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1. Rothenstein J, Cleary SP, Pond GR, Dale D, Gallinger S, Moore MJ, Brierley J, Siu LL: Neuroendocrine tumors of the gastrointestinal tract: a decade of experience at the Princess Margaret Hospital. Am J Clin Oncol; 2008 Feb;31(1):64-70
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Over the past decade, novel treatment approaches have been developed.
  • Anatomic distribution of the primary location revealed that 35% were from the foregut, 40% from midgut, 11% from hindgut, and 14% from unknown origin.
  • Curative surgery was performed in 35% of the cohort, whereas radiotherapy and chemotherapy of any intent were delivered to 13% and 34%, respectively.
  • These patients should be evaluated by a multidisciplinary team regarding new approaches to surgery and other therapies.
  • [MeSH-major] Adenoma, Islet Cell / therapy. Carcinoid Tumor / therapy. Carcinoma, Small Cell / therapy. Gastrointestinal Neoplasms / therapy. Neuroendocrine Tumors / therapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Cohort Studies. Combined Modality Therapy. Female. Follow-Up Studies. Humans. Male. Middle Aged. Prognosis. Radiotherapy, Adjuvant. Retrospective Studies. Survival Rate. Time Factors

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  • (PMID = 18376230.001).
  • [ISSN] 1537-453X
  • [Journal-full-title] American journal of clinical oncology
  • [ISO-abbreviation] Am. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Randomized Controlled Trial
  • [Publication-country] United States
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2. Ricci S, Antonuzzo A, Galli L, Orlandini C, Ferdeghini M, Boni G, Roncella M, Mosca F, Conte PF: Long-acting depot lanreotide in the treatment of patients with advanced neuroendocrine tumors. Am J Clin Oncol; 2000 Aug;23(4):412-5
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  • [Title] Long-acting depot lanreotide in the treatment of patients with advanced neuroendocrine tumors.
  • Long-acting depot forms of somatostatin analogs administered by intramuscular injections are now available for the treatment of neuroendocrine tumors (NETs).
  • Thirteen patients were pretreated with subcutaneous octreotide, chemotherapy, or hepatic metastasis alcoholization.
  • Lanreotide was administered as intramuscular injections at the dose of 30 mg every 2 weeks until there was objective, biochemical, or symptomatic tumor progression.
  • Objective partial responses (PRs) were documented in 2 patients (8%), whereas 10 patients (40%) had tumor stabilization.
  • The PRs were observed in patients with midgut carcinoids, of whom one was pretreated with subcutaneous octreotide.
  • The overall biochemical response rate was 42%, including 2 complete responses (CRs) (10.5%) and 6 PRs (31.5%); all biochemical responses were observed mostly in patients with carcinoid tumors; the duration of response was 18+ and 30+ months for CRs; the median duration of biochemical response was 7 months (range, 4-18+) for PRs.
  • Median duration of lanreotide treatment was 10 months (range, 2-30+).
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Neuroendocrine Tumors / drug therapy. Peptides, Cyclic / therapeutic use. Somatostatin / analogs & derivatives
  • [MeSH-minor] Abdominal Pain / chemically induced. Adult. Aged. Biomarkers, Tumor / analysis. Carcinoid Tumor / drug therapy. Delayed-Action Preparations. Diarrhea / chemically induced. Disease Progression. Female. Flushing / chemically induced. Gastrinoma / drug therapy. Humans. Injections, Intramuscular. Liver Neoplasms / drug therapy. Liver Neoplasms / secondary. Male. Middle Aged. Pancreatic Neoplasms / drug therapy. Patient Compliance. Remission Induction

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  • (PMID = 10955874.001).
  • [ISSN] 0277-3732
  • [Journal-full-title] American journal of clinical oncology
  • [ISO-abbreviation] Am. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Biomarkers, Tumor; 0 / Delayed-Action Preparations; 0 / Peptides, Cyclic; 118992-92-0 / lanreotide; 51110-01-1 / Somatostatin
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3. Anthony L, Freda PU: From somatostatin to octreotide LAR: evolution of a somatostatin analogue. Curr Med Res Opin; 2009 Dec;25(12):2989-99
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  • Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are rare, slow-growing neoplasms that have usually metastasized by the time of diagnosis.
  • The majority of GEP-NETs are carcinoid tumors whose syndrome is caused by the hypersecretion of biogenic amines, peptides and polypeptides responsible for the principal symptoms of diarrhea and flushing.
  • CONCLUSIONS: Octreotide is a potent synthetic somatostatin analogue that has become the mainstay of medical therapy for tumor control in neuroendocrine disorders such as acromegaly and GEP-NETs.
  • Moreover, recent results from the PROMID study have confirmed the antiproliferative effect of octreotide LAR in patients with well-differentiated metastatic GEP-NETs of the midgut.
  • New therapeutic uses of octreotide are currently under investigation in a variety of clinical settings.
  • [MeSH-major] Acromegaly / drug therapy. Drug Design. Octreotide / therapeutic use. Somatostatin / analogs & derivatives. Somatostatin / therapeutic use
  • [MeSH-minor] Animals. Clinical Trials as Topic / methods. Delayed-Action Preparations / chemical synthesis. Delayed-Action Preparations / therapeutic use. Drug Evaluation, Preclinical / methods. Humans. Retrospective Studies

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  • (PMID = 19842996.001).
  • [ISSN] 1473-4877
  • [Journal-full-title] Current medical research and opinion
  • [ISO-abbreviation] Curr Med Res Opin
  • [Language] eng
  • [Grant] United States / NIDDK NIH HHS / DK / R01 DK064720
  • [Publication-type] Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Delayed-Action Preparations; 51110-01-1 / Somatostatin; RWM8CCW8GP / Octreotide
  • [Number-of-references] 86
  • [Other-IDs] NLM/ NIHMS475890; NLM/ PMC3678951
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4. Ruszniewski P, O'Toole D: Ablative therapies for liver metastases of gastroenteropancreatic endocrine tumors. Neuroendocrinology; 2004;80 Suppl 1:74-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Ablative therapies for liver metastases of gastroenteropancreatic endocrine tumors.
  • Results of systemic chemotherapy are also disappointing especially in patients with metastases from midgut GEP tumors.
  • These latter patients usually have carcinoid syndrome which can be controlled by somatostatin analogues.
  • Other therapeutic options in the treatment of highly vascular liver metastases from GEP tumors are locoregional strategies by inducing vascular occlusion resulting in ischemia and necrosis of tumoral tissue.
  • TACE has proven effective in controlling symptoms and gives objective tumor response in about half of patients.
  • [MeSH-major] Liver Neoplasms / secondary. Liver Neoplasms / therapy. Neuroendocrine Tumors / pathology. Neuroendocrine Tumors / therapy
  • [MeSH-minor] Catheter Ablation / methods. Chemoembolization, Therapeutic / methods. Cryotherapy. Humans. Vasectomy / methods

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  • (PMID = 15477722.001).
  • [ISSN] 0028-3835
  • [Journal-full-title] Neuroendocrinology
  • [ISO-abbreviation] Neuroendocrinology
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Switzerland
  • [Number-of-references] 42
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5. Corbetta S, Peracchi M, Cappiello V, Lania A, Lauri E, Vago L, Beck-Peccoz P, Spada A: Circulating ghrelin levels in patients with pancreatic and gastrointestinal neuroendocrine tumors: identification of one pancreatic ghrelinoma. J Clin Endocrinol Metab; 2003 Jul;88(7):3117-20
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • We measured plasma ghrelin levels in 16 patients with gastrointestinal carcinoid (10 with midgut and 6 with gastric carcinoid), 24 patients with pancreatic tumor (8 with gastrinoma, 2 with insulinoma, 2 with vipoma, 1 with glucagonoma, and 11 with nonfunctioning tumor), and 35 healthy controls.
  • Plasma ghrelin levels recorded in patients with gastroenteropancreatic tumors were similar to controls (mean +/- SE, 182.7 +/- 66.5 pM in patients vs. 329 +/- 32 pM in controls, P = not significant), and no significant difference between gastrointestinal and pancreatic, functioning and nonfunctioning, and metastatic and nonmetastatic tumors was observed.
  • One patient with metastatic nonfunctioning pancreatic tumor had circulating ghrelin levels of 12,000 pM that were slightly reduced during chemotherapy and interferon therapy.
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Biomarkers, Tumor / blood. Female. Gastrinoma / blood. Ghrelin. Glucagonoma / blood. Humans. Insulinoma / blood. Male. Middle Aged. Retrospective Studies. Vipoma / blood

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  • (PMID = 12843152.001).
  • [ISSN] 0021-972X
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Ghrelin; 0 / Peptide Hormones
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6. Warner RR: Carcinoid case presentation and discussion: the American perspective. Endocr Relat Cancer; 2003 Dec;10(4):489-96
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Carcinoid case presentation and discussion: the American perspective.
  • The rationale underlying an aggressive approach in the management of some carcinoid patients is explained and illustrated by the presented case of a middle-aged man with advanced classic typical midgut carcinoid.
  • The patient exhibited somatostatin receptor scintigraphy-positive massive liver metastases, carcinoid syndrome, severe tricuspid and pulmonic cardiac valve disease with congestive heart failure, ascites and malnutrition.
  • He had been treated for several years with supportive medications and biotherapy including octreotide and alpha interferon but his tumor eventually progressed and his overall condition was markedly deteriorated when he first sought more aggressive treatment.
  • This consisted of prompt replacement of both tricuspid and pulmonic valves, followed by hepatic artery chemoembolus (HACE) injection and then surgical tumor debulking including excision of the primary tumor in the small intestine.
  • Prophylactic cholecystectomy was also performed and a biopsy of tumor was submitted for cell culture drug resistance testing.
  • This was followed by systemic chemotherapy utilizing the drug (docetaxel) which the in vitro studies suggested as most likely to be effective.
  • His excellent response to this succession of treatments exemplifies the successful application of aggressive sequential multi-modality therapy.
  • [MeSH-major] Carcinoid Heart Disease / pathology. Carcinoid Heart Disease / therapy. Intestinal Neoplasms / pathology. Intestinal Neoplasms / therapy. Liver Neoplasms / secondary. Liver Neoplasms / therapy
  • [MeSH-minor] Antineoplastic Agents, Hormonal / pharmacology. Chemoembolization, Therapeutic. Combined Modality Therapy. Heart Valve Prosthesis Implantation. Humans. Male. Middle Aged. Octreotide / pharmacology. Pulmonary Valve / pathology. Pulmonary Valve / surgery. Taxoids / pharmacology. Tricuspid Valve Insufficiency / pathology. Tricuspid Valve Insufficiency / surgery

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  • (PMID = 14713263.001).
  • [ISSN] 1351-0088
  • [Journal-full-title] Endocrine-related cancer
  • [ISO-abbreviation] Endocr. Relat. Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Taxoids; 15H5577CQD / docetaxel; RWM8CCW8GP / Octreotide
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7. Berković MC, Altabas V, Herman D, Hrabar D, Goldoni V, Vizner B, Zjacić-Rotkvić V: A single-centre experience with octreotide in the treatment of different hypersecretory syndromes in patients with functional gastroenteropancreatic neuroendocrine tumors. Coll Antropol; 2007 Jun;31(2):531-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A single-centre experience with octreotide in the treatment of different hypersecretory syndromes in patients with functional gastroenteropancreatic neuroendocrine tumors.
  • The aim of this research was to assess the clinical and biochemical efficacy of the octreotide in the treatment of patients with various functional gastroenteropancreatic neuroendocrine tumors (GEP-NETs).
  • They were diagnosed with VIPoma, glucagonoma, gastrinoma, medullary thyroid carcinoma (solitary and as a part of MEN-II syndrome), pancreatic carcinoids (solitary and as a part of multiple endocrine neoplasia type-1 syndrome-MEN-1 syndrome) and midgut carcinoids.
  • The patients presented with Verner-Morrison, glucagonoma, Zollinger Ellison and carcinoid syndrome respectively.
  • All had a metastatic disease at the time of diagnosis and a positive octreoscan finding.
  • Symptomatic efficacy assessments were made by diarrhea reductions during treatment course, and laboratory efficacy was assessed through changes in 5-HIAA and CgA levels.
  • Assessments were made initially and following 6 months of therapy.
  • There was a positive correlation between the 5-HIAA reduction and the decrease in stool number at baseline and during treatment course (p < 0.05).
  • [MeSH-major] Antineoplastic Agents, Hormonal / therapeutic use. Neuroendocrine Tumors / drug therapy. Octreotide / therapeutic use. Pancreatic Neoplasms / drug therapy. Stomach Neoplasms / drug therapy. Thyroid Neoplasms / drug therapy
  • [MeSH-minor] Biomarkers, Tumor. Female. Humans. Male. Malignant Carcinoid Syndrome / drug therapy. Middle Aged. Treatment Outcome

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  • (PMID = 17847934.001).
  • [ISSN] 0350-6134
  • [Journal-full-title] Collegium antropologicum
  • [ISO-abbreviation] Coll Antropol
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] Croatia
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Biomarkers, Tumor; RWM8CCW8GP / Octreotide
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9. Ricci S, Antonuzzo A, Galli L, Ferdeghini M, Bodei L, Orlandini C, Conte PF: Octreotide acetate long-acting release in patients with metastatic neuroendocrine tumors pretreated with lanreotide. Ann Oncol; 2000 Sep;11(9):1127-30
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • PATIENTS AND METHODS: Fifteen patients (8 females, 7 males, median age 67 years, range 28-81 years) with metastatic NETs (8 endocrine pancreatic tumors, 7 midgut carcinoids) were enrolled in the study.
  • All patients were in progressive disease (objective: 11 patients, symptomatic: 10 patients, biochemical: 11 patients) after treatment with slow release lanreotide, 30 mg every 14 days for a median time of 8 months (range 3-19 months).
  • The PR was observed in one patient with non-functioning endocrine pancreatic tumor with progressive liver and lymph node metastases after 16 months of i.m. lanreotide therapy.
  • Median duration of octreotide LAR treatment was seven months (range 3-12+ months).

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  • (PMID = 11061606.001).
  • [ISSN] 0923-7534
  • [Journal-full-title] Annals of oncology : official journal of the European Society for Medical Oncology
  • [ISO-abbreviation] Ann. Oncol.
  • [Language] ENG
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Biomarkers, Tumor; 0 / Chromogranin A; 0 / Chromogranins; 0 / Delayed-Action Preparations; 0 / Peptides, Cyclic; 118992-92-0 / lanreotide; 51110-01-1 / Somatostatin; 54-16-0 / Hydroxyindoleacetic Acid; RWM8CCW8GP / Octreotide
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10. Nilsson O, Arvidsson Y, Johanson V, Forssell-Aronsson E, Ahlman H: New medical strategies for midgut carcinoids. Anticancer Agents Med Chem; 2010 Mar;10(3):250-69
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] New medical strategies for midgut carcinoids.
  • These patients can be palliated by interventional tumour reduction and medical treatment with somatostatin analogues; no effective chemotherapy is available.
  • Radionuclide therapy via somatostatin receptors is one new therapeutic alternative.
  • The recognition that neuroendocrine tumours express specific receptors for growth factors and chemokines, which are of importance for tumour growth, vascularization, and spread, may open the way for new therapeutic approaches.
  • The signalling pathways in carcinoid tumours are incompletely explored.
  • This review summarizes potential new treatment strategies from clinical and experimental studies, e.g. inhibition of angiogenesis, targeting of growth factors or their receptors by tyrosine kinase inhibitors, interference with specific cellular pathways (mTOR, PI3K, RAS/RAF, Notch), and also inhibition of the proteasome and histone deacetylation.
  • Combining targeted therapy with chemotherapy, or using drugs to sensitize for radionuclide therapy, may enhance the treatment outcome.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Carcinoid Tumor / drug therapy. Gastrointestinal Neoplasms / drug therapy
  • [MeSH-minor] Angiogenesis Inhibitors / chemistry. Angiogenesis Inhibitors / pharmacology. Angiogenesis Inhibitors / therapeutic use. Combined Modality Therapy. Enzyme Inhibitors / chemistry. Enzyme Inhibitors / pharmacology. Enzyme Inhibitors / therapeutic use. Humans. Signal Transduction / drug effects


11. Oberg K: Diagnosis and treatment of carcinoid tumors. Expert Rev Anticancer Ther; 2003 Dec;3(6):863-77
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Diagnosis and treatment of carcinoid tumors.
  • Carcinoid tumors belong to the family of neuroendocrine tumors, which are usually slow growing with distinct biological and clinical characteristics.
  • The former classification system of foregut, midgut and hindgut tumors is still used in clinical routine, although there is a new World Health Organization classification.
  • Determination of the histopathology of carcinoid tumors is of utmost importance and involves specific immunohistochemical staining for chromogranin A, synaptophysin, serotonin and gastrin.
  • Proliferation capacity measured by Ki67 is used to guide forthcoming medical treatment.
  • Localization procedures include computerized tomography, ultrasound, magnetic resonance imaging, somatostatin receptor scintigraphy and positron emission tomography.
  • Surgery remains the cornerstone of treatment and provides the only chance of a cure.
  • Other cytoreductive procedures include radiofrequency ablation, laser treatment and chemoembolization.
  • Biological treatment includes cytotoxic agents, such as somatostatin analogs and interferon-alpha, which should be applied in slow-growing neoplasms.
  • Combination regimens including cisplatin, etoposide, streptozotocin and 5-fluorouracil should be reserved for treatment of highly proliferating tumors.
  • Future therapy of carcinoid tumors will be based on the specific tumor biology and treatment will be customized for each individual patient.
  • New therapies, such as antiangiogenic agents and new, long-acting somatostatin analogs, together with further development of tumor-targeted treatments, will come into clinical use in the near future.
  • [MeSH-major] Carcinoid Tumor / diagnosis. Carcinoid Tumor / drug therapy
  • [MeSH-minor] Animals. Antineoplastic Agents / therapeutic use. Clinical Trials as Topic / statistics & numerical data. Humans. Neuroendocrine Tumors / diagnosis. Neuroendocrine Tumors / drug therapy. Neuroendocrine Tumors / therapy

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  • (PMID = 14686708.001).
  • [ISSN] 1473-7140
  • [Journal-full-title] Expert review of anticancer therapy
  • [ISO-abbreviation] Expert Rev Anticancer Ther
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 134
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12. Skogseid B: Nonsurgical treatment of advanced malignant neuroendocrine pancreatic tumors and midgut carcinoids. World J Surg; 2001 Jun;25(6):700-3
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Nonsurgical treatment of advanced malignant neuroendocrine pancreatic tumors and midgut carcinoids.
  • Evidenced-based medicine and consensus on systemic treatment of advanced malignant disease is virtually nonexistent, and the various available therapeutic regimens should be considered primarily palliative.
  • Symptomatic treatment of patients with endocrine functioning tumors, however, is of utmost importance and leads to extensive prolongation of survival.
  • Biotherapy by means of somatostatin analogs and interferon-alpha facilitates symptomatic control and offers stabilization of tumor progression for extended periods of time.
  • Pancreatic endocrine tumors metastatic to the liver frequently respond to chemotherapy by means of a significant reduction in tumor volume.
  • Programs including streptozotocin and 5-fluorouracil or doxorubicin are generally regarded as first line treatment for pancreatic endocrine tumors with liver metastases, whereas midgut carcinoid tumors often are resistant to systemic chemotherapy.
  • Treatment attempts in patients with the latter disease may rather include interferon-alpha and somatostatin analogs.
  • Repeated surgical intervention including various debulking procedures should be considered here and in patients with advanced neuroendocrine pancreatic tumors and midgut carcinoids requiring systemic antitumor treatment.
  • [MeSH-major] Carcinoid Tumor / therapy. Intestinal Neoplasms / therapy. Neuroendocrine Tumors / therapy. Pancreatic Neoplasms / therapy
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Fluorouracil / administration & dosage. Humans. Interferon-alpha / therapeutic use. Streptozocin / administration & dosage

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  • (PMID = 11376401.001).
  • [ISSN] 0364-2313
  • [Journal-full-title] World journal of surgery
  • [ISO-abbreviation] World J Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Interferon-alpha; 5W494URQ81 / Streptozocin; U3P01618RT / Fluorouracil
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13. Ahlman H, Nilsson O, Olausson M: Interventional treatment of the carcinoid syndrome. Neuroendocrinology; 2004;80 Suppl 1:67-73
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Interventional treatment of the carcinoid syndrome.
  • Liver metastases imply a major problem in patients with carcinoid tumours and hormone overproduction.
  • In selected cases liver transplantation can be a treatment alternative.
  • Prior to all interventions patients with midgut carcinoids are protected with somatostatin analogues to reduce hormone secretion.
  • [MeSH-major] Carcinoid Tumor / therapy. Gastrointestinal Neoplasms / therapy
  • [MeSH-minor] Drug Therapy / methods. Embolization, Therapeutic / methods. Humans. Liver Neoplasms / surgery. Mastectomy, Segmental / methods. Models, Biological. Preoperative Care / methods. Somatostatin / analogs & derivatives. Somatostatin / therapeutic use. Treatment Outcome

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  • (PMID = 15477721.001).
  • [ISSN] 0028-3835
  • [Journal-full-title] Neuroendocrinology
  • [ISO-abbreviation] Neuroendocrinology
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 51110-01-1 / Somatostatin
  • [Number-of-references] 37
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14. Zomerhuis MT, Hussain SM, Feelders RA, van der Lely AJ, de Herder WW: Octreotide exerts only acute, but no sustained, effects on MRI enhancement of liver metastases in carcinoid syndrome. Neuroendocrinology; 2005;82(1):41-8
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  • [Title] Octreotide exerts only acute, but no sustained, effects on MRI enhancement of liver metastases in carcinoid syndrome.
  • We have investigated the acute and sustained hemodynamic effects of octreotide on hepatic metastases of midgut carcinoids using contrast-enhanced dynamic magnetic resonance imaging (MRI).
  • Seven patients with the carcinoid syndrome and metastasized midgut carcinoid tumors underwent functional dynamic multi-phase gadolinium-enhanced MRI of selected liver metastases at baseline and 60 min after the subcutaneous (s.c.) administration of 100 microg octreotide, and also after 3 months with three times daily (t.i.d.
  • Baseline MRIs showed the typical aspect of carcinoid liver metastases with a very bright signal on the T2-weighted sequences and intense enhancement in the arterial phase after injection of gadolinium-diethylenetriaminepentaacetate.
  • This study further shows that contrast-enhanced dynamic MRI can be a very useful tool for studying hemodynamic effects of medical therapies on liver metastases in patients with metastatic midgut carcinoids.
  • [MeSH-major] Antineoplastic Agents, Hormonal / pharmacology. Carcinoid Tumor / drug therapy. Carcinoid Tumor / pathology. Liver Neoplasms / drug therapy. Liver Neoplasms / secondary. Octreotide / pharmacology. Splanchnic Circulation / drug effects
  • [MeSH-minor] Aged. Female. Gastrointestinal Neoplasms / drug therapy. Gastrointestinal Neoplasms / pathology. Humans. Image Enhancement. Magnetic Resonance Imaging. Male. Middle Aged. Regional Blood Flow / drug effects

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  • [Copyright] Copyright 2005 S. Karger AG, Basel.
  • (PMID = 16391492.001).
  • [ISSN] 0028-3835
  • [Journal-full-title] Neuroendocrinology
  • [ISO-abbreviation] Neuroendocrinology
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; RWM8CCW8GP / Octreotide
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15. Larsson G, Janson ET: Anemia in patients with midgut carcinoid, treated with alpha interferon: effects by erythropoietin treatment on the perceived quality of life. Eur J Cancer Care (Engl); 2008 Mar;17(2):200-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Anemia in patients with midgut carcinoid, treated with alpha interferon: effects by erythropoietin treatment on the perceived quality of life.
  • One important side effect from alpha interferon is depression of bone marrow function and studies have shown that patients with carcinoid tumours treated with alpha interferon suffers from fatigue and impaired physical functions.
  • The aim of this pilot study was to investigate if treatment with erythropoietin (EPO) could have a positive effect on self-rated quality of life (QoL).
  • Eighteen patients with midgut carcinoid treated with alpha interferon were included in the study.
  • Even though the analysis did not reveal any statistically significant relation between the observed increase in Hb levels and self-rated QoL, this pilot study has increased the knowledge about benefits, doses and frequency of EPO treatment in patients with midgut carcinoid suffering from interferon related anaemia.
  • [MeSH-major] Antineoplastic Agents / adverse effects. Carcinoid Tumor / drug therapy. Erythropoietin / therapeutic use. Gastrointestinal Neoplasms / drug therapy. Interferon-alpha / adverse effects. Quality of Life
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Anemia / drug therapy. Anemia / etiology. Fatigue / etiology. Female. Follow-Up Studies. Hemoglobins / metabolism. Humans. Male. Middle Aged. Pilot Projects. Treatment Outcome

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  • (PMID = 18302658.001).
  • [ISSN] 1365-2354
  • [Journal-full-title] European journal of cancer care
  • [ISO-abbreviation] Eur J Cancer Care (Engl)
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Hemoglobins; 0 / Interferon-alpha; 11096-26-7 / Erythropoietin
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16. Engelbach M, Heusel CP, Kriegsmann J, Both S, Walgenbach S: [Drug therapy of carcinoids of the gastrointestinal tract]. Zentralbl Chir; 2001 Sep;126(9):682-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Drug therapy of carcinoids of the gastrointestinal tract].
  • [Transliterated title] Medikamentöse Therapie bei Karzinoiden des Gastrointestinaltraktes.
  • Carcinoid tumors are rare and slowly growing neuroendocrine tumors of the foregut, midgut and hindgut.
  • Drug therapy is of special importance in patients with inoperable metastasising disease.
  • This palliative therapy is aimed at reduction of the hormone-dependent symptoms and inhibition of tumor growth.
  • Drug therapy can be supplemented by surgical and radiological intervention through interdisciplinary cooperation of the surgeon, radiologist, endocrinologist and gastroenterologist.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoid Tumor / drug therapy. Gastrointestinal Neoplasms / drug therapy. Interferon-alpha / therapeutic use. Somatostatin / analogs & derivatives

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  • (PMID = 11699283.001).
  • [ISSN] 0044-409X
  • [Journal-full-title] Zentralblatt für Chirurgie
  • [ISO-abbreviation] Zentralbl Chir
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Interferon-alpha; 51110-01-1 / Somatostatin
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17. O'Toole D, Maire F, Ruszniewski P: Ablative therapies for liver metastases of digestive endocrine tumours. Endocr Relat Cancer; 2003 Dec;10(4):463-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Ablative therapies for liver metastases of digestive endocrine tumours.
  • Surgery is the treatment method of choice for hepatic metastases but this is frequently impossible due to the extent of disease.
  • Systemic chemotherapy is offered to patients with diffuse and/or progressive liver metastases but results are disappointing especially in patients with metastases of midgut origin.
  • In the latter patients with carcinoid syndrome, somatostatin analogs are frequently initially effective but their efficacy wanes due to disease progression and development of tachyphylaxis.
  • Other therapeutic options in the treatment of hepatic metastases are locoregional strategies where vascular occlusion induces ischemia in these highly vascular tumors using either surgical or radiological techniques.
  • Trans-catheter arterial chemoembolization has proven effective in terms of long palliation and objective tumor responses.
  • Other treatments aimed at regional destruction either alone or in combination with surgery include radiofrequency ablation and cryotherapy.
  • [MeSH-major] Gastrointestinal Neoplasms / therapy. Liver Neoplasms / secondary. Liver Neoplasms / therapy. Neuroendocrine Tumors / therapy
  • [MeSH-minor] Catheter Ablation. Chemoembolization, Therapeutic. Cryotherapy. Humans

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  • (PMID = 14713259.001).
  • [ISSN] 1351-0088
  • [Journal-full-title] Endocrine-related cancer
  • [ISO-abbreviation] Endocr. Relat. Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 50
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18. Oberg K: Chemotherapy and biotherapy in the treatment of neuroendocrine tumours. Ann Oncol; 2001;12 Suppl 2:S111-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Chemotherapy and biotherapy in the treatment of neuroendocrine tumours.
  • The medical treatment of neuroendocrine GEP tumours must be based on the growth properties of the tumour.
  • Medical treatment includes chemotherapy, somatostatin analogues and alpha interferons.
  • Chemotherapy has been particularly active in patients with high proliferating neuroendocrine tumours such as endocrine pancreatic tumours and lung carcinoids.
  • However, in low proliferating tumours such as classical midgut carcinoids the response rates with the same combinations of cytotoxic agents have only generated short lasting responses in less than 10% of patients.
  • In these patients, biological treatment has been of benefit.
  • Alpha interferon at doses of 3-9 million units three to seven times per week subcutaneously, has given biochemical response rates of 50% and significant tumour reduction in about 15% of patients with long duration, up to three years.
  • Somatostatin analogues have been widely used in the treatment of neuroendocrine gut and pancreatic tumours.
  • Octreotide is registered in most countries for the treatment of patients with carcinoid syndrome and also VIP and glucagon producing tumours.

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  • (PMID = 11762335.001).
  • [ISSN] 0923-7534
  • [Journal-full-title] Annals of oncology : official journal of the European Society for Medical Oncology
  • [ISO-abbreviation] Ann. Oncol.
  • [Language] ENG
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antibiotics, Antineoplastic; 0 / Antineoplastic Agents; 0 / Antineoplastic Agents, Hormonal; 0 / Interferon-alpha; 0 / Peptides, Cyclic; 0 / Receptors, Somatostatin; 118992-92-0 / lanreotide; 51110-01-1 / Somatostatin; 5W494URQ81 / Streptozocin; Q20Q21Q62J / Cisplatin; RWM8CCW8GP / Octreotide
  • [Number-of-references] 23
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19. van der Lely AJ, de Herder WW: Carcinoid syndrome: diagnosis and medical management. Arq Bras Endocrinol Metabol; 2005 Oct;49(5):850-60
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Carcinoid syndrome: diagnosis and medical management.
  • Midgut carcinoid can present with the carcinoid syndrome in the presence of liver metastases.
  • A nonspecific biochemical tumor marker for carcinoid tumors is serum chromogranin A and a specific marker for the carcinoid syndrome is the increased urinary excretion of 5-hydroxy indole acetic acid (5-HIAA).
  • Localizing studies in carcinoid tumors/syndrome are: transabdominal ultrasonography (US), endoscopy, endoscopic US, videocapsule endoscopy, computerized tomography, magnetic resonance imaging, selective abdominal angiography, 111In-pentetreotide scintigraphy (and intraoperative radionuclide probe), 123I (131I)-metaiodobenzylguanidine (MIBG) scintigraphy, bone scintigraphy and 11C-5-HT positron emission tomography (PET).
  • Therapies for carcinoid tumors/syndrome are: surgery, somatostatin analogs, interferon-alpha, radiotherapy, liver dearterialization, liver (chemo, or radio)-embolization, alcohol sclerotherapy of liver metastases, radiofrequency ablation of liver metastases, cryosurgery of liver metastases, occasionally liver transplantation, radiotherapy-coupled somatostatin analogs, 131I-MIBG and occasionally chemotherapy.
  • [MeSH-major] Gastrointestinal Neoplasms. Malignant Carcinoid Syndrome
  • [MeSH-minor] Biomarkers, Tumor / blood. Chromogranin A. Chromogranins / blood. Humans. Hydroxyindoleacetic Acid / blood

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  • (PMID = 16444370.001).
  • [ISSN] 0004-2730
  • [Journal-full-title] Arquivos brasileiros de endocrinologia e metabologia
  • [ISO-abbreviation] Arq Bras Endocrinol Metabol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Brazil
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Chromogranin A; 0 / Chromogranins; 54-16-0 / Hydroxyindoleacetic Acid
  • [Number-of-references] 74
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20. Kasi VS, Ahsanuddin AN, Gilbert C, Orr L, Moran J, Sorrell VL: Isolated metastatic myocardial carcinoid tumor in a 48-year-old man. Mayo Clin Proc; 2002 Jun;77(6):591-4
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  • [Title] Isolated metastatic myocardial carcinoid tumor in a 48-year-old man.
  • The mass, which involved the subvalvar right ventricular free wall, was resected and determined to be a metastatic carcinoid tumor by histologic and immunohistochemical analysis.
  • Further investigation revealed the presence of a midgut carcinoid tumor located within the terminal ileum, which was also resected surgically.
  • The patient recovered well after surgery and adjunctive chemotherapy.
  • To our knowledge, this is the first report of comprehensive nuclear and echocardiographic imaging, supplemented by surgical and pathologic findings, in an asymptomatic patient with isolated myocardial metastasis of an ileal carcinoid tumor.
  • [MeSH-major] Carcinoid Tumor / secondary. Heart Neoplasms / complications. Heart Neoplasms / secondary. Ileal Neoplasms / pathology. Ventricular Dysfunction, Right / etiology

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  • [ErratumIn] Mayo Clin Proc 2002 Dec;77(12):1396. Ahsanudin Arshad N [corrected to Ahsanuddin Arshad N]
  • (PMID = 12059131.001).
  • [ISSN] 0025-6196
  • [Journal-full-title] Mayo Clinic proceedings
  • [ISO-abbreviation] Mayo Clin. Proc.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
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21. Sywak MS, Pasieka JL, McEwan A, Kline G, Rorstad O: 131I-meta-iodobenzylguanidine in the management of metastatic midgut carcinoid tumors. World J Surg; 2004 Nov;28(11):1157-62
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  • [Title] 131I-meta-iodobenzylguanidine in the management of metastatic midgut carcinoid tumors.
  • The management of metastatic neuroendocrine tumors incorporates multimodal therapy with surgery, biotherapy, and chemotherapy.
  • Tumor-targeted therapies using radiolabeled octreotide and metaiodobenzylguanidine (mIBG) represent a novel treatment approach.
  • The aim of this study was to evaluate the effectiveness of 131I-mIBG in the treatment of metastatic midgut carcinoid tumors. survival outcomes were assessed for patients treated at two regional cancer centers and then compared.
  • One center used 131I-mIBG routinely in the management of metastatic carcinoid tumors (center A), and the other did not use this modality (center B).
  • Only patients with histologically proven metastatic carcinoid tumor shown, or thought most likely, to be of midgut origin were included in the study.
  • During the period 1980 to 2002, a series of 58 patients from center A with metastatic carcinoid tumor arising from the midgut underwent multimodality therapy with the addition of 131I-mIBG.
  • The median dose of 131I-mIBG administered was 6751 MBq, and there was an average of 2.8 treatments per patient.
  • During the same period, 58 patients with metastatic carcinoid were treated at center B with similar multimodality therapy without the use of 131I-mIBG therapy.
  • Although retrospective in nature, this study suggests that the addition of 131I-mIBG therapy to the treatment protocol of patients with metastatic midgut carcinoid tumors prolongs survival.
  • [MeSH-major] 3-Iodobenzylguanidine / therapeutic use. Antineoplastic Agents / therapeutic use. Carcinoid Tumor / drug therapy. Intestinal Neoplasms / drug therapy
  • [MeSH-minor] Aged. Combined Modality Therapy. Female. Humans. Ileal Neoplasms / drug therapy. Ileal Neoplasms / pathology. Jejunal Neoplasms / drug therapy. Jejunal Neoplasms / pathology. Liver Neoplasms / secondary. Lymphatic Metastasis. Male. Middle Aged. Peritoneal Neoplasms / secondary. Retrospective Studies. Survival Analysis

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  • (PMID = 15490060.001).
  • [ISSN] 0364-2313
  • [Journal-full-title] World journal of surgery
  • [ISO-abbreviation] World J Surg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 35MRW7B4AD / 3-Iodobenzylguanidine
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