title: Ultra-high-dose lanreotide treatment in patients with metastatic neuroendocrine gastroenteropancreatic tumors.
abstract: BACKGROUND
  Symptomatic control and occasionally even tumor regression of functional neuroendocrine tumors (NET) of the gastroenteropancreatic (GEP) system can be achieved by somatostatin analogues. Assuming a dose-dependent antiproliferative effect of somatostatin analogues, we performed a study with the somatostatin analogue lanreotide in ultra-high dosages in patients with progressive, metastatic GEP NET.
  
  
  METHODS
  30 patients with metastatic GEP NET, progressive during treatment with somatostatin analogues (< or =1.5 mg/day) and/or interferon-alpha, underwent ultra-high-dose lanreotide therapy (5 mg lanreotide s.c. three times a day). Tumor growth was evaluated every 3 months. Serum chromogranin A, serum serotonin as well as urinary 5-hydroxyindoleacetic acetic acid levels were also determined at 3-month intervals. In patients with functional tumors, tumor-related symptoms were documented.
  
  
  RESULTS
  After a 1-year treatment period with ultra-high-dose lanreotide, 1 complete and 1 partial remission were observed in patients with functional midgut NET. Eleven patients had stable disease and 11 patients showed continuing tumor growth after 3-12 months of treatment. Symptoms decreased significantly during therapy.
  
  
  CONCLUSIONS
  Our data show that ultra-high-dose lanreotide treatment in patients with metastatic GEP NET can lead to control of both symptoms and proliferation in at least some patients refractory to conventional therapies.
authors.affiliation: Department of Gastroenterology, Klinikum Benjamin-Franklin, Freie Universität, Berlin, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Faiss
authors.forename: U
authors.initials: U
authors.lastname: Räth
authors.forename: U
authors.initials: U
authors.lastname: Mansmann
authors.forename: D
authors.initials: D
authors.lastname: Caird
authors.forename: N
authors.initials: N
authors.lastname: Clemens
authors.forename: E O
authors.initials: EO
authors.lastname: Riecken
authors.forename: B
authors.initials: B
authors.lastname: Wiedenmann
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D014408:Biomarkers, Tumor / Q000097:blood; D016009:Chi-Square Distribution; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D018358:Neuroendocrine Tumors / Q000188:drug therapy*; D010190:Pancreatic Neoplasms / Q000188:drug therapy*; D010456:Peptides, Cyclic / Q000008:administration & dosage* / Q000009:adverse effects; D013004:Somatostatin / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D010456:Peptides, Cyclic; C060347:lanreotide; D013004:Somatostatin