title: Does combination of "cold" and "hot" somatostatin analogs prolong survival of patients with neuroendocrine neoplasms?
abstract: A number of detected neuroendocrine neoplasms (NENs) has been on the increase due to our awareness of the NENs risk and the development of different imaging techniques. Therapy of NENs involves surgery, chemotherapy, "cold" somatostatin analogs (SSA), peptide receptor radionuclide therapy (PRRT) and kinase inhibitors in pancreatic NENs. The aim of this study is to assess the efficacy of SSA in combination with "hot" somatostatin analogs, and the survival rate of our patients with advanced NENs. Seventy nine patients with metastatic NEN and positive somatostatin receptor scintigraphy (SRS) were enrolled in the study. Every patient was supposed to receive a dose of 7.4 GBq/m2PRRT in 4-5 cycles every 4-9 weeks. Response to the therapy was assessed according to Response Evaluation Criteria In Solid Tumors (RECIST). SSA were administered one month after the last cycle of PRRT and have been continued during the whole follow up period. Median observation time was 33 months (IQR 13.6-55.6), median time to progression was 28 months (IQR 12.1-39.2) and median time to event was 28 months (IQR 12.1-39.2). Overall survival for this group of patients was 60 months. PFS was 39 months and EFS was equal to 33 months. In our group of patients not many serious adverse events were observed. PRRT using radiolabelled somatostatin analogs followed by therapy with "cold" somatostatin analogs is a promising treatment option for patients with metastatic or inoperable somatostatin receptor-positive NENs with the possibility of survival prolongation.
authors.affiliation: Department of Endocrinology, University Hospital, Krakow, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Sowa-Staszczak
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Stefanska
authors.forename: Pawel
authors.initials: P
authors.lastname: Chrapczynski
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Trofimiuk-Müldner
authors.forename: Miroslaw
authors.initials: M
authors.lastname: Szura
authors.forename: Alicja
authors.initials: A
authors.lastname: Hubalewska-Dydejczyk
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D018358:Neuroendocrine Tumors / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy*; D015282:Octreotide / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D009942:Organometallic Compounds / Q000008:administration & dosage*; D011877:Radionuclide Imaging; D018000:Receptors, Peptide / Q000819:agonists / Q000737:chemistry / Q000627:therapeutic use; D017481:Receptors, Somatostatin / Q000819:agonists; D013004:Somatostatin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D009942:Organometallic Compounds; D018000:Receptors, Peptide; D017481:Receptors, Somatostatin; D013004:Somatostatin; C447941:lutetium Lu 177 dotatate; D015282:Octreotide