Shortened interval of long-acting octreotide administration is effective in patients with well-differentiated neuroendocrine carcinomas in progression on standard doses

被引:62
作者
Ferolla, P. [2 ]
Faggiano, A. [1 ]
Grimaldi, F. [3 ]
Ferone, D. [4 ,5 ]
Scarpelli, G. [2 ]
Ramundo, V. [6 ]
Severino, R. [6 ]
Bellucci, M. C. [2 ]
Camera, L. M. [7 ]
Lombardi, G. [6 ]
Angeletti, G. [2 ]
Colao, A. [6 ]
机构
[1] IRCCS Fdn SDN, I-80143 Naples, Italy
[2] Umbria Reg Canc Network, Multidisciplinary Grp Diag & Treatment Neuroendoc, Perugia, Italy
[3] S Maria della Misericordia Hosp, Unit Endocrinol, Udine, Italy
[4] Univ Genoa, Dept Endocrinol & Med Sci, Genoa, Italy
[5] Univ Genoa, Ctr Excellence Biomed Res, Genoa, Italy
[6] Univ Naples Federico II, Dept Mol & Clin Endocrinol & Oncol, Naples, Italy
[7] Univ Naples Federico II, Dept Biomorphol & Funct Sci, Naples, Italy
关键词
High doses; octreotide LAR therapy; neuroendocrine tumor; progressive disease; somatostatin analogues; PROLONGED-RELEASE LANREOTIDE; SOMATOSTATIN ANALOG; GASTROINTESTINAL TUMORS; DIAGNOSIS; FORMULATION; MANAGEMENT; EFFICACY; THERAPY; ACETATE; TRIALS;
D O I
10.3275/7869
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: In patients with well-differentiated (WD) neuroendocrine tumors (NET), long-acting octreotide (LAR), conventionally administered at a dose of 30 mg every 28 days, has well-documented anti-secretive but limited anti-proliferative effects. Aim: The objective of this study was to evaluate a different schedule of LAR treatment consistent with a shorter interval between administrations (21 days) in WDNET patients with progressive disease at standard-dose interval. Subjects and methods: Twenty-eight patients followed for diagnosis and therapy of WDNET who had tumor progression during therapy with LAR 30 mg every 28 days were enrolled. Clinical, biological, and objective tumor response was evaluated after LAR 30 mg every 21 days. Time to progression was also evaluated after LAR 30 mg every 21 days and compared to LAR 30 mg every 28 days. Results: The treatment with LAR 30 mg every 21 days resulted in complete and partial control of clinical symptoms in 40% and 60% of cases, respectively. Circulating neuroendocrine markers were significantly decreased in 30% of cases. A stabilization of disease was obtained in 93% and objective response in 7%. The median time to progression was significantly longer by using the shortened interval of LAR administration as compared to the standard one (30 vs 9 months, p<0.0001). The treatment was safe and well tolerated. Conclusions: The shortened schedule of LAR administration was able to re-institute control of clinical symptoms, to decrease level of circulating neuroendocrine markers and to increase time to progression in patients previously escaping from a standard schedule treatment. (J. Endocrinol. Invest. 35: 326-331, 2012) (C)2012, Editrice Kurtis
引用
收藏
页码:326 / 331
页数:6
相关论文
共 30 条
[1]  
[Anonymous], 2004, PATHOLOGY GENETICS T
[2]   SOMATOSTATIN ANALOG PHASE-I TRIALS IN NEUROENDOCRINE NEOPLASMS [J].
ANTHONY, L ;
JOHNSON, D ;
HANDE, K ;
SHAFF, M ;
WINN, S ;
KROZELY, M ;
OATES, J .
ACTA ONCOLOGICA, 1993, 32 (02) :217-223
[3]   GASTROENTEROPANCREATIC ENDOCRINE TUMORS - EFFECT OF SANDOSTATIN(R) ON TUMOR-GROWTH [J].
ARNOLD, R ;
BENNING, R ;
NEUHAUS, C ;
ROLWAGE, M ;
TRAUTMANN, ME .
DIGESTION, 1993, 54 :72-75
[4]   Long-acting octreotide and prolonged-release lanreotide formulations have different pharmacokinetic profiles [J].
Astruc, B ;
Marbach, P ;
Bouterfa, H ;
Denot, C ;
Safari, M ;
Vitaliti, A ;
Sheppard, M .
JOURNAL OF CLINICAL PHARMACOLOGY, 2005, 45 (07) :836-844
[5]   Lanreotide autogel every 6 weeks compared with lanreotide microparticles every 3 weeks in patients with well differentiated neuroendocrine tumors - A phase III study [J].
Bajetta, Emilio ;
Procopio, Giuseppe ;
Catena, Laura ;
Martinetti, Antonia ;
De Dosso, Sara ;
Ricci, Sergio ;
Lecchi, Alberto S. ;
Boscani, Paolo F. ;
Iacobelli, Stefano ;
Carteni, Giacomo ;
De Braud, Filippo ;
Loli, Paola ;
Tartaglia, Andreas ;
Bajetta, Roberto ;
Ferrari, Leonardo .
CANCER, 2006, 107 (10) :2474-2481
[6]   Pharmacokinetics, pharmacodynamics, and safety of microencapsulated octreotide acetate in healthy subjects [J].
Chen, TL ;
Miller, TF ;
Prasad, P ;
Lee, J ;
Krauss, J ;
Miscik, K ;
Kalafsky, G ;
McLeod, JF .
JOURNAL OF CLINICAL PHARMACOLOGY, 2000, 40 (05) :475-481
[7]   Beneficial effect of dose escalation of Octreotide-LAR as first-line therapy in patients with acromegaly [J].
Colao, Annamaria ;
Pivonello, Rosario ;
Auriemma, Renata S. ;
Galdiero, Mariano ;
Savastano, Silvia ;
Lombardi, Gaetano .
EUROPEAN JOURNAL OF ENDOCRINOLOGY, 2007, 157 (05) :579-587
[8]  
DiBartolomeo M, 1996, CANCER-AM CANCER SOC, V77, P402, DOI 10.1002/(SICI)1097-0142(19960115)77:2<402::AID-CNCR25>3.0.CO
[9]  
2-4
[10]   New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1) [J].
Eisenhauer, E. A. ;
Therasse, P. ;
Bogaerts, J. ;
Schwartz, L. H. ;
Sargent, D. ;
Ford, R. ;
Dancey, J. ;
Arbuck, S. ;
Gwyther, S. ;
Mooney, M. ;
Rubinstein, L. ;
Shankar, L. ;
Dodd, L. ;
Kaplan, R. ;
Lacombe, D. ;
Verweij, J. .
EUROPEAN JOURNAL OF CANCER, 2009, 45 (02) :228-247