The antitumoral effect of the long-acting somatostatin analog lanreotide in neuroendocrine tumors

Ducreux, Michel; Ruszniewski, Philippe; Chayvialle, Jean‐Alain; Blumberg, Joëlle; Cloarec, D; Michel, H; Raymond, J M; Dupas, Jean‐Louis; Gouérou, H; Jian, Raymond; Genestin, Elisabeth; Hammel, Pascal; Rougier, Philippe

doi:10.1111/j.1572-0241.2000.03210.x

Cited by 173 publications

(84 citation statements)

References 14 publications

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“…Treatment with high-dose octreotide 500 mg three times a day did not seem to offer additional benefit in tumour growth control. Those results were consistent with a contemporary phase II study that included 58 patients receiving 500-1000 mg three times a day (19), but slightly lower than those from Saltz et al, which investigated the activity of immediate-release octreotide in 34 patients with gastroenteropancreatic (GEP)-NETs (20). No objective response was identified, but 50% (17/34) of patients showed SD for at least 8 weeks and 71% of patients with symptomatic disease had symptom relief and hormone level reduction with a median survival of 22 months.…”

Section: Somatostatin Analoguessupporting

confidence: 75%

GEP–NETs UPDATE: Biotherapy for neuroendocrine tumours

Alonso‐Gordoa

Capdevila

Grande

2015

European Journal of Endocrinology

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Neuroendocrine tumours (NETs) represent a less frequent and heterogeneous group of tumours, which has experienced, in recent years, a significant increase in effective therapeutic possibilities overcoming the disappointing results from chemotherapy. Initial improvements in treatment strategies came from somatostatin analogues (SSAs) that have widely demonstrated a significant improvement in symptomatic relief and tumour control growth by a complex mechanism of action over cell survival, angiogenesis and immunomodulation. Recent investigations have pointed out novel SSAs with a wider binding profile (pasireotide), chimeric molecules against somatostatin receptors and dopamine receptors and the combination with targeted agents, such as mTOR inhibitors or antiangiogenic agents. Immunotherapy is the second cornerstone in NET treatment and has been represented with interferon alpha for a long time, with a demonstrated activity on tumour and clinical response. Its less manageable adverse events have limited its usage. However, different checkpoints in immune system regulation have been effectively targeted in different solid tumours, and novel approaches are currently arising in NETs. In conclusion, biotherapy remains an active treatment strategy for initial approach in patients with NETs. Further investigation on patients' selection, molecular profiles, treatment sequence or combination and optimisation of current and novel biotherapy agents is required.

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Section: Somatostatin Analoguessupporting

confidence: 75%

GEP–NETs UPDATE: Biotherapy for neuroendocrine tumours

Alonso‐Gordoa

Capdevila

Grande

2015

European Journal of Endocrinology

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“…Somatostatin receptor scintigraphy or imaging with a metabolic tracer of NETs, such as 18 F-DOPA PET (36), are such methods for functional imaging. Binderup et al reported in a recent study (37) that 18 F-FDG PET had the highest sensitivity for poorly differentiated NETs with a high proliferation rate, a Ki-67 of at least 15%, and negative somatostatin receptor scintigraphy findings, indicating that 18 F-FDG PET may be of diagnostic value in such cases. In another recent study (38), Ezziddin et al investigated the role of the Ki-67 proliferation index in predicting the efficacy of PRRT in NET patients and found that Ki-67 indices of up to 20% have no discernible negative effect on response to PRRT.…”

Section: Discussionmentioning

confidence: 99%

“…Treatment with somatostatin analogs (SSA), interferon-a, or the combination can reduce symptoms due to hormone overproduction in patients with NETs, but tumor reduction is achieved in only a small percentage of patients (17)(18)(19)(20). However, in a recently published study, Rinke et al (17) reported a longer median time to progression in patients using octreotide long-acting release (Sandostatin LAR; Novartis), compared with controls.…”

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confidence: 96%

Quality of Life in 265 Patients with Gastroenteropancreatic or Bronchial Neuroendocrine Tumors Treated with [¹⁷⁷Lu-DOTA⁰,Tyr³]Octreotate

Khan¹,

Krenning²,

Essen³

et al. 2011

J Nucl Med

166

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Quality of life (QOL) is an important outcome in cancer therapy. In this study, we investigated the QOL and symptoms after [ 177 Lu-DOTA 0 ,Tyr 3 ]octreotate ( 177 Lu-octreotate) therapy in patients with inoperable or metastasized gastroenteropancreatic or bronchial neuroendocrine tumors (NETs). Methods: Two hundred sixty-five Dutch patients completed the QOL questionnaire of the European Organization for the Research and Treatment of Cancer after being treated for NETs. ANOVA was used for statistical analyses, with a P value of 0.05 or less being considered significant. Differences of at least 10 points in global health status (GHS)/QOL scores, symptom scores, and Karnofsky performance scores (KPS) before and after therapy were regarded as indicating an improvement. Results: Regardless of the treatment outcome, GHS/QOL, insomnia, appetite loss, and diarrhea improved significantly in the total group. These improvements were also seen in patients with bone metastases or a decrease of 50% or more in chromogranin A. Improvement in the scores by at least 10 points was also analyzed in a subgroup of patients with decreased GHS/ QOL or symptoms at the start of therapy: in 36% of these patients, GHS/QOL improved after therapy; in 49%, fatigue; in 70%, nausea plus vomiting; in 53%, pain; in 44%, dyspnea; in 59%, insomnia; in 63%, appetite loss; in 60%, constipation; and in 67%, diarrhea. Additionally, we did not see a statistically significant deterioration in patients who had GHS/QOL 100, KPS 100, or no symptoms at the start. In patients with initial stable disease or remission after treatment, GHS/QOL and KPS decreased significantly when regrowth of the tumors occurred. Conclusion: GHS/QOL, KPS, and symptoms improved significantly after 177 Lu-octreotate therapy, and there was no significant decrease in QOL in patients who had no symptoms before therapy. In patients who had suboptimal scores for GHS/QOL or symptoms before therapy, a clinically significant improvement was demonstrated. Our results indicate that 177 Lu-octreotate therapy not only reduces tumors and prolongs overall survival but also improves the patients' self-assessed QOL.Key Words: gastroenteropancreatic neuroendocrine tumor; bronchial neuroendocrine tumor; quality of life; health-related quality of life; peptide receptor radionuclide therapy; [ 177 Lu-DOTA 0 ,Tyr 3 ]octreotate

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“…5,6,17 Reductions in tumor size has been reported but only as a minor response in a small proportion of patients. 18,19 Stabilization of tumor mass itself is a relevant outcome for patients with NET.…”

Section: Discussionmentioning

confidence: 99%

Lanreotide autogel every 6 weeks compared with Lanreotide microparticles every 3 weeks in patients with well differentiated neuroendocrine tumors

Bajetta

Procopio

Catena

et al. 2006

Cancer

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BACKGROUND.The noninferiority of a 6‐week dosing schedule of lanreotide Autogel (Lan ATG) at a dose of 120 mg compared with a 3‐week dosing schedule of lanreotide microparticles (Lan MP) at a dose of 60 mg was investigated in patients with neuroendocrine tumors (NET).METHODS.Patients who had sporadic, well differentiated NET with a low grade of malignancy were recruited for this open‐label, Phase III, multicenter trial. Patients were randomized to receive either 3 deep subcutaneous injections of Lan ATG (120 mg, every 6 weeks) or 6 intramuscular injections of Lan MP (60 mg, every 3 weeks). Tumor markers, tumor size, and symptoms were assessed between baseline and Week 18. Success was classified as a response that ranged from disappearance to an increase <25% in tumor marker, tumor size, or symptom frequency.RESULTS.Sixty patients were randomized, and 46 patients completed the study. Both for tumor markers and for tumor size, Lan ATG was not inferior to Lan MP (55% and 59% of patients responded on tumor markers, respectively; 68% and 66% of patients responded on tumor size, respectively). There were too few symptomatic patients to compare carcinoid symptoms. Both treatments were tolerated well, and no safety concerns were identified.CONCLUSIONS.Lan ATG at a dose of 120 mg every 6 weeks was as effective for controlling NET as Lan MP at a dose of 60 mg every 3 weeks. Cancer 2006. © 2006 American Cancer Society.

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The antitumoral effect of the long-acting somatostatin analog lanreotide in neuroendocrine tumors

Abstract: Lanreotide is safe and well tolerated in patients with carcinoid tumors. It seems to have both symptomatic and antitumoral effects in this setting.

Cited by 173 publications

References 14 publications

GEP–NETs UPDATE: Biotherapy for neuroendocrine tumours

GEP–NETs UPDATE: Biotherapy for neuroendocrine tumours

Quality of Life in 265 Patients with Gastroenteropancreatic or Bronchial Neuroendocrine Tumors Treated with [¹⁷⁷Lu-DOTA⁰,Tyr³]Octreotate

Lanreotide autogel every 6 weeks compared with Lanreotide microparticles every 3 weeks in patients with well differentiated neuroendocrine tumors

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The antitumoral effect of the long-acting somatostatin analog lanreotide in neuroendocrine tumors

Abstract: Lanreotide is safe and well tolerated in patients with carcinoid tumors. It seems to have both symptomatic and antitumoral effects in this setting.

Cited by 173 publications

References 14 publications

GEP–NETs UPDATE: Biotherapy for neuroendocrine tumours

GEP–NETs UPDATE: Biotherapy for neuroendocrine tumours

Quality of Life in 265 Patients with Gastroenteropancreatic or Bronchial Neuroendocrine Tumors Treated with [177Lu-DOTA0,Tyr3]Octreotate

Lanreotide autogel every 6 weeks compared with Lanreotide microparticles every 3 weeks in patients with well differentiated neuroendocrine tumors

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Product

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About

Quality of Life in 265 Patients with Gastroenteropancreatic or Bronchial Neuroendocrine Tumors Treated with [¹⁷⁷Lu-DOTA⁰,Tyr³]Octreotate