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1. Appetecchia M, Baldelli R: Somatostatin analogues in the treatment of gastroenteropancreatic neuroendocrine tumours, current aspects and new perspectives. J Exp Clin Cancer Res; 2010;29:19
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  • [Title] Somatostatin analogues in the treatment of gastroenteropancreatic neuroendocrine tumours, current aspects and new perspectives.
  • Gastroenteropancreatic neuroendocrine tumours (GEP NETs) are rare tumours that present many clinical features.They secrete peptides and neuroamines that cause distinct clinical syndromes, including carcinoid syndrome.
  • However, many are clinically silent until late presentation with mass effects.In 2000 the WHO developed a new classification which gives a better description of the characteristics and biological behaviour of the tumour.Surgical resection is the treatment of first choice for a patient with a GEP NET.
  • In metastatic disease multiple therapeutic approaches are possible.
  • In these cases the goal is to improve quality of life and to extent survival.GEP NETs express somatostatin receptors (SSTRs), which are bound by somatostatin (SST) or its synthetic analogues, although the subtypes and number of SSTRs expressed is very variable.Somatostatin analogues are used frequently to control hormone-related symptoms while their anti-neoplastic activity, even if it has not been widely studied and the regarding data are discordant, seems to result prevalently in tumour stabilisation.A few patients who fail to respond or cease to respond to standard SST analogues treatment seem to have a response to higher doses of these drugs.The use of higher doses of somatostatin analogues or the development of new subtype selective agonists and chimaeric somatostatin analogues, or pan-somatostatin will probably improve the clinical management of these patients.This review provides an update on the use of somatostatin analogues in the management of GEP NETs and discusses novel clinical strategies based on SSTR 2 gene transfer therapy.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Gastrointestinal Neoplasms / drug therapy. Neuroendocrine Tumors / drug therapy. Pancreatic Neoplasms / drug therapy. Somatostatin / analogs & derivatives. Somatostatin / therapeutic use
  • [MeSH-minor] Animals. Genetic Therapy. Humans. Interferons / administration & dosage. Receptors, Somatostatin / genetics

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  • (PMID = 20196864.001).
  • [ISSN] 1756-9966
  • [Journal-full-title] Journal of experimental & clinical cancer research : CR
  • [ISO-abbreviation] J. Exp. Clin. Cancer Res.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Receptors, Somatostatin; 0 / somatostatin receptor 2; 51110-01-1 / Somatostatin; 9008-11-1 / Interferons
  • [Number-of-references] 114
  • [Other-IDs] NLM/ PMC2845555
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2. Kwekkeboom DJ, Bakker WH, Kam BL, Teunissen JJ, Kooij PP, de Herder WW, Feelders RA, van Eijck CH, de Jong M, Srinivasan A, Erion JL, Krenning EP: Treatment of patients with gastro-entero-pancreatic (GEP) tumours with the novel radiolabelled somatostatin analogue [177Lu-DOTA(0),Tyr3]octreotate. Eur J Nucl Med Mol Imaging; 2003 Mar;30(3):417-22
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  • [Title] Treatment of patients with gastro-entero-pancreatic (GEP) tumours with the novel radiolabelled somatostatin analogue [177Lu-DOTA(0),Tyr3]octreotate.
  • Medical treatment and chemotherapy are seldom successful in achieving objective tumour reduction in patients with metastatic neuroendocrine tumours.
  • Treatment with the radiolabelled somatostatin analogue [(90)Y-DOTA(0),Tyr(3)]octreotide may result in partial remissions in 10-25% of patients.
  • Also, labelled with the beta- and gamma-emitting radionuclide (177)Lu, it has proved very successful in achieving tumour regression in animal models.
  • The effects of (177)Lu-octreotate therapy were studied in 35 patients with neuroendocrine gastro-entero-pancreatic (GEP) tumours who underwent follow-up for 3-6 months after receiving their final dose.
  • Patients were treated with doses of 100, 150 or 200 mCi (177)Lu-octreotate, to a final cumulative dose of 600-800 mCi, with treatment intervals of 6-9 weeks.
  • The effects of the therapy on tumour size were evaluable in 34 patients.
  • Three months after the final administration, complete remission was found in one patient (3%), partial remission in 12 (35%), stable disease in 14 (41%) and progressive disease in seven (21%), including three patients who died during the treatment period.
  • Tumour response was positively correlated with a high uptake on the octreoscan, limited hepatic tumour mass and a high Karnofsky Performance Score.
  • Because of the limited efficacy of alternative therapies, many physicians currently adopt an expectant attitude when dealing with patients with metastatic GEP tumours.
  • However, in view of the high success rate of therapy with (177)Lu-octreotate and the absence of serious side-effects, we advocate its use in patients with GEP tumours without waiting for tumour progression.
  • [MeSH-major] Gastrointestinal Neoplasms / radiotherapy. Gastrointestinal Neoplasms / secondary. Neuroendocrine Tumors / radiotherapy. Neuroendocrine Tumors / secondary. Organometallic Compounds / therapeutic use. Pancreatic Neoplasms / radiotherapy. Pancreatic Neoplasms / secondary
  • [MeSH-minor] Abdominal Pain / etiology. Adult. Aged. Alopecia / etiology. Female. Humans. Male. Middle Aged. Nausea / etiology. Octreotide / analogs & derivatives. Radiopharmaceuticals / adverse effects. Radiopharmaceuticals / therapeutic use. Treatment Outcome. Vomiting / etiology

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  • (PMID = 12634971.001).
  • [ISSN] 1619-7070
  • [Journal-full-title] European journal of nuclear medicine and molecular imaging
  • [ISO-abbreviation] Eur. J. Nucl. Med. Mol. Imaging
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / (177lutetium-DOTA(O)Tyr3)octreotate; 0 / Organometallic Compounds; 0 / Radiopharmaceuticals; RWM8CCW8GP / Octreotide
  • [Other-IDs] NLM/ PMC1998890
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3. de Herder WW, Krenning EP, Van Eijck CH, Lamberts SW: Considerations concerning a tailored, individualized therapeutic management of patients with (neuro)endocrine tumours of the gastrointestinal tract and pancreas. Endocr Relat Cancer; 2004 Mar;11(1):19-34
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  • [Title] Considerations concerning a tailored, individualized therapeutic management of patients with (neuro)endocrine tumours of the gastrointestinal tract and pancreas.
  • Endocrine tumours of the gastrointestinal tract and pancreas may present at different disease stages with either hormonal or hormone-related symptoms/syndromes, or without hormonal symptoms.
  • In the therapeutic approach to a patient with these tumours, excessive hormonal secretion and/or its effects should always be controlled first.
  • Tumour-related deficiencies or disorders should also be corrected.
  • Subsequently, control should be aimed at the tumour growth.
  • Surgery is generally considered as first-line therapy for patients with localized disease, as it can be curative.
  • However, in patients with metastatic disease the role of first-line surgery is not clearly established and other therapies should be considered, such as non-surgical cytoreductive therapies, biotherapy (with somatostatin analogues or interferon-alpha), embolization and chemoembolization of liver metastases, chemotherapy (with single or multiple dose regimens) and peptide receptor-targeted radiotherapy.
  • The delicate balance of the use of the different therapeutical options in patients with endocrine tumours of the gastrointestinal tract and pancreas emphasizes the importance of team approach and team expertise.
  • [MeSH-major] Gastrointestinal Neoplasms / therapy. Neuroendocrine Tumors / therapy. Pancreatic Neoplasms / therapy
  • [MeSH-minor] Gastrinoma / radiotherapy. Humans. Peptides, Cyclic / therapeutic use

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  • (PMID = 15027883.001).
  • [ISSN] 1351-0088
  • [Journal-full-title] Endocrine-related cancer
  • [ISO-abbreviation] Endocr. Relat. Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Peptides, Cyclic; 0 / octreotate, Tyr(3)-
  • [Number-of-references] 177
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4. Alexandrescu DT, O'Boyle K, Feliz A, Fueg A, Wiernik PH: Metastatic solid-pseudopapillary tumour of the pancreas: clinico-biological correlates and management. Clin Oncol (R Coll Radiol); 2005 Aug;17(5):358-63
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  • [Title] Metastatic solid-pseudopapillary tumour of the pancreas: clinico-biological correlates and management.
  • Solid-pseudopapillary tumour of the pancreas is a rare neoplasm of young women, currently categorised in the World Health Organization classification under exocrine pancreatic tumours.
  • We describe two patients with solid-pseudopapillary tumour of the pancreas.
  • A smaller, localised tumour in an unusually young white man was surgically excised with no evidence of recurrence after 2 years.
  • A literature review was carried out, and the main clinico-pathological features and strategies of treatment of solid-pseudopapillary tumour of the pancreas are presented.
  • Pathological, genetic and molecular features distinguish solid-pseudopapillary tumours from pancreatic ductal adenocarcinoma.
  • Furthermore, neuroendocrine differentiation can be found focally in occasional cases of solid-pseudopapillary tumour.
  • Chemotherapy and radiation therapy are used in rare cases when resection is not possible.
  • No current chemotherapy regimens are considered standard in the treatment of this tumour.
  • A rational chemotherapy protocol for such a rare tumour needs to consider its origin and clinical behaviour.
  • However, the indolent clinical progression of solid-pseudopapillary tumours is similar to that of pancreatic neuroendocrine tumour.
  • [MeSH-major] Carcinoma, Papillary / surgery. Pancreatic Neoplasms / surgery
  • [MeSH-minor] Adult. Female. Humans. Male. Middle Aged. Neoplasm Metastasis. Tomography, X-Ray Computed. Treatment Outcome

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  • (PMID = 16097567.001).
  • [ISSN] 0936-6555
  • [Journal-full-title] Clinical oncology (Royal College of Radiologists (Great Britain))
  • [ISO-abbreviation] Clin Oncol (R Coll Radiol)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
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5. Bajetta E, Ferrari L, Procopio G, Catena L, Ferrario E, Martinetti A, Di Bartolomeo M, Buzzoni R, Celio L, Vitali M, Beretta E, Seregni E, Bombardieri E: Efficacy of a chemotherapy combination for the treatment of metastatic neuroendocrine tumours. Ann Oncol; 2002 Apr;13(4):614-21
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  • [Title] Efficacy of a chemotherapy combination for the treatment of metastatic neuroendocrine tumours.
  • OBJECTIVES: Neuroendocrine tumours (NETs) are heterogeneous neoplasms for which there is no standard treatment.
  • PATIENTS AND METHODS: Eighty-two consecutive patients entered the study, of whom 21 had inoperable, locally advanced disease and 61 had metastatic disease.
  • Response rate, time to progression (TTP) and overall survival (OS) were evaluated based on histotype.
  • The median duration of treatment was 4 months and the objective responses had a median duration of 38 months.
  • The new WHO endocrine tumour histotyping, examining also the tumour biology, may give additional information for selecting patients to chemotherapy.

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  • (PMID = 12056713.001).
  • [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; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 3Z8479ZZ5X / Epirubicin; 7GR28W0FJI / Dacarbazine; U3P01618RT / Fluorouracil
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6. Scholz A, Wagner K, Welzel M, Remlinger F, Wiedenmann B, Siemeister G, Rosewicz S, Detjen KM: The oral multitarget tumour growth inhibitor, ZK 304709, inhibits growth of pancreatic neuroendocrine tumours in an orthotopic mouse model. Gut; 2009 Feb;58(2):261-70
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  • [Title] The oral multitarget tumour growth inhibitor, ZK 304709, inhibits growth of pancreatic neuroendocrine tumours in an orthotopic mouse model.
  • BACKGROUND AND AIMS: Current systemic therapies for neuroendocrine tumours (NETs) do not provide sufficient control of tumour growth.
  • However, efficient evaluation of novel drugs is hindered by the lack of a suitable preclinical animal model.
  • Here an orthotopic mouse model of pancreatic NET is established and used to study the action of ZK 304709, a first in class, oral multitarget tumour growth inhibitor.
  • ZK 304709 is an inhibitor of cyclin-dependent kinases (Cdks) 1, 2, 4, 7 and 9, vascular endothelial growth factor receptor-type kinases (VEGF-RTKs) 1-3 and platelet-derived growth factor receptor-type kinase beta (PDGF-RTKss).
  • For induction of orthotopic NETs, BON cells were injected into the pancreas of NMRI(nu/nu) mice.
  • Primary tumour growth and metastatic spread were recorded after 9 weeks, and apoptosis, microvessel density and lymphatic vessel density were determined.
  • Apoptosis similarly occurred in vivo in ZK 304709-treated orthotopic BON tumours, resulting in a 80% reduction of primary tumour growth.
  • In contrast, treatment with lanreotide or 5-fluorouracil and streptozotocin failed to inhibit tumour gowth.
  • ZK 304709 also reduced tumour microvessel density, implicating antiangiogenic mechanisms.
  • CONCLUSION: BON orthotopic tumours provide an informative model for preclinical drug evaluation in NETs.
  • In this model, ZK 304709 achieved efficacious tumour growth control via induction of apoptosis and inhibition of tumour-induced angiogenesis.
  • [MeSH-major] Angiogenesis Inhibitors / therapeutic use. Neuroendocrine Tumors / drug therapy. Pancreatic Neoplasms / drug therapy
  • [MeSH-minor] Animals. Apoptosis / drug effects. Biomarkers / analysis. Cell Nucleus / chemistry. Dose-Response Relationship, Drug. Female. Flow Cytometry. Fluorescent Antibody Technique. Histocytochemistry. Humans. Hypoxia-Inducible Factor 1, alpha Subunit / analysis. Inhibitor of Apoptosis Proteins. Lymphatic Metastasis. Mice. Mice, Nude. Microtubule-Associated Proteins / analysis. Neovascularization, Pathologic / drug therapy. Tumor Cells, Cultured. Xenograft Model Antitumor Assays / methods

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  • [CommentIn] Gut. 2009 Feb;58(2):164-5 [19136520.001]
  • (PMID = 18829975.001).
  • [ISSN] 1468-3288
  • [Journal-full-title] Gut
  • [ISO-abbreviation] Gut
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Angiogenesis Inhibitors; 0 / BIRC5 protein, human; 0 / Biomarkers; 0 / HIF1A protein, human; 0 / Hypoxia-Inducible Factor 1, alpha Subunit; 0 / Inhibitor of Apoptosis Proteins; 0 / Microtubule-Associated Proteins
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7. Ducreux M, Baudin E, Schlumberger M: [Treatment strategy of neuroendocrine tumors]. Rev Prat; 2002 Feb 1;52(3):290-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Treatment strategy of neuroendocrine tumors].
  • [Transliterated title] Stratégie de traitement des tumeurs neuro-endocrines.
  • Therapeutic strategy of neuroendocrine tumours is complex, due to their heterogeneity and to the fact that although generally slow growing, a significant proportion demonstrates aggressive tumour growth.
  • Symptomatic carcinoid syndrome and various pancreatic endocrine tumours with symptomatic syndromes are well controlled with somatostatin analogues.
  • Surgery remains the mainstay of treatment if the tumour can be resected.
  • Metastatic pancreatic neuroendocrine tumour are treated when resection is not feasible with combination chemotherapy using adriamycin and streptozotocin, which remains a standard of care.
  • In well differentiated tumour of the gut or the lung there is no clear standard of chemotherapy and treatment vary according to the tumour course.
  • In indolent cases, somatostatin analogues are the best treatment, in case of aggressive tumours chemoembolisation should be preferred when the disease is located or predominant in the liver.
  • Poorly differentiated tumours are treated by combination chemotherapy with etoposide and cisplatin, and surgery has no indication.
  • Gastrinoma and other pancreatic tumours arising in the context of multiple endocrine neoplasia type I disease need a specific therapeutic strategy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Growth Hormone / therapeutic use. Hormones / therapeutic use. Neuroendocrine Tumors / drug therapy. Pancreatic Neoplasms / drug therapy
  • [MeSH-minor] Antibiotics, Antineoplastic / therapeutic use. Chemoembolization, Therapeutic. Doxorubicin / therapeutic use. Gastrinoma / drug therapy. Humans. Malignant Carcinoid Syndrome / drug therapy. Multiple Endocrine Neoplasia. Neoplasm Metastasis. Streptozocin / therapeutic use

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  • (PMID = 11925720.001).
  • [ISSN] 0035-2640
  • [Journal-full-title] La Revue du praticien
  • [ISO-abbreviation] Rev Prat
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Antibiotics, Antineoplastic; 0 / Hormones; 5W494URQ81 / Streptozocin; 80168379AG / Doxorubicin; 9002-72-6 / Growth Hormone
  • [Number-of-references] 23
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8. Tomassetti P, Migliori M, Campana D, Brocchi E, Piscitelli L, Salomone T, Corinaldesi R: Basis for treatment of functioning neuroendocrine tumours. Dig Liver Dis; 2004 Feb;36 Suppl 1:S35-41
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Basis for treatment of functioning neuroendocrine tumours.
  • The rarity of these types of tumours, their possible episodic expression and the variable clinical symptoms, are the reasons why patients are often diagnosed late in the advanced stages of the disease.
  • For these reasons, the patients with advanced metastatic disease should be treated aggressively with medical and surgical therapies aimed at reducing both symptoms and complications through strategies that reduce tumour bulk and block hormonal effects.
  • The medical treatment of functioning endocrine tumours of the gastrointestinal tract must be based on the growth properties of the tumour and includes chemotherapy, somatostatin analogs, alpha-interferon alone and associated with somatostatin analogs, chemoembolization and radiolabelled somatostatin analogs.
  • Even if chemotherapy has been basis of therapy for these types of tumours for a long time, it is currently reserved for progressive disease and anaplastic tumours.
  • Biotherapy, with interferon and somatostatin analogs has been demonstrated to have a significant antitumor effect and causes an improvement of symptoms in patients with functioning neuroendocrine tumours.
  • Furthermore, these drugs produce a notable improvement in the quality of life.
  • Radioactive targeting therapy is the most promising new treatment modality for patients who have SST receptor positive tumours.
  • [MeSH-major] Gastrointestinal Neoplasms / therapy. Neuroendocrine Tumors / therapy. Pancreatic Neoplasms / therapy

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  • (PMID = 15077910.001).
  • [ISSN] 1590-8658
  • [Journal-full-title] Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
  • [ISO-abbreviation] Dig Liver Dis
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Netherlands
  • [Number-of-references] 73
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9. Toumpanakis C, Meyer T, Caplin ME: Cytotoxic treatment including embolization/chemoembolization for neuroendocrine tumours. Best Pract Res Clin Endocrinol Metab; 2007 Mar;21(1):131-44

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Cytotoxic treatment including embolization/chemoembolization for neuroendocrine tumours.
  • In patients with advanced neuroendocrine tumours, surgery is curative in only a minority of cases, whilst the anti-tumour effect of somatostatin analogues, despite efficient symptom control, is limited.
  • Systemic chemotherapy has been proved to be effective only in certain tumour types.
  • Although metastatic midgut carcinoids and well-differentiated gastrointestinal carcinoids are relatively insensitive to chemotherapy, pancreatic neuroendocrine tumours show a response rate of around 40% to streptozotocin-based combinations, particularly with fluorouracil and doxorubicin.
  • In patients with predominant liver disease, ischaemia of tumour lesions induced by vascular occlusion by particle embolization or chemoembolization may be considered.
  • This may have clinical and biochemical responses up to 80%, and objective responses up to 60%, in disease which is progressive despite previous treatments.
  • [MeSH-major] Chemoembolization, Therapeutic. Embolization, Therapeutic. Neuroendocrine Tumors / therapy
  • [MeSH-minor] Antineoplastic Agents / administration & dosage. Antineoplastic Agents / adverse effects. Antineoplastic Agents / contraindications. Humans. Treatment Outcome

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  • (PMID = 17382269.001).
  • [ISSN] 1521-690X
  • [Journal-full-title] Best practice & research. Clinical endocrinology & metabolism
  • [ISO-abbreviation] Best Pract. Res. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 61
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10. Hansen CP, Knigge U: [Biotherapy of neuroendocrine tumours of the gastrointestinal tract and pancreas]. Ugeskr Laeger; 2008 Jun 9;170(24):2145-8
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  • [Title] [Biotherapy of neuroendocrine tumours of the gastrointestinal tract and pancreas].
  • [Transliterated title] Biologisk behandling af neuroendokrine tumorer i mave-tarm-kanalen.
  • Biotherapy of hormonal symptoms and tumour growth is a mainstay in the therapy of metastatic neuroendocrine tumours of the gastrointestinal tract and pancreas.
  • The effect on tumour growth is less convincing although a stabilization of disease is recorded in almost 50% of patients.
  • Interferon treatment should mainly be considered for tumours with a low proliferation index.
  • [MeSH-major] Antineoplastic Agents, Hormonal / therapeutic use. Gastrointestinal Agents / therapeutic use. Gastrointestinal Neoplasms / drug therapy. Immunologic Factors / therapeutic use. Neuroendocrine Tumors / drug therapy. Pancreatic Neoplasms / drug therapy
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / adverse effects. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Humans. Interferon-alpha / adverse effects. Interferon-alpha / therapeutic use. Octreotide / adverse effects. Octreotide / therapeutic use. Peptides, Cyclic / adverse effects. Peptides, Cyclic / therapeutic use. Somatostatin / adverse effects. Somatostatin / analogs & derivatives. Somatostatin / therapeutic use. Treatment Outcome

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  • (PMID = 18565299.001).
  • [ISSN] 1603-6824
  • [Journal-full-title] Ugeskrift for laeger
  • [ISO-abbreviation] Ugeskr. Laeg.
  • [Language] dan
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Denmark
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Gastrointestinal Agents; 0 / Immunologic Factors; 0 / Interferon-alpha; 0 / Peptides, Cyclic; 118992-92-0 / lanreotide; 51110-01-1 / Somatostatin; RWM8CCW8GP / Octreotide
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11. Schott M, Feldkamp J, Lettmann M, Simon D, Scherbaum WA, Seissler J: Dendritic cell immunotherapy in a neuroendocrine pancreas carcinoma. Clin Endocrinol (Oxf); 2001 Aug;55(2):271-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Dendritic cell immunotherapy in a neuroendocrine pancreas carcinoma.
  • OBJECTIVE: Metastatic neuroendocrine carcinomas of the pancreas frequently fail to respond to conventional therapies, including radiation and chemotherapy.
  • We therefore tested a dendritic cell-based immunotherapy in an attempt to eradicate residual tumour masses in a patient suffering from a metastatic insulin-producing pancreatic carcinoma.
  • DESIGN: Autologous dendritic cells (DCs) were generated from peripheral blood monocytes in the presence of granulocyte/macrophage colony-stimulating factor, interleukin-4 and tumour necrosis factor alpha.
  • DCs were loaded with tumour-derived lysate (TL), and were delivered by subcutaneous injections in 4-week intervals.
  • RESULTS: Three weeks after first treatment, the patient developed a strong delayed-type hypersensitivity (DTH) skin reaction with an erythema and induration after the challenge with TL-pulsed DCs, which indicates the efficient generation of antigen-specific memory T-cells.
  • Most strikingly, DC-based vaccination was accompanied by a steady decrease of the tumour marker chromogranin A from 2.93 umol/l initially to below the detection limit of 0.15 umol/l within 9 months of therapy.
  • The ultrasound examination revealed a tumour regression of the metastasis in the right lobe of the liver.
  • CONCLUSIONS: Our data indicate that vaccination with tumour lysate-pulsed DCs induced a significant antitumour immune response in a neuroendocrine carcinoma of the pancreas.
  • This approach represents an alternative strategy for the treatment of advanced neuroendocrine carcinomas that are resistant to conventional therapy.
  • [MeSH-major] Dendritic Cells / immunology. Immunotherapy / methods. Neuroendocrine Tumors / therapy. Pancreatic Neoplasms / therapy
  • [MeSH-minor] Adult. Biomarkers, Tumor / blood. Cell Division. Chromogranin A. Chromogranins / blood. Dose-Response Relationship, Drug. Humans. Hypersensitivity, Delayed / etiology. Liver Neoplasms / immunology. Liver Neoplasms / secondary. Liver Neoplasms / therapy. Male. Pulse Therapy, Drug. T-Lymphocytes / drug effects. Treatment Outcome

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  • (PMID = 11531937.001).
  • [ISSN] 0300-0664
  • [Journal-full-title] Clinical endocrinology
  • [ISO-abbreviation] Clin. Endocrinol. (Oxf)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Chromogranin A; 0 / Chromogranins
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12. Bodelier AG, Haak HR: [Gastroenteropancreatic neuroendocrine tumours (carcinoid tumours): definition, clinical aspects, diagnosis and therapy]. Ned Tijdschr Geneeskd; 2006 Aug 26;150(34):1868-72
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  • [Title] [Gastroenteropancreatic neuroendocrine tumours (carcinoid tumours): definition, clinical aspects, diagnosis and therapy].
  • [Transliterated title] Gastro-enteropancreatische neuro-endocriene tumoren (carcinoïde tumoren): definitie, kliniek, diagnostiek en therapie.
  • Carcinoid tumours are rare neuroendocrine tumours.
  • In 2000 the WHO developed a new classification which gives a better description of the characteristics and biological behaviour of the tumour.
  • Their advised designation is gastroenteropancreatic neuroendocrine tumour (GEP-NET).
  • In the recent past years new positron emission tomography (PET) tracers have been developed and PET scanning is likely to become an important tool in the near future.
  • Surgical resection is the treatment of first choice for a patient with a GEP-NET.
  • In metastatic disease a number of forms ofpalliative treatment are possible.
  • Cytotoxic chemotherapy seems only to be effective in aggressive, poorly-differentiated tumours.
  • Therapy with somatostatin analogues leads to objective tumour regression in a minority of patients only.
  • New advances in peptide receptor radionuclide therapy using radioactive-labelled somatostatin analoga are showing better results.
  • [MeSH-major] Carcinoid Tumor / diagnosis. Gastrointestinal Neoplasms / diagnosis. Pancreatic Neoplasms / diagnosis
  • [MeSH-minor] Humans. Positron-Emission Tomography / methods. Somatostatin / analogs & derivatives. Somatostatin / therapeutic use

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  • [CommentIn] Ned Tijdschr Geneeskd. 2006 Oct 28;150(43):2401; author reply 2401 [17100134.001]
  • [CommentIn] Ned Tijdschr Geneeskd. 2006 Oct 28;150(43):2401-3; author reply 2403 [17103497.001]
  • (PMID = 16970007.001).
  • [ISSN] 0028-2162
  • [Journal-full-title] Nederlands tijdschrift voor geneeskunde
  • [ISO-abbreviation] Ned Tijdschr Geneeskd
  • [Language] dut
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 51110-01-1 / Somatostatin
  • [Number-of-references] 35
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13. Arnold R, Simon B, Wied M: Treatment of neuroendocrine GEP tumours with somatostatin analogues: a review. Digestion; 2000;62 Suppl 1:84-91
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Treatment of neuroendocrine GEP tumours with somatostatin analogues: a review.
  • BACKGROUND: Somatostatin and its long-acting analogues are effective in symptom control in patients with functionally active neuroendocrine GEP tumours.
  • Several in vitro and in vivo reports suggest that they are also able to control tumour growth.
  • METHODS: Critical review of published data on the effect of long-acting somatostatin analogues on symptom and growth control in patients with metastatic neuroendocrine GEP tumours.
  • RESULTS: With the exception of insulinoma and gastrinoma, octreotide acetate and other long-acting somatostatin formulations are currently the therapeutic principle of first choice to control hormone-mediated symptoms.
  • Available data on growth control indicate that stabilization of tumour growth seems to be the most beneficial antiproliferative effect occurring in up to 50% of patients.
  • However, it is unknown which tumour entity responds best to long- acting somatostatin analogues.
  • CONCLUSION: Additional studies in patients with known spontaneous tumour growth and avoiding a mix-up of different entities of neuroendocrine malignancies are necessary to identify subpopulations of neuroendocrine tumours which respond to long-acting somatostatin analogues in terms of longer lasting growth inhibition.
  • [MeSH-major] Antineoplastic Agents, Hormonal / therapeutic use. Gastrointestinal Neoplasms / drug therapy. Neuroendocrine Tumors / drug therapy. Octreotide / therapeutic use. Pancreatic Neoplasms / drug therapy. Peptides, Cyclic / therapeutic use. Somatostatin / analogs & derivatives
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Humans. Interferon-alpha / therapeutic use. Syndrome

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  • [Copyright] Copyright 2000 S. Karger AG, Basel
  • (PMID = 10940693.001).
  • [ISSN] 0012-2823
  • [Journal-full-title] Digestion
  • [ISO-abbreviation] Digestion
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Antineoplastic Agents, Hormonal; 0 / Interferon-alpha; 0 / Peptides, Cyclic; 0G3DE8943Y / lanreotide; 51110-01-1 / Somatostatin; RWM8CCW8GP / Octreotide
  • [Number-of-references] 53
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14. O'Toole D, Hentic O, Corcos O, Ruszniewski P: Chemotherapy for gastro-enteropancreatic endocrine tumours. Neuroendocrinology; 2004;80 Suppl 1:79-84
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Chemotherapy for gastro-enteropancreatic endocrine tumours.
  • Despite similar histological and morphological aspects, gastro-enteropancreatic (GEP) endocrine tumours represent a heterogeneous group of tumours with varying clinical expression depending on tumour type (functional or not), origin and extension, but also on histological differentiation and proliferative capacity.
  • The natural history of well-differentiated tumours is often favourable without treatment and GEP endocrine tumours may remain indolent for many years.
  • Chemotherapy may however be indicated in the presence of symptomatic non-progressive disease (progression evaluated over 3-6 months).
  • In contrast, poorly differentiated GEP endocrine tumours are frequently aggressive and early treatment is required.
  • Accurate staging is mandatory and where surgery is possible (even in the event of limited metastatic disease), this option should be re-evaluated in a multidisciplinary approach.
  • Approximately 2/3 of malignant GEP tumours are metastatic at discovery and surgery is possible in a minority of patients; therefore, chemotherapy, with/without other strategies (e.g. local ablation), is frequently indicated in patients with symptomatic, bulky or progressive disease.
  • For well-differentiated pancreatic tumours, the reference association is Adriamycin with streptozotocin yielding objective responses (OR) in 40-60% of patients.
  • Prolonged treatment is limited due to potential cardiotoxicity of Adriamycin and standard 2nd-line regimens are not of proven efficacy; thus, other treatment modalities are usually additionally required (e.g. chemo-embolisation).
  • Published series evaluating chemotherapy for midgut endocrine tumours are outdated and disappointing.
  • Chemotherapy, using cisplatin and etoposide, is the reference treatment and frequently yields OR rates >50%.
  • Overall, advances in therapeutic chemotherapeutic options are required in the management of all types of advanced GEP endocrine tumours and evaluation of new drugs (e.g. irinotecan) and combination strategies (chemotherapy with local ablative therapies) are required in the future.
  • [MeSH-major] Gastrointestinal Neoplasms / therapy. Neuroendocrine Tumors / therapy. Pancreatic Neoplasms / therapy
  • [MeSH-minor] Chemoembolization, Therapeutic / methods. Humans. Liver Neoplasms / secondary. Liver Neoplasms / therapy

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  • (PMID = 15477723.001).
  • [ISSN] 0028-3835
  • [Journal-full-title] Neuroendocrinology
  • [ISO-abbreviation] Neuroendocrinology
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Switzerland
  • [Number-of-references] 37
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15. Pistevou-Gombaki K, Eleftheriadis N, Plataniotis GA, Sofroniadis I, Kouloulias VE: Octreotide for palliative treatment of hepatic metastases from non-neuroendocrine primary tumours: evaluation of quality of life using the EORTC QLQ-C30 questionnaire. Palliat Med; 2003 Apr;17(3):257-62
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Octreotide for palliative treatment of hepatic metastases from non-neuroendocrine primary tumours: evaluation of quality of life using the EORTC QLQ-C30 questionnaire.
  • BACKGROUND AND AIM: While octreotide has been used in palliative treatment of hepatocellular carcinoma and neuroendocrine tumours with good results, little is known about the possible role of this in palliative treatment of hepatic metastases.
  • MATERIAL AND METHODS: We present our experience from the use of octreotide in palliative treatment of symptomatic liver metastases in 16 patients (11 males, five females, age ranged 43-69 years) with proven hepatic metastases from different primary tumours (six with non-small lung cancer, four with colon carcinoma, two with primary pancreatic head carcinoma, two with prostate cancer and two with adenocarcinoma of the stomach).
  • All patients were administered 20 mg long-acting octreotide IM (octreotide LAR) once the first day, octreotide SC 0.5 mg three times daily on days 2-14 and then 20 mg long-acting octreotide IM every month.
  • Quality of life was assessed by using the European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire (QLQ-C30).
  • Tumour response was evaluated by using ultrasonography.
  • Two patients died two months after the initiation of the study due to generalized metastatic disease, while the remaining 14 patients were still alive seven months after the initiation of the study.
  • CONCLUSIONS: Although further studies are warranted, we consider the use of octreotide a good alternative in palliative treatment of symptomatic liver metastases in patients with end-stage malignant disease.
  • [MeSH-major] Antineoplastic Agents, Hormonal / therapeutic use. Liver Neoplasms / drug therapy. Octreotide / therapeutic use. Pain / drug therapy. Palliative Care. Quality of Life. Surveys and Questionnaires
  • [MeSH-minor] Adult. Aged. Drug Administration Schedule. Female. Humans. Male. Middle Aged. Statistics, Nonparametric

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  • (PMID = 12725479.001).
  • [ISSN] 0269-2163
  • [Journal-full-title] Palliative medicine
  • [ISO-abbreviation] Palliat Med
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; RWM8CCW8GP / Octreotide
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16. Gur C, Lalazar G, Salmon A, Dubiner V, Gross DJ: Metastatic pancreatic neuroendocrine tumor presenting as a pituitary space occupying lesion: a case report. Pituitary; 2008;11(3):293-7
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  • [Title] Metastatic pancreatic neuroendocrine tumor presenting as a pituitary space occupying lesion: a case report.
  • Neuroendocrine tumor metastases to the pituitary gland are very rare.
  • There are few case reports of carcinoid tumor metastases to the pituitary, but no cases of pancreatic neuroendocrine pituitary metastases have been reported.
  • However a histological (trans-sphenoidal and liver biopsies) and systemic investigation proved it to be a metastasis of an undiagnosed pancreatic neuroendocrine tumor.
  • Our patient was unique in respect to the location of the metastasis and the uncharacteristically high proliferative index of her tumor.
  • She received conventional therapy consisting of Sandostatin, chemotherapy and radiotherapy as well as labeled somatostatin following an avid uptake on octreotide scanning.
  • [MeSH-major] Neuroendocrine Tumors / secondary. Pancreatic Neoplasms / pathology. Pituitary Neoplasms / secondary
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chemotherapy, Adjuvant. Fatal Outcome. Female. Humans. Middle Aged. Radiotherapy, Adjuvant. Tomography, Emission-Computed, Single-Photon

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  • (PMID = 17638085.001).
  • [ISSN] 1386-341X
  • [Journal-full-title] Pituitary
  • [ISO-abbreviation] Pituitary
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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17. Shah T, Caplin M: Endocrine tumours of the gastrointestinal tract. Biotherapy for metastatic endocrine tumours. Best Pract Res Clin Gastroenterol; 2005 Aug;19(4):617-36
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Endocrine tumours of the gastrointestinal tract. Biotherapy for metastatic endocrine tumours.
  • Somatostatin analogues have been the mainstay of symptomatic management of patients with neuroendocrine tumours (NETs) for two decades with the main mechanism of action being inhibition of peptide release.
  • Treatment can also provide disease stabilisation in a proportion of patients.
  • In a minority of patients treatment may lead to partial response.
  • [MeSH-major] Carcinoma, Neuroendocrine / drug therapy. Carcinoma, Neuroendocrine / secondary. Gastrointestinal Neoplasms / drug therapy. Gastrointestinal Neoplasms / pathology. Pancreatic Neoplasms / drug therapy. Pancreatic Neoplasms / pathology. Somatostatin / analogs & derivatives
  • [MeSH-minor] Antineoplastic Agents, Hormonal / administration & dosage. Antineoplastic Agents, Hormonal / adverse effects. Antineoplastic Agents, Hormonal / therapeutic use. Drug Therapy, Combination. Gastrointestinal Agents / administration & dosage. Gastrointestinal Agents / therapeutic use. Gels. Humans. Interferon-alpha / therapeutic use. Octreotide / administration & dosage. Octreotide / adverse effects. Octreotide / therapeutic use. Peptides, Cyclic / administration & dosage. Peptides, Cyclic / therapeutic use. Quality of Life

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  • (PMID = 16183531.001).
  • [ISSN] 1521-6918
  • [Journal-full-title] Best practice & research. Clinical gastroenterology
  • [ISO-abbreviation] Best Pract Res Clin Gastroenterol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Gastrointestinal Agents; 0 / Gels; 0 / Interferon-alpha; 0 / Peptides, Cyclic; 118992-92-0 / lanreotide; 51110-01-1 / Somatostatin; RWM8CCW8GP / Octreotide
  • [Number-of-references] 96
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18. Hubalewska-Dydejczyk A, Szybiński P, Fröss-Baron K, Mikolajczak R, Huszno B, Sowa-Staszczak A: (99m)Tc-EDDA/HYNIC-octreotate - a new radiotracer for detection and staging of NET: a case of metastatic duodenal carcinoid. Nucl Med Rev Cent East Eur; 2005;8(2):155-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] (99m)Tc-EDDA/HYNIC-octreotate - a new radiotracer for detection and staging of NET: a case of metastatic duodenal carcinoid.
  • Somatostatin receptor scintigraphy (SRS) has become a routine imaging method for the diagnostics of neuroendocrine tumours (NET). (99m)Tc-EDDA/HYNIC-octreotate (Polatom, Poland) is a new radiotracer with high affinity for SSTR2 and similar physiological biodistribution to (111)In-Octreoscan.
  • The patient had been operated due to the tumour mass detected in pancreatic head area.
  • The patient was qualified for chemotherapy stopped due to severe leucopenia. (99m)Tc EDDA/HYNIC-octreotate scintigraphy was performed for staging and to determine SSTR status of the tumour before planned 90Y-DOTATATE therapy.
  • The multiple metastatic lesions were detected all over the body.
  • On the basis of SRS result the patient was qualified for 90Y-DOTA-TATE therapy.
  • [MeSH-major] Bone Neoplasms / radionuclide imaging. Bone Neoplasms / secondary. Duodenal Neoplasms / radionuclide imaging. Liver Neoplasms / radionuclide imaging. Liver Neoplasms / secondary. Neuroendocrine Tumors / radionuclide imaging. Neuroendocrine Tumors / secondary. Organotechnetium Compounds

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  • (PMID = 16437406.001).
  • [ISSN] 1506-9680
  • [Journal-full-title] Nuclear medicine review. Central & Eastern Europe
  • [ISO-abbreviation] Nucl Med Rev Cent East Eur
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Poland
  • [Chemical-registry-number] 0 / Organotechnetium Compounds; 0 / Radiopharmaceuticals; 0 / technetium 99m EDDA-HYNIC-Tyr(3)-octreotide
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19. Nikou GC, Marinou K, Thomakos P, Papageorgiou D, Sanzanidis V, Nikolaou P, Kosmidis C, Moulakakis A, Mallas E: Chromogranin a levels in diagnosis, treatment and follow-up of 42 patients with non-functioning pancreatic endocrine tumours. Pancreatology; 2008;8(4-5):510-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Chromogranin a levels in diagnosis, treatment and follow-up of 42 patients with non-functioning pancreatic endocrine tumours.
  • BACKGROUND/AIMS: Non-functioning pancreatic endocrine tumours (NFPET) constitute the largest component (35-50%) of pancreatic endocrine tumours.
  • They are characterized by the absence of symptoms of hormone hypersecretion and frequently have clinical manifestations similar to the more common exocrine pancreatic adenocarcinoma.
  • The present studyaims toevaluate the clinical features, diagnostic approach and, in particular, the significance of serum chromogranin A levels (CgA) in the management and outcome of 42 patients with NFPET (from a series of 121 patients with pancreatic endocrine tumours).
  • At diagnosis, all patients were checked for the presence of multiple endocrine neoplasia type I syndrome.
  • RESULTS: Dyspepsia (66.5%) and weight loss (47.6%) were the most common symptoms at diagnosis, while in 21.4% of patients tumour lesions were revealed incidentally.
  • The levels also reflected tumour progression or response to treatment during the follow-up period.
  • Moreover, in 2 patients OctreoScan revealed unexpected metastatic mesenteric deposits, which had not been found by the other studies.
  • CONCLUSIONS:. (1) NFPET may present with clinical manifestations similar to those of an exocrine pancreatic tumour;.
  • (2) plasma CgA levels reflect tumour load, and also seem to correlate with tumour progression or response to treatment;.
  • (3) surgeryin patients with localized disease at presentation can be curative, while it can also reduce tumour burden in patients with metastases;.
  • (5) systemic chemotherapy or chemoembolization seem to be beneficial in high-grade and progressive tumours.
  • [MeSH-major] Biomarkers, Tumor / blood. Chemoembolization, Therapeutic. Chromogranin A / blood. Multiple Endocrine Neoplasia Type 1 / blood. Neuroendocrine Tumors / blood. Pancreatic Neoplasms / blood

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  • [Copyright] Copyright 2008 S. Karger AG, Basel.
  • (PMID = 18765956.001).
  • [ISSN] 1424-3911
  • [Journal-full-title] Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]
  • [ISO-abbreviation] Pancreatology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Chromogranin A
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20. Lombard-Bohas C, Mitry E, O'Toole D, Louvet C, Pillon D, Cadiot G, Borson-Chazot F, Aparicio T, Ducreux M, Lecomte T, Etienne PL, Cacheux W, Legoux JL, Seitz JF, Ruszniewski P, Chayvialle JA, Rougier P, FFCD-ANGH-GERCOR: Thirteen-month registration of patients with gastroenteropancreatic endocrine tumours in France. Neuroendocrinology; 2009;89(2):217-22
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • The primary sites were the small bowel and colon (288), pancreas (211), unknown (77), stomach (33), non-digestive primary sites (24), appendix (20), rectum-anus (12), and oesophagus or cardia (3).
  • Most pancreatic tumours were non-functional (72%).
  • Metastatic disease was observed in 73.4% of cases.
  • The following treatment modalities were employed: resection of primary tumour: 66%; systemic chemotherapy: 41%; somatostatin analogues: 44 and 26% for GEP of small intestine and pancreas, respectively; interferon: 12%, and intra-arterial hepatic (chemo)embolization in 23 and 15% of GEP arising from the midgut and pancreas, respectively.
  • Despite their low prevalence, well-differentiated GEP represent a significant and heterogeneous clinical group, which warrants improved medical education, referral to expert centres at an early stage, and the design of prospective therapeutic trials.
  • [MeSH-major] Gastrointestinal Neoplasms / epidemiology. Neuroendocrine Tumors / epidemiology. Pancreatic Neoplasms / epidemiology. Registries
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Child. Female. France. Humans. Male. Middle Aged. Time Factors

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  • [Copyright] (c) 2008 S. Karger AG, Basel.
  • (PMID = 18719344.001).
  • [ISSN] 1423-0194
  • [Journal-full-title] Neuroendocrinology
  • [ISO-abbreviation] Neuroendocrinology
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study
  • [Publication-country] Switzerland
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21. Bracht LK, Wen P, Meyerhardt JA, Kulke MH, Hornick JL, Redston M, LaFrankie DC, Black PM, Kesari S, Norden A, Drappatz J: DNA repair enzyme expression and differential response to temozolomide in a patient with both glioblastoma and metastatic pancreatic neuroendocrine tumor. J Clin Oncol; 2008 Oct 10;26(29):4843-4
Hazardous Substances Data Bank. DACARBAZINE .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] DNA repair enzyme expression and differential response to temozolomide in a patient with both glioblastoma and metastatic pancreatic neuroendocrine tumor.
  • [MeSH-major] Antineoplastic Agents, Alkylating / therapeutic use. Brain Neoplasms / therapy. DNA Repair Enzymes / biosynthesis. Dacarbazine / analogs & derivatives. Glioblastoma / therapy. Liver Neoplasms / drug therapy. Neuroendocrine Tumors / drug therapy. Pancreatic Neoplasms / drug therapy
  • [MeSH-minor] Combined Modality Therapy. Disease Progression. Fatal Outcome. Humans. Male. Middle Aged. Remission Induction






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