Document Detail

Is the new WHO classification of neuroendocrine tumours useful for selecting an appropriate treatment?
MedLine Citation:
PMID:  15939719     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Neuroendocrine tumours (NETs) are a rare and heterogeneous group of neoplasms. The most recent WHO classification provides clinical tools and indications to make the diagnosis and to suggest the correct treatment in different subgroups of patients. The aim of this trial was to apply the new classification criteria in clinical practice and, accordingly, to choose the most appropriate treatment. PATIENTS AND METHODS: Thirty-one evaluable patients, not previously treated, classified as advanced well differentiated NETs according to the new classification, were given long-acting release octreotide 30 mg every 28 days until evidence of disease progression. The treatment activity was evaluated according to objective, biochemical and symptomatic responses. Safety and tolerability were also assessed. RESULTS: Two partial objective tumour responses were obtained (6%), stabilization occurred in 16 patients (52%) and 95% of patients had a disease stabilisation lasting > or =6 months. However, eight patients showed rapid disease progression within 6 months of therapy and six patients after 6 months. Biochemical responses, evaluated by changes in serum chromogranine A levels were reported in 20/24 patients (83%). Symptomatic responses were observed in 6/14 patients (43%): a complete syndrome remission in one patient, partial syndrome remission in five patients, no change in four patients and progressive disease in four patients. The median overall survival was not reached, and the median time to disease progression was 18 months (range 1-49 months). The treatment was well tolerated, no severe adverse events were observed and no patient withdrew from the study because of adverse events. CONCLUSIONS: The WHO classification enables identification of low-grade NET patients who may be suitable for hormonal treatment. Octreotide LAR was seen to be effective in controlling the disease and was well tolerated. However, eight patients failed to respond to the treatment, despite histological evidence of a well differentiated tumour according to the new classification. This suggests that further histological examination should be carried out, especially in patients with visceral metastases and a short disease-free interval.
E Bajetta; L Catena; G Procopio; E Bichisao; L Ferrari; S Della Torre; S De Dosso; S Iacobelli; R Buzzoni; L Mariani; J Rosai
Related Documents :
7411659 - Free t4, free t3, and reverse t3 in critically ill, thermally injured patients.
7776719 - Commonly asked questions about thyroid function.
17102569 - Prevalence of subclinical hypothyroidism in patients with metabolic syndrome.
16733509 - Work capacity and oxygen uptake abnormalities in hyperthyroidism.
17601419 - Hidradenitis suppurativa in 64 female patients: retrospective study comparing oral anti...
2868149 - Prognostic value of thyroid stimulating antibodies and tsh-binding inhibiting immunoglo...
15334699 - Expression of growth hormone and its receptor in chronic atrophic gastritis and its cli...
3760979 - Direct quantitation of thoracic gallium-67 uptake in sarcoidosis.
24658819 - Early onset hypercholesterolemia induced by the second generation tyrosine kinase inhib...
Publication Detail:
Type:  Journal Article; Multicenter Study     Date:  2005-06-06
Journal Detail:
Title:  Annals of oncology : official journal of the European Society for Medical Oncology / ESMO     Volume:  16     ISSN:  0923-7534     ISO Abbreviation:  Ann. Oncol.     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-07-25     Completed Date:  2005-12-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9007735     Medline TA:  Ann Oncol     Country:  England    
Other Details:
Languages:  eng     Pagination:  1374-80     Citation Subset:  IM    
Medical Oncology Unit 2, ITMO Group, Nuclear Medicine, Department of Statistics, Department of Pathology, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Aged, 80 and over
Antineoplastic Agents, Hormonal / therapeutic use*
Cell Differentiation
Lung Neoplasms / drug therapy,  metabolism,  secondary
Middle Aged
Neoplasm Staging
Neuroendocrine Tumors / classification*,  drug therapy*
Octreotide / therapeutic use*
Pancreatic Neoplasms / drug therapy,  metabolism,  secondary
Thyroid Neoplasms / drug therapy,  metabolism,  secondary
Tumor Markers, Biological / analysis
World Health Organization*
Reg. No./Substance:
0/Antineoplastic Agents, Hormonal; 0/Tumor Markers, Biological; 83150-76-9/Octreotide

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

Previous Document:  Prognostic indexes in follicular lymphoma: a comparison of different prognostic systems.
Next Document:  Clinical significance of cytogenetics and interphase fluorescence in situ hybridization analysis in ...