Document Detail


Long-acting somatostatin analogues are an effective treatment for type 1 gastric carcinoid tumours.
MedLine Citation:
PMID:  18662970     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Gastric carcinoid tumours type 1 (GCA1) originate from hyperplastic enterochromaffin-like (ECL) cells secondary to hypergastrinaemia. Treatment with somatostatin analogues (SSA) might impede ECL-cell hyperplasia by suppressing gastrin secretion and/or by a direct anti-proliferative effect on ECL cells. We conducted a multicentre prospective study to assess the effects of long-acting SSA on hypergastrinaemia and ECL-cell proliferation in patients with GCA1. METHODS: We studied 15 patients with GCA1 treated with monthly long-acting release octreotide (LAR) (20-30 mg; n=14) or Lanreotide 90 mg (n=1) for at least 6 months. Patients had serum gastrin and chromogranin A measurements performed and biopsies taken from both tumours and surrounding mucosa before, and every 6-12 months following treatment. Sections were immunostained for neuroendocrine markers. The cell proliferation index Ki-67, intensity of staining before and after treatment and the degree of gastric wall invasion were also assessed. RESULTS: All patients tolerated treatment well (mean follow-up of 18 months). In 11 patients (73%), a complete disappearance of the tumours at 1 year of treatment was observed on endoscopy, while in three patients (20%), the tumours decreased significantly in number and size. Gastrin levels normalized in 25% of patients, and were reduced by more than 80% in the remaining 75%. CONCLUSIONS: Treatment with SSAs in GCA1 leads to a substantial tumour load reduction, with a concomitant decrease of serum gastrin levels. Our data indicate an important anti-proliferative effect of SSA on ECL cells, providing clinical benefit and obviating, at least temporarily, the need for invasive therapies for GCA1.
Authors:
Simona Grozinsky-Glasberg; Gregory Kaltsas; Chamutal Gur; Eyal Gal; Dimitrios Thomas; Susana Fichman; Krystallenia Alexandraki; Dganit Barak; Benjamin Glaser; Ilan Shimon; David J Gross
Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study     Date:  2008-07-28
Journal Detail:
Title:  European journal of endocrinology / European Federation of Endocrine Societies     Volume:  159     ISSN:  1479-683X     ISO Abbreviation:  Eur. J. Endocrinol.     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-09-22     Completed Date:  2008-10-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423848     Medline TA:  Eur J Endocrinol     Country:  England    
Other Details:
Languages:  eng     Pagination:  475-82     Citation Subset:  IM    
Affiliation:
Institutes of Endocrinology, Rabin Medical Center, Beilinson Hospital, Petah Tikva, 49500, Israel. simonag@clalit.org.il
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MeSH Terms
Descriptor/Qualifier:
Antineoplastic Agents, Hormonal / administration & dosage*
Carcinoid Tumor / drug therapy*,  pathology
Enterochromaffin Cells / pathology
Female
Follow-Up Studies
Humans
Male
Middle Aged
Octreotide / administration & dosage*
Prospective Studies
Stomach Neoplasms / drug therapy*,  pathology
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antineoplastic Agents, Hormonal; 83150-76-9/Octreotide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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