Serum pancreastatin levels predict response to hepatic artery chemoembolization and somatostatin analogue therapy in metastatic neuroendocrine tumors

Dc, Desai; O’Dorisio, Thomas M.; Schirmer, William J.; Jung, Stephen S.; Khabiri, Hooman; Villanueva, Violet; Martin, Edward W.

doi:10.1016/s0167-0115(00)00167-1

Cited by 34 publications

(17 citation statements)

References 24 publications

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“…25 Our group previously found that decreased pancreastatin levels after TACE treatment may correlate with response to treatment, and proposed that an increase in pancreastatin level after a previous decrease may provide an indication for repeat TACE. 13 Seventy-eight percent of patients treated with TACE experienced decreased or stable levels of pancreastatin after treatment; those whose pancreastatin levels did not decrease at least 20% after treatment all died within 8 months. 13 The fact that pancreastatin response to TACE treatment was not able to predict survival in the present group of patients may be caused by the relatively small number of patients in this study.…”

Section: Discussionmentioning

confidence: 96%

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Repeat Transarterial Chemoembolization (TACE) for Progressive Hepatic Carcinoid Metastases Provides Results Similar to First TACE

Varker

Martin

Klemanski

et al. 2007

Journal of Gastrointestinal Surgery

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Section: Discussionmentioning

confidence: 96%

“…Finally, biochemical response to therapy was determined by assessment of serum pancreastatin levels. 13 …”

Section: Assessment Of Responsementioning

confidence: 99%

Repeat Transarterial Chemoembolization (TACE) for Progressive Hepatic Carcinoid Metastases Provides Results Similar to First TACE

Varker

Martin

Klemanski

et al. 2007

Journal of Gastrointestinal Surgery

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“…[22][23][24][25] Previously, we showed that a 20% reduction in serum pancreastatin correlated with improved outcome after HACE for carcinoid. 9 Using this same cutoff, responses were seen in 80% of patients including complete response in 14%. This response correlated with other measures of response as well as being predictive of improved survival by univariate analysis.…”

Section: Discussionmentioning

confidence: 99%

“…Complete response was considered as normalization (i.e., <135 pg/ml) of serum pancreastatin in a patient who had an elevated pancreastatin before HACE. A reduction of pancreastatin by 20% or more was considered a partial response, 9 whereas an initial increase by 20% or more was considered a progression. Stable disease was defined as an increase or decrease in pancreastatin by less than 20%.…”

Section: Response Assessmentmentioning

confidence: 99%

Hepatic Artery Chemoembolization in 122 Patients with Metastatic Carcinoid Tumor: Lessons Learned

Bloomston

Al-Saif

Klemanski

et al. 2007

Journal of Gastrointestinal Surgery

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107

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“…31 However, no study to date has demonstrated the potential survival benefit of the known biochemical response with somatostatin therapy.…”

Section: Discussionmentioning

confidence: 99%

Circulating markers of prognosis and response to treatment in patients with midgut carcinoid tumours

Turner

Johnston

McCance

et al. 2006

Gut

109

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Background and aims: Midgut carcinoid tumours are uncommon tumours with an unpredictable clinical behaviour and few useful prognostic markers. Somatostatin analogues are widely used in treatment but a survival advantage has not been proven. We analysed features associated with poor prognosis and assessed the clinical implications of the biochemical response to therapy. Methods: Clinical and biochemical data were collected for patients with midgut carcinoid tumours attending a tertiary referral neuroendocrine clinic from 1978 to 2000. Using death as the end point, univariate and multivariate survival analyses were performed to identify prognostic indicators. The significance of altering biomarkers with therapy was also studied by including repeated measurements of the most prognostic biochemical parameter in a time dependent covariate survival analysis. Results: We identified 139 patients with sufficient data for our analyses. Factors associated with a poor outcome on univariate analysis included: plasma neurokinin A (NKA), urinary 5-hydroxyindolacetic acid output, age, and >5 liver metastases. Plasma NKA was the strongest and only independent predictor of outcome on multivariate analysis. Patients in whom NKA continued to rise despite somatostatin analogues had a significantly worse survival than those in whom NKA stabilised or fell (one year survival rate 40% v 87%). Time dependent covariate analysis concluded that survival was better predicted by the most recent plasma NKA value rather than by the initial value. Conclusions: Plasma NKA is an accurate marker of prognosis for midgut carcinoid tumours. This is the first paper to support a survival advantage in patients in whom plasma NKA is altered by somatostatin analogues.

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Serum pancreastatin levels predict response to hepatic artery chemoembolization and somatostatin analogue therapy in metastatic neuroendocrine tumors

Cited by 34 publications

References 24 publications

Repeat Transarterial Chemoembolization (TACE) for Progressive Hepatic Carcinoid Metastases Provides Results Similar to First TACE

Repeat Transarterial Chemoembolization (TACE) for Progressive Hepatic Carcinoid Metastases Provides Results Similar to First TACE

Hepatic Artery Chemoembolization in 122 Patients with Metastatic Carcinoid Tumor: Lessons Learned

Circulating markers of prognosis and response to treatment in patients with midgut carcinoid tumours

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