title: Tailored intermittent therapy of carcinoid.
abstract: OBJECTIVE
  There is no established standard care of carcinoids as all experts agree. Endogenous somatostatin diurnal rhythm is influenced by administration of lanreotid. The purpose of this study is to evaluate efficacy of lanreotid on the clinical course in a group of patients with metastatic carcinoid.
  
  
  METHODS
  In 43 patients with carcinoid tumors somatostatin serum level, 5-HIAA (5-hydroxyindolacetic acid), NSE (neuron-specific enolase), and chromogranin A were examined. Fifteen patients received 30mg of somatulin (Lanreotid) in two-week intervals.
  
  
  RESULTS
  Therapy with somatostatin analogue improved symptoms in 70-80% of patients with metastases and carcinoid syndrome. 5-HIAA significantly decreased after lanreotid therapy. NSE values are undulating. With progression of the disease they rise. Chromogranin is higher in patients with advanced metastatic disease. Mesor of the diurnal excretion of somatostatin is higher (32 pg/mL) in patients with metastatic disease than in patients without (20 pg/mL). After lanreotid administration mesor decreased (16 pg/mL) in the group of patients with metastases.
  
  
  CONCLUSIONS
  Intermittent lanreotid therapy is efficient. A rise--(ascend) of endogenous SMS level could be one of the markers of increased activity of carcinoid cells and an indication for the next application of lanreotid therapy. Mean survival of patients with metastatic carcinoid in our study was 46.3 months.
authors.affiliation: Department of Internal Medicine, Comenius University, Bratislava, Slovakia. kinova@faneba.sk
authors.forename: Sona
authors.initials: S
authors.lastname: Kinová
authors.forename: Ivan
authors.initials: I
authors.lastname: Duris
authors.forename: Elena
authors.initials: E
authors.lastname: Kratochvíl'ová
authors.forename: Eva
authors.initials: E
authors.lastname: Kovácová
authors.forename: Michal
authors.initials: M
authors.lastname: Koren
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002276:Carcinoid Tumor / Q000188:drug therapy*; D053379:Chromogranin A / Q000097:blood; D005260:Female; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000097:blood; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010456:Peptides, Cyclic / Q000627:therapeutic use*; D010751:Phosphopyruvate Hydratase / Q000097:blood; D013004:Somatostatin / Q000031:analogs & derivatives* / Q000097:blood / Q000378:metabolism / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D053379:Chromogranin A; D010456:Peptides, Cyclic; C060347:lanreotide; D013004:Somatostatin; D006897:Hydroxyindoleacetic Acid; D010751:Phosphopyruvate Hydratase