The antidiarrheal efficacy of a proprietary amino acid mixture (enterade) in neuroendocrine tumor (NET) patients: Updated data.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 614-614
Author(s):  
Aman Chauhan ◽  
Rachel C. Miller ◽  
Laura Luque ◽  
Heidi Weiss ◽  
Lowell Brian Anthony
Keyword(s):  
Quality Of Life ◽  
Neuroendocrine Tumor ◽  
Somatostatin Analogs ◽  
Tumor Resection ◽  
Bacterial Overgrowth ◽  
Unknown Primary ◽  
Acid Mixture ◽  
Tumor Patients ◽  
Short Gut Syndrome

614 Background: Diarrhea is a common quality of life limiting symptom seen in neuroendocrine tumor patient. Diarrhea in these patients could be due to excessive serotonin production, secondary to post-operative short gut syndrome, steatorrhea from somatostatin analogs, bile acid colitis or intestinal bacterial overgrowth. In this study we summarize our single center experience with enterade. Methods: Medical records of all the NET patients treated with enterade for symptomatic diarrhea were retrospectively reviewed after appropriate IRB approval. Patients were treated at Markey cancer center between May 2017-June 2019. Results: Total 98 patients were offered enterade. enterade was instructed to be taken as one 8 Oz bottle BID for 1 week. Antidiarrheal efficacy data was available on 49 patients at the time of abstract submission. 37 (75%) patients had GEPNETs, 8 had bronchial NETs, 1 gynecological NET and 3 patients had unknown primary. 28 (57%) patients had history of prior bowel resection either for primary neuroendocrine tumor resection or debulking. 28 (57%) patients were on somatostatin analog at the time of initiation of enterade. 42 (85%) out of 49 patients reported subjective improvement in diarrheal symptoms. 27 (64%) out of these 42 responders reported at least 50 percent reduction in diarrhea frequency. Conclusions: 85% (42/49) neuroendocrine tumor patients reported improvement in diarrhea with enterade. 64% (27/42) reported more than 50% reduction in diarrhea frequency. A prospective Phase II study of enterade in neuroendocrine tumor patients with quality of life limiting diarrhea is currently being conducted (NCT03722511).

The antidiarrheal efficacy of a proprietary amino acid mixture in neuroendocrine tumor (NET) patients.

2018 ◽  
Vol 36 (34_suppl) ◽  
pp. 218-218
Author(s):  
Laura Luque ◽  
Aman Chauhan ◽  
Qian Yu ◽  
Rachel C Miller ◽  
Heidi Weiss ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Amino Acid ◽  
Neuroendocrine Tumor ◽  
Phase Ii ◽  
Somatostatin Analogs ◽  
The United States ◽  
Acid Mixture ◽  
Tumor Patients ◽  
Short Gut Syndrome

218 Background: Gastroenteropancreatic neuroendocrine tumor (GEPNET) incidence has risen 6-fold over past 3 decades. North American Neuroendocrine Tumor Society estimates that over 100,000 GEPNET patients are currently living in the United States. One of the common quality of life limiting symptom seen in GEPNET patient is diarrhea. Diarrhea in these patients could be due to excessive serotonin production, secondary to post-operative short gut syndrome, steatorrhea from somatostatin analogs, bile acid colitis or intestinal bacterial overgrowth. A novel amino acid based oral rehydration solution (enterade) is currently being evaluated in a Phase II clinical trial for antidiarrheal effects in post bone marrow transplant patients (NCT02919670). We conducted a pilot study of enterade in neuroendocrine tumor (NET's) patients with quality of life limiting diarrhea. Methods: Medical records of all the NET patients given enterade to alleviate symptomatic diarrhea were evaluated. Patients were treated at Markey Cancer Center between May 2017-June 2018. Results: Total 69 NETs patients were treated with enterade. Enterade was administered as 8 Oz bottle BID for 1 a week. Antidiarrheal efficacy data was available on 41 patients at the time of abstract submission. 15 patients had small bowel NETs, 5 had bronchial NETs, 1 had colorectal NETs, 3 had NETs of unknown primary, 3 had gastric NETS, 3 had pancreatic NETs and one had high grade neuroendocrine carcinoma of the prostate. Data regarding primary site was unavailable in 10/41 patients. 21 patients had history of prior bowel resection either for primary neuroendocrine tumor resection or debulking. 25 patients were on somatostatin analogs at the time of initiation of enterade. 31 out of 41 patients reported some reduction in diarrhea frequency. 21 out of these 41 patients reported at least a 50% reduction in diarrhea frequency. Conclusions: 75.6% (31/41) neuroendocrine tumor patients reported improvement in diarrhea frequency with enterade. 51.2% (21/41) reported more than 50% reduction in diarrhea frequency. A prospective Phase II study of enterade in neuroendocrine tumor patients with quality of life limiting diarrhea is currently planned.

The antidiarrheal efficacy of a proprietary amino acid mixture in gastroenteropancreatic neuroendocrine patients.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 509-509 ◽  
Author(s):  
Aman Chauhan ◽  
Rachel C Miller ◽  
Qian Yu ◽  
Bilal Aslam ◽  
Heidi Weiss ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Amino Acid ◽  
Neuroendocrine Tumor ◽  
Phase Ii ◽  
Somatostatin Analogs ◽  
The United States ◽  
Acid Mixture ◽  
Tumor Patients ◽  
Gastroenteropancreatic Neuroendocrine Tumor

509 Background: Based on SEER database, gastroenteropancreatic neuroendocrine tumor incidence has increased 6 fold from 1 in 100,000 cases to about 6 in 100,000 cases over past 3 decades. North American Neuroendocrine Tumor Society estimates that over 100,000 GEPNET patients are currently living in the United States. One of the common quality of life limiting symptom seen in GEPNET patient is diarrhea. Diarrhea in these patients could be due to excessive serotonin production, secondary to post-operative short gut syndrome, steatorrhea from somatostatin analogs, bile acid colitis or intestinal bacterial overgrowth. A novel amino acid based oral rehydration solution (Enterade) is currently being evaluated in a Phase II clinical trial for antidiarrheal effects in post bone marrow transplant patients (NCT02919670). We conducted a pilot study of Enterade in neuroendocrine tumor patients with quality of life limiting diarrhea to evaluate its antidiarrheal efficacy. Methods: Medical records of all the GEPNET patients treated with Enterade for symptomatic diarrhea were evaluated. Patients were treated at Markey cancer center between May 2017-August 2017. Results: Total 8 patients were treated with Enterade. Five were small bowel NETs and 3 were pancreatic NETs. Five patients had prior bowel resections for removal of primary tumor; 5 patients were on somatostatin analogs at the time of initiation of Enterade. Five (62%) patients reported improvement in diarrhea within 6 days of initiating Enterade. The responders had 50 % reduction in their stool output. Mean stools dropped from 6 per day to 3 per day in responders. Conclusions: These pilot data suggest that Enterade may be an effective option in diarrhea control in NET patients. A prospective Phase II study of Enterade in gastroenteropancreatic neuroendocrine tumor patients with quality of life limiting diarrhea is planned.

scholarly journals Can an amino acid mixture alleviate gastrointestinal symptoms in neuroendocrine tumor patients?

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Aman Chauhan ◽  
Satya Das ◽  
Rachel Miller ◽  
Laura Luque ◽  
Samuel N. Cheuvront ◽  
...  
Keyword(s):  
Amino Acid ◽  
Neuroendocrine Tumor ◽  
Gastrointestinal Symptoms ◽  
Retrospective Chart Review ◽  
Final Analysis ◽  
Acid Mixture ◽  
Tumor Patients ◽  
Short Gut Syndrome ◽  
Oral Rehydration ◽  
The Mean

Abstract Background Neuroendocrine tumors, although relatively rare in incidence, are now the second most prevalent gastrointestinal neoplasm owing to indolent disease biology. A small but significant sub-group of neuroendocrine tumor patients suffer from diarrhea. This is usually secondary to carcinoid syndrome but can also be a result of short gut syndrome, bile acid excess or iatrogenic etiologies. Recently, an amino acid based oral rehydration solution (enterade® Advanced Oncology Formula) was found to have anti-diarrheal properties in preclinical models. Methods A retrospective chart review of all NET patients treated with enterade® AO was performed after IRB approval. Results Ninety-eight NET patients who had received enterade® AO at our clinic from May 2017 through June 2019 were included. Patients (N = 49 of 98) with follow up data on bowel movements (BMs) were included for final analysis. Eighty-four percent of patients (41/49) had fewer BMs after taking enterade® AO and 66% (27/41) reported more than 50% reduction in BM frequency. The mean number of daily BMs was 6.6 (range, 3–20) at baseline before initiation of therapy, while the mean number of BMs at 1 week time point post enterade® AO was 2.9 (range, 0–11). Conclusions Our retrospective observations are encouraging and support prospective validation with appropriate controls in NET patients. This is first published report of the potential anti-diarrheal activity of enterade® AO in NET patients.

scholarly journals Quality of life following surgical treatment of lesions within the pineal region

2018 ◽  
Vol 130 (1) ◽  
pp. 28-37 ◽  
Author(s):  
Stepan Fedorko ◽  
Klaus Zweckberger ◽  
Andreas W. Unterberg
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Neurological Outcome ◽  
Tumor Resection ◽  
Pineal Region ◽  
Subtotal Resection ◽  
Modified Rankin Scale ◽  
Tumor Patients

OBJECTIVEPineal region tumors are a rare and heterogeneous group of lesions. The optimal therapeutic approach is currently a topic of controversy, particularly in light of the potential operative risks and complications. The potential beneficial effects of surgery have already been described, but information about neurological outcome and, in particular, health-related quality of life (HRQOL) is still lacking in the literature. The aim of this study was to assess the therapeutic effect of resection of pineal region lesions, emphasizing grade of tumor resection, neurological outcome, quality of life, and the necessity of additional shunt procedures.METHODSThe authors performed a prospective study of HRQOL in 32 patients who had undergone surgical treatment of lesions in the pineal region (20 tumors and 12 cysts) between 2008 and 2014. All patients had at least 6 months of follow-up, with reexamination including standardized neurological assessment, an evaluation of dependency using the modified Rankin Scale, and an evaluation of HRQOL. The authors retrospectively examined patient charts and collected information regarding imaging studies, neurological status prior to surgery, surgical strategies used, any complications, and histological diagnoses.RESULTSIn this study, there was no surgery-associated mortality or major morbidity. Permanent minor morbidity was reported for 4 patients (13%). Comparing pre- and postoperative neurological symptoms, 75% of tumor patients had either complete resolution or improvement of preoperative symptoms; symptoms were unchanged in 10% of tumor patients and deteriorated in 15%. In patients with pineal cysts, long-term follow-up showed that 42% of patients were free of any symptoms and 58% experienced improvement of their preoperative symptoms. These outcomes were also reflected in the modified Rankin Scale scores, which demonstrated significant improvement following resection of pineal region lesions. Furthermore, significant improvements in HRQOL scores occurred in global health status, in all functional scales, and in pain, nausea and vomiting, fatigue, and insomnia (p < 0.0001). Moreover, a significant reduction in the necessity for permanent shunt procedures was observed after gross-total tumor resection compared with subtotal resection (p = 0.035) of pineal cysts.CONCLUSIONSDespite potential risks, (radical) surgery is a highly effective and safe treatment option for pineal region lesions and should be considered for the majority of patients.

The interplay between emotion regulation, emotional well-being and cognitive functioning in brain tumor patients and their caregivers

2019 ◽  
Author(s):  
Hannelore Aerts ◽  
Tineke Van Vrekhem ◽  
Lara Stas ◽  
Daniele Marinazzo
Keyword(s):  
Quality Of Life ◽  
Emotion Regulation ◽  
Brain Tumor ◽  
Cognitive Functioning ◽  
Tumor Resection ◽  
Well Being ◽  
Emotion Regulation Strategies ◽  
Tumor Patients ◽  
Regulation Strategies

Objective: Brain tumor patients may suffer from a range of health-impairing problems reducing their quality of life. To identify potential targets for interventions, we examined the influence of different emotion regulation strategies on emotional well-being and cognitive functioning as indices of quality of life in patients and their caregivers in the early phase of treatment. Methods: To this end, we conducted a longitudinal study, measuring emotion regulation, emotional well-being and cognitive functioning on the day before each patient’s tumor resection (28 patients and 11 caregivers) and several months after neurosurgery (22 patients and 10 caregivers).Results: Results showed emotion regulation strategies are relatively stable from pre- to post-operative assessment. Nevertheless, several associations between emotion regulation strategies and quality of life indices were evident after tumor resection. In particular, our results were largely in line with previous research findings in healthy and other patient populations, corroborating the adaptive character of cognitive reappraisal, whereas suppression and expression of emotions were related to reduced cognitive and affective functioning, respectively.Conclusions: Based on these results, we suggest that further intervention or qualitative studies explore whether therapeutic interventions directed towards mastery of cognitive reappraisal techniques and appropriate expression of emotions could lead to improved long-term adjustment among brain tumor patients and their caregivers.

scholarly journals Quality of Life in Patients with Acromegaly before and after Transsphenoidal Surgical Resection

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Jing Gu ◽  
Shiyuan Xiang ◽  
Min He ◽  
Meng Wang ◽  
Yanfang Gu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Somatostatin Analogs ◽  
Tumor Resection ◽  
Repeated Measurements ◽  
Sf 36 ◽  
Before And After ◽  
Discordant Group

Objective. We aimed to determine the perioperative changes in the quality of life (QoL) in patients with acromegaly and to reveal the relationship between biochemical indicators and quality of life change after tumor resection. Methods. Patients with acromegaly were enrolled from a tertiary pituitary center. SF-36 scale and AcroQoL scale were used to determine the QoL before and after surgery. We analyzed changes in QoL using a generalized linear model for repeated measurements. We compared the changes in QoL among three groups (remission, active, and discordant group) based on postoperative growth hormone (GH) and insulin-like growth factor-1. Results. 151 patients (75 males and 76 females) diagnosed with acromegaly were included. The average age was 43.9 ± 12.3 years. The median total SF-36 scale was 65.3% (IQR: 63.2%–69.2%). Overall AcroQoL score at baseline was 59.1% (IQR: 51.8%–71.8%). Nadir GH levels (coefficient −0.08, p=0.047), T3 levels (coefficient 2.8, p=0.001), and testosterone levels (coefficient −0.20, p=0.033) in males were independent predictive factors of the total SF-36 score. During the follow-up, the median overall SF-36 score increased to 66.1% at 3 months and 75.3% at 6 months (p<0.001) after surgery. The median overall AcroQoL score increased to 74.5% at 3 months and 77.3% at 6 months (p<0.001) after surgery. At 6-month follow-up, median scores were still less than 70% in appearance, vitality, and mental health dimensions. The QoL after surgery were similar among the three groups, although higher GH and more preoperative somatostatin analogs usage were observed in the active group. Conclusion. In conclusion, acromegalic patients were associated with low QoL, which could be reversed partially by surgery. The improvement was independent of the endocrine remission. Appearance, vitality, and mental health were three major aspects that warrant further attention from physicians and caregivers after surgery.

scholarly journals Sunitinib achieved fast and sustained control of VIPoma symptoms

2015 ◽  
Vol 172 (1) ◽  
pp. K1-K3 ◽  
Author(s):  
Louis de Mestier ◽  
Thomas Walter ◽  
Hedia Brixi ◽  
Catherine Lombard-Bohas ◽  
Guillaume Cadiot
Keyword(s):  
Quality Of Life ◽  
Tyrosine Kinase ◽  
Targeted Therapies ◽  
Therapeutic Option ◽  
Somatostatin Analogs ◽  
Watery Diarrhea ◽  
Tyrosine Kinase Receptors ◽  
Secretory Pathways ◽  
Discharge From Hospital

VIPomas are rare-functioning neuroendocrine tumors (NETs). Overproduction of vasointestinal peptide (VIP) leads to the Verner–Morrison syndrome, whose management is challenging when refractory to somatostatin analogs. Two patients with progressive metastatic pancreatic NETs and refractory VIPoma symptoms were treated with sunitinib. This led to fast and sustained total relief of VIPoma symptoms, enabling earlier discharge from hospital and improvement in their quality of life. In both cases, sunitinib discontinuation led to the quick recurrence of watery diarrhea, which resolved within a few days after reintroducing sunitinib. The anti-secretory effect of sunitinib on VIPoma syndrome was probably not related to any anti-tumor effect. These observations agree with the rare reported cases of anti-secretory effects with targeted therapies. The sunitinib-driven inhibition of multiple-tyrosine kinase receptors might act on secretory pathways and describe sunitinib's ability to improve VIPoma symptoms. Sunitinib could be a therapeutic option to control refractory VIPoma symptoms in patients with NETs.

A Preliminary Report on Quality of Life and Sexual Function in Brain Tumor Patients

2021 ◽  
Vol 18 (4) ◽  
pp. 737-742
Author(s):  
Maria L. Boccia ◽  
Elizabeth I. Anyanda ◽  
Ekokobe Fonkem
Keyword(s):  
Quality Of Life ◽  
Brain Tumor ◽  
Sexual Function ◽  
Preliminary Report ◽  
Tumor Patients
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