title: Antitumour activity of somatostatin analogues in sporadic, progressive, metastatic pulmonary carcinoids.
abstract: Antiproliferative activity of somatostatin analogues (SSAs) has been demonstrated in digestive neuroendocrine tumours but few data have been published on pulmonary carcinoids (PC). The aim of this retrospective study was to report the antitumour activity of SSAs in patients with progressive, metastatic PC.
  
  
  
  Patients with PC and treated with SSA monotherapy were reviewed. Disease was classified according to the tumour slope prior to SSA initiation as rapidly progressive (at least 20% increase in the sum of the longest diameter of target lesions or the appearance of one or more new lesions within 6 months) or slowly progressive (if progression occurred over 6 months). Survival outcomes were progression-free survival (PFS) and overall survival (OS). We additionally examined the overall response rate and safety. Prognostic factors associated with PFS and OS were sought. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using the Cox model.
  
  
  
  Among 67 patients reviewed, 61 were included in the study. Forty-one (67%) of them exhibited slowly progressive disease prior to SSAs, 41 (67%) had atypical carcinoids and 29 (48%) had functioning tumours. Forty-six (76%) patients had received SSAs as first-line therapy. The best overall response was stable disease in 47 (77%) patients. The median duration of SSAs was 13.7 months. With a median follow-up of 5.8 years, median PFS and OS were 17.4 (95% CI: 8.7-26.0) and 58.4 (95% CI: 44.2-102.7) months, respectively. Functioning tumours and slowly progressive disease were significantly associated with longer PFS: HR = 0.48 ([95% CI: 0.24-0.95], p = 0.03) and HR = 7.43 ([95% CI: 3.02-18.25], p < 0.0001), respectively. Only functioning tumours remained significantly associated with OS: HR = 0.33 ([95% CI: 0.14-0.79], p = 0.01). Treatment had been discontinued in two patients due to side-effects.
  
  
  
  Median PFS observed in our study is encouraging for PC patients. Patients with functioning tumours and slowly progressive disease treated with SSAs have better prognosis.
authors.affiliation: Department of Medical Oncology, Gustave Roussy Cancer Campus, Villejuif, France.
authors.forename: Ivana
authors.initials: I
authors.lastname: Sullivan
authors.affiliation: Department of Biostatistics and Epidemiology, Gustave Roussy Cancer Campus, Villejuif, France; U1018 INSERM, CESP, Université Paris-Sud, Université Paris-Saclay, France.
authors.forename: Gwénaël
authors.initials: G
authors.lastname: Le Teuff
authors.affiliation: Department of Medical Oncology, Gustave Roussy Cancer Campus, Villejuif, France.
authors.forename: Joël
authors.initials: J
authors.lastname: Guigay
authors.affiliation: Department of Radiology, Gustave Roussy Cancer Campus, Villejuif, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Caramella
authors.affiliation: Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy Cancer Campus, Villejuif, France.
authors.forename: Amandine
authors.initials: A
authors.lastname: Berdelou
authors.affiliation: Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy Cancer Campus, Villejuif, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Leboulleux
authors.affiliation: Department of Radiology, Gustave Roussy Cancer Campus, Villejuif, France.
authors.forename: Désirée
authors.initials: D
authors.lastname: Déandréis
authors.affiliation: Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy Cancer Campus, Villejuif, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Hadoux
authors.affiliation: Department of Medical Oncology, Gustave Roussy Cancer Campus, Villejuif, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Ducreux
authors.affiliation: Department of Pathology, Gustave Roussy Cancer Campus, Villejuif, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Duvillard
authors.affiliation: Department of Pathology, Gustave Roussy Cancer Campus, Villejuif, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Adam
authors.affiliation: Department of Pathology, Gustave Roussy Cancer Campus, Villejuif, France.
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Scoazec
authors.affiliation: Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy Cancer Campus, Villejuif, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Baudin
authors.affiliation: Department of Medical Oncology, Gustave Roussy Cancer Campus, Villejuif, France. Electronic address: david.planchard@gustaveroussy.fr.
authors.forename: David
authors.initials: D
authors.lastname: Planchard
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002276:Carcinoid Tumor / Q000188:drug therapy* / Q000401:mortality; D049109:Cell Proliferation / Q000187:drug effects; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D015282:Octreotide / Q000627:therapeutic use*; D010456:Peptides, Cyclic / Q000627:therapeutic use*; D012189:Retrospective Studies; D013004:Somatostatin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D010456:Peptides, Cyclic; C060347:lanreotide; D013004:Somatostatin; D015282:Octreotide
keywords: Antitumour activity; Metastatic disease; Pulmonary carcinoids; Somatostatin analogues