumors

ENDOCRINOLOGY IN THE TIME OF COVID-19: Clinical management of neuroendocrine neoplasms (NENs)

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