Review of recents advances in medical treatment for neuroendocrine neoplasms: somatostatin analogs and chemotherapy

Abstract

Neuroendocrine neoplasms (NENs) are a heterogeneous group of rare tumours often producing high levels of hormones and causing symptoms. There are a number of different types of NENs. They usually arise as advanced and low/intermediate grade only in a minority of cases, as high grade. Treatment depends on which type and may include surgery, interventional radiology, and systemic treatment, including chemotherapy, somatostatin analogs, interferon α2b, peptide receptor radionuclide therapy, and only for pancreatic neuroendocrine tumors, molecular targeted agents, including everolimus and sunitinib. The aim of the article is to review the medical approaches with somatostatin analogs and chemotherapy. The treatment of NENs is mainly based on their biological characteristics of aggressiveness and functional features, such as symptoms and endocrine markers.

Large Cell Metastatic Pancreatic Neuroendocrine Carcinoma Treated with Somatostatin Analogues - Case Report and Literature Review

“…Patients with poorly differentiated NEC with ki67 >55% had a response rate of 42%-67% to the treatment with cisplatin/etoposide while those with ki67< 55% had a response rate of 15%. The regimen consisted of VP-16 130 mg/m 2 per day for three days and CDDP 45 mg/m 2 per day for two days, on days two and three respectively, every 3 weeks (29) or CDDP 100 mg/ m 2 per day + VP-16 100 mg/m 2 per day for three days, every three weeks (30) or VP-16 100 mg/m 2 per day for three days + CDDP 45 mg/m 2 per day for two days, every four weeks (31) or CDDP was administered at 80 mg/m 2 day 1 and VP-16 at 100 mg/ m 2 per day for three days, every three weeks (32,33). Second-line chemotherapy after platinum-containing regimens has not been well defined.…”

“…Second-line chemotherapy after platinum-containing regimens has not been well defined. FOLFIRI regimen (5fluorouracil + leucovorin+ irinotecan) or temozolomide in combination with capecitabine +/bevacizumab showed a response rate of 33%, with a median PFS of six months and a median OS of 22 months (33,34).…”

Peptide Conjugates with Small Molecules Designed to Enhance Efficacy and Safety

“…Somatostatin exhibits many direct and indirect effects to suppress growth and differentiation in several different cancer cells. Somatostatin analogs such as Octreotide, Lanreotide, and Pasireotide are clinically used in the treatment of acromegaly, as well as hormone-dependent tumors such as pancreatic, and vasoactive intestinal peptide-secreting tumors [72,73]. Somatostatin analogs have also been clinically studied in breast, lung, prostate and gastrointestinal cancers [73].…”

Pre-clinical toxicological study of analogue of hypothalamic hormone tsifetrilin

“…В настоящее время в клинической практике применяется зарубежный препарат, структурный аналог соматостатина -сандостатин (октреотид). Показаниями для применения сандостатина служат опухоли островкового аппарата поджелудочной железы, рак поджелудочной железы, карциноидные опухоли, медуллярный рак щитовидной железы, аденомы гипофиза [2,3].…”