The expanding role of somatostatin analogs in the management of neuroendocrine tumors

Edward M. Wolin

Research output: Contribution to journalReview article

47 Citations (Scopus)

Abstract

BACKGROUND: Neuroendocrine tumors (NETs) are neoplasms arising most often in the GI tract, pancreas, or lung. Diagnosis of NETs is often delayed until the disease is advanced, because of the variable and nonspecific nature of the initial symptoms. Surgical resection for cure is therefore not an option for most patients. METHODS: Somatostatin analogues represent the cornerstone of therapy for patients with NETs. This article reviews the important role that somatostatin analogues continue to play in the treatment of patients with NETs. RESULTS: Octreotide was the first somatostatin analogue to be developed; more than 30 years of data have accumulated demonstrating its efficacy and safety. Lanreotide is another somatostatin analogue in clinical use, and pasireotide is a promising somatostatin analogue in development. Newer long-acting depot formulations are now available offering once-monthly administration. Although octreotide was initially developed for symptom control, recent results indicate that it also has an antiproliferative effect, significantly increasing time to progression in patients with midgut NETs. Combinations of octreotide with other targeted therapies may further improve patient outcomes. Findings in recent studies of the combination of octreotide and the mTOR inhibitor everolimus are encouraging. The combinations of octreotide with other agents (eg, interferon-α, bevacizumab, cetuximab, AMG-706, and sunitinib) are being investigated. CONCLUSIONS: Somatostatin analogues have been used to treat the symptoms of NETs for decades and also have an antineoplastic effect, markedly prolonging progression-free survival. Somatostatin analogues are likely to remain the cornerstone of treatment for most patients with advanced NETs. Promising new combination therapies are undergoing clinical investigation.

Original languageEnglish (US)
Pages (from-to)161-168
Number of pages8
JournalGastrointestinal Cancer Research
Volume5
Issue number5
StatePublished - Sep 2012
Externally publishedYes

Fingerprint

Neuroendocrine Tumors
Somatostatin
Octreotide
Therapeutics
Antineoplastic Agents
Interferons
Disease-Free Survival
Gastrointestinal Tract
Pancreas
Safety
Lung
Neoplasms

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology

Cite this

The expanding role of somatostatin analogs in the management of neuroendocrine tumors. / Wolin, Edward M.

In: Gastrointestinal Cancer Research, Vol. 5, No. 5, 09.2012, p. 161-168.

Research output: Contribution to journalReview article

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abstract = "BACKGROUND: Neuroendocrine tumors (NETs) are neoplasms arising most often in the GI tract, pancreas, or lung. Diagnosis of NETs is often delayed until the disease is advanced, because of the variable and nonspecific nature of the initial symptoms. Surgical resection for cure is therefore not an option for most patients. METHODS: Somatostatin analogues represent the cornerstone of therapy for patients with NETs. This article reviews the important role that somatostatin analogues continue to play in the treatment of patients with NETs. RESULTS: Octreotide was the first somatostatin analogue to be developed; more than 30 years of data have accumulated demonstrating its efficacy and safety. Lanreotide is another somatostatin analogue in clinical use, and pasireotide is a promising somatostatin analogue in development. Newer long-acting depot formulations are now available offering once-monthly administration. Although octreotide was initially developed for symptom control, recent results indicate that it also has an antiproliferative effect, significantly increasing time to progression in patients with midgut NETs. Combinations of octreotide with other targeted therapies may further improve patient outcomes. Findings in recent studies of the combination of octreotide and the mTOR inhibitor everolimus are encouraging. The combinations of octreotide with other agents (eg, interferon-α, bevacizumab, cetuximab, AMG-706, and sunitinib) are being investigated. CONCLUSIONS: Somatostatin analogues have been used to treat the symptoms of NETs for decades and also have an antineoplastic effect, markedly prolonging progression-free survival. Somatostatin analogues are likely to remain the cornerstone of treatment for most patients with advanced NETs. Promising new combination therapies are undergoing clinical investigation.",
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