scholarly journals NON SURGICAL TREATMENT OF CARCINOID LUNGS TUMORS

2021 ◽  
Vol 9 (12) ◽  
pp. 647-651
Author(s):  
Bourhafour Mouna ◽  
◽  
Chekrine Tarik ◽  
Bouchbika Zineb ◽  
Benchakroun Nadia ◽  
...  
Keyword(s):  
Peptide Receptor Radionuclide Therapy ◽  
Somatostatin Analogues ◽  
Neuroendocrine Neoplasms ◽  
Low Grade ◽  
Intermediate Form ◽  
Typical Carcinoid ◽  
Grade Malignancy ◽  
Long Acting ◽  
Non Surgical Treatment ◽  
Systemic Therapies

Typical carcinoid lungs tumors are neuroendocrine bronchopulmonary tumors with a low-grade malignancy, and an atypical carcinoid is an intermediate form of these tumors. Their systemic treatment is greatly influenced by therapeutic evidence derived from the more frequent gastroenteropancreatic neuroendocrine neoplasms. Currently, systemic therapies for lung carcinoids, aiming at controlling tumor growth include long acting somatostatin analogues (SSAs), peptide receptor radionuclide therapy, chemotherapy and molecular-targeted therapy.

Metastatic gastroenteropancreatic neuroendocrine tumors treated with somatostatin analogues: Ten years experience in a third level hospital in Mexico City.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 514-514
Author(s):  
Alberto Pimentel ◽  
Abdel Karim Dip Borunda ◽  
Luis Jonathan Bueno Rosario ◽  
Gloria Martinez Martinez ◽  
Miguel Angel Pluma ◽  
...  
Keyword(s):  
Neuroendocrine Tumors ◽  
Symptom Control ◽  
Progression Free Survival ◽  
Somatostatin Analogues ◽  
Low Grade ◽  
Common Symptom ◽  
First Line ◽  
Gastroenteropancreatic Neuroendocrine Tumors ◽  
Long Acting

514 Background: Gastroenteropancreatic neuroendocrine tumors (GEP NET´s) are infrequent tumors, with a variety of symptoms depending of the kind of peptide they secrete as well as the affected organs. Long acting somatostatin analogues have shown an adequate rate of symptom control in functional tumors, they also have demonstrated antiproliferative effect, which is translated in a significant improvement of progression free and overall survival Methods: In this retrospective analysis of patients with metastatic GEP NET treated with long acting somatostatin analogues as first line, treated between 2005 and 2015, we evaluated clinical and pathological features, symptoms, disease control and survival adjusted with OMS classification Results: Our cohort included 95 patients with a mean age of 53 years. Primary affected sites were midgut (29.4%), followed by pNET (17.%), stomach (14.7%), and primary unknown in 14%. 20% of cases were functional tumors with diarrhea as the most common symptom in 70% and flushing in 50%. Considering the whole cohort the most prevalent symptom was abdominal pain in the 50% of cases. The OMS classification showed low grade tumors in 65% and 35% intermediate grade. Most common metastatic organ sites were; liver only 35%, liver and other 30%, peritoneum 10% and lymph nodes in 6%, non-specified sites in 19%. Somatostatine analogues used in first line were octreotide in 80% and lanreotide in 20%. Survival results demonstrated a progression free survival for the whole cohort of 84months. No differences between lanreotide and octreotide were observed. Conclusions: This study represents the first Mexican cohort of patients with GEP NET’s treated with somatostatin analogues with a long follow up.

scholarly journals Strategies Towards Improving Clinical Outcomes of Peptide Receptor Radionuclide Therapy

2021 ◽  
Vol 23 (4) ◽  
Author(s):  
N.S. Minczeles ◽  
J. Hofland ◽  
W.W. de Herder ◽  
T. Brabander
Keyword(s):  
Radionuclide Therapy ◽  
Somatostatin Receptor ◽  
Peptide Receptor Radionuclide Therapy ◽  
Phase Iii ◽  
Neuroendocrine Neoplasms ◽  
Low Grade ◽  
Renal Protection ◽  
Peptide Receptor ◽  
Phase Iii Trials ◽  
Third Line

Abstract Purpose of Review Peptide receptor radionuclide therapy (PRRT) with [177Lu-DOTA0,Tyr3] octreotate is an effective and safe second- or third-line treatment option for patients with low-grade advanced gastroenteropancreatic (GEP) neuroendocrine neoplasms (NEN). In this review, we will focus on possible extensions of the current use of PRRT and on new approaches which could further improve its treatment efficacy and safety. Recent Findings Promising results were published regarding PRRT in other NENs, including lung NENs or high-grade NENs, and applying PRRT as neoadjuvant or salvage therapy. Furthermore, a diversity of strategic approaches, including dosimetry, somatostatin receptor antagonists, somatostatin receptor upregulation, radiosensitization, different radionuclides, albumin binding, alternative renal protection, and liver-directed therapy in combination with PRRT, have the potential to improve the outcome of PRRT. Also, novel biomarkers are presented that could predict response to PRRT. Summary Multiple preclinical and early clinical studies have shown encouraging potential to advance the clinical outcome of PRRT in NEN patients. However, at this moment, most of these strategies have not yet reached the clinical setting of randomized phase III trials.

Systemic Therapy for Neuroendocrine Neoplasms

2019 ◽  
Vol 03 (01) ◽  
pp. 063-070
Author(s):  
David Chan ◽  
Simron Singh
Keyword(s):  
Carcinoid Syndrome ◽  
Systemic Treatment ◽  
Histological Grade ◽  
Delayed Diagnosis ◽  
Peptide Receptor Radionuclide Therapy ◽  
Somatostatin Analogues ◽  
Neuroendocrine Neoplasms ◽  
Ongoing Research ◽  
Disease Characteristics ◽  
Grade 3

AbstractNeuroendocrine neoplasms (NENs) are heterogeneous malignancies which are becoming more common. Systemic treatment is considered for patients with advanced disease, and treatment decisions are often driven by the histological grade of the tumor and the site of primary. Somatostatin analogues are the first-line option of choice for gastroenteropancreatic NENs but subsequent options may include the targeted agents everolimus and sunitinib as well as peptide receptor radionuclide therapy. Telotristat is a new option for the treatment of refractory carcinoid syndrome diarrhea. Chemotherapy is infrequently used for Grade 1 to 2 NENs (except for the combination of capecitabine and temozolomide) but is the mainstay of therapy for Grade 3 neuroendocrine carcinomas. Bronchial NENs are graded differently and there are few proven options for systemic treatment. Optimal integration of available systemic therapies, the timely recognition of tumor heterogeneity, and the use of nuclear medicine are areas of ongoing research. Finally, the patient experience is impacted by factors such as delayed diagnosis and symptoms of carcinoid syndrome. Clinicians need to account for patient priorities and disease characteristics to individualize therapy choices for patients with advanced NEN.

scholarly journals Targeted Cancer Therapy: What’s New in the Field of Neuroendocrine Neoplasms?

Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1701
Author(s):  
Anna La Salvia ◽  
Paula Espinosa-Olarte ◽  
Maria Del Carmen Riesco-Martinez ◽  
Beatriz Anton-Pascual ◽  
Rocío Garcia-Carbonero
Keyword(s):  
Treatment Options ◽  
Somatostatin Receptors ◽  
Peptide Receptor Radionuclide Therapy ◽  
Somatostatin Analogues ◽  
Neuroendocrine Neoplasms ◽  
Antiangiogenic Agents ◽  
Drug Conjugates ◽  
Therapeutic Drugs ◽  
Anatomic Distribution ◽  
Pancreatic Origin

Neuroendocrine tumors (NETs) are a heterogeneous family of neoplasms of increasing incidence and high prevalence due to their relatively indolent nature. Their wide anatomic distribution and their characteristic ability to secrete hormonally active substances pose unique challenges for clinical management. They are also characterized by the common expression of somatostatin receptors, a target that has been extremely useful for diagnosis and treatment (i.e., somatostatin analogues (SSAs) and peptide-receptor radionuclide therapy (PRRT)). Chemotherapy is of limited use for NETs of non-pancreatic origin, and the only approved targeted agents for advanced progressive NETs are sunitinib for those of pancreatic origin, and everolimus for lung, gastrointestinal and pancreatic primaries. Despite recent therapeutic achievements, thus, systemic treatment options remain limited. In this review we will discuss the state-of-the-art targeted therapies in the field of NETs, and also future perspectives of novel therapeutic drugs or strategies in clinical development, including recently presented results from randomized trials of yet unapproved antiangiogenic agents (i.e., pazopanib, surufatinib and axitinib), PRRT including both approved radiopharmaceuticals (177Lu-Oxodotreotide) and others in development (177Lu-Edotreotide, 177Lu-Satoreotide Tetraxetan), immunotherapy and other innovative targeted strategies (antibody-drug conjugates, bites,…) that shall soon improve the landscape of personalized treatment options in NET patients.

scholarly journals Prevalence of Delta-Like Protein 3 in a Consecutive Series of Surgically Resected Lung Neuroendocrine Neoplasms

2021 ◽  
Vol 11 ◽  
Author(s):  
Greta Alì ◽  
Iosè Di Stefano ◽  
Anello Marcello Poma ◽  
Stefano Ricci ◽  
Agnese Proietti ◽  
...  
Keyword(s):  
Tumor Cells ◽  
Notch Pathway ◽  
Disease Free Survival ◽  
Neuroendocrine Neoplasms ◽  
Consecutive Series ◽  
Low Grade ◽  
High Grade ◽  
Typical Carcinoid ◽  
Cell Lung Carcinoma ◽  
Peripheral Location

Delta-like protein 3 (DLL3) is a protein of the Notch pathway, and it is a potential therapeutic target for high-grade lung neuroendocrine tumors (NETs), i.e., small cell lung carcinoma (SCLC) and large cell neuroendocrine carcinoma (LCNEC). However, DLL3 prevalence in lung NETs and its association with clinicopathological characteristics and prognosis remained unclear. We analyzed the immunohistochemical expression of DLL3 and its prognostic role in a consecutive series of 155 surgically resected lung NETs, including typical carcinoid (TC), atypical carcinoid (AC), LCNEC, and SCLC patients. The DLL3 expression was categorized as high (>50% positive tumor cells) or low (<50%). In addition, tumors were categorized by H-score (i.e., percentage of positive cells by staining intensity, ≥150 vs. <150). DLL3 staining was positive in 99/155 (64%) samples, and high DLL3 expression was frequently observed in high-grade tumors. In detail, 46.9% and 75% of SCLC and 48.8% and 53.7% of LCNEC specimens showed a high DLL3 expression by using H-score and percentage of positive tumor cells, respectively. Regarding low-grade NETs, only 4.9% and 12.2% TCs and 19.5% and 24.4% ACs had high DLL3 expression considering H-score and percentage of positive tumor cells, respectively. High DLL3 expression was associated with advanced American Joint Committee on Cancer (AJCC) stage, peripheral location, and chromogranin A expression in high-grade tumors (p < 0.05). In low-grade NETs, high DLL3 expression was associated with female sex, peripheral location, a higher number of mitoses, higher Ki-67 index, presence of necrosis, and pleural infiltration (p < 0.05). No association was observed between high DLL3 expression and overall survival (OS) and disease-free survival (DFS) in high-grade NETs, whereas high DLL3 expression was associated with lower DFS in ACs (p = 0.01). In conclusion, our study demonstrated a high prevalence of DLL3 expression in high-grade lung NET patients and its association with aggressive clinicopathological features. These findings confirm that DLL3 could represent a useful biomarker for target therapy in high-grade tumors. Our results also suggest that the DLL3 expression could identify a subset of AC tumors with more aggressive behavior, thus providing the basis for new therapeutic options in this group of patients.

Trends in the incidence and survival outcomes in patients with lung neuroendocrine neoplasms in the United States.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19120-e19120
Author(s):  
Rohit Gosain ◽  
Shrunjal Shah ◽  
Arvind Dasari ◽  
Thorvardur Ragnar Halfdanarson ◽  
Sarbajit Mukherjee
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Cell Lung Cancer ◽  
The United States ◽  
Population Based ◽  
Future Research ◽  
Neuroendocrine Neoplasms ◽  
Low Grade ◽  
Typical Carcinoid ◽  
Adjusted Incidence

e19120 Background: The incidence and prevalence of Neuroendocrine Neoplasms (NENs) are rapidly rising. Epidemiologic trends have been reported for common NENs, but specific data for lung NENs has been lacking. Methods: We conducted a retrospective population-based analysis utilizing the Surveillance, Epidemiology, and End Results (SEER) database, and studied lung NENs patients from 1988 to 2015. Associated population data was utilized to report the annual age-adjusted incidence and overall survival trends. Trends in the incidence and survival of large-cell lung cancer (LCLC) and atypical carcinoid (AC) were reported from 2000-2015, while that for typical carcinoid (TC) and small cell lung cancer (SCLC) were reported from 1988-2015. Results: We examined a total of 115,995 lung NENs [103,980 – SCLC; 3,303 – LCLC; 8,146 – TC; 656 – AC]. The age-adjusted incidence rate revealed decline in SCLC from 8.6 in 1988 to 5.3 in 2015 per 100,000; while other NENs showed an increase: TC increased from 0.57 in 1988 to 0.77 in 2015 per 100,000, AC increased from 0.17 in 2001 to 0.22 in 2015 per 100,000, and lastly, LCLC increased from 0.35 in 2001 to 0.41 in 2015 per 100,000. On multivariable analyses, the median overall survival (OS) and disease-specific survival (DSS) rate varied significantly by stage, grade, age at diagnosis, histological type, insurance type, marital status, and race. The 5-year OS rate among SCLC and LCLC patients was 5% and 17%, respectively, consistent with their high-grade nature. On the other hand, TC and AC, representing low-grade neuroendocrine tumors, had good 5-year OS: 84% and 64%, respectively. Conclusions: The incidence of lung NENs is rising, possibly because of advanced radiological techniques. However, we have seen a downtrend in the incidence of SCLCs likely because of declining smoking habits. Such population-based studies are essential for resource allocation and to prioritize future research directions.

scholarly journals Treatment with somatostatin analogues and PRRT in metastatic middle ear adenoma with neuroendocrine features

2021 ◽  
Vol 2021 ◽  
Author(s):  
Joana Lima Ferreira ◽  
Bernardo Marques ◽  
C Willemien Menke-van der Houven van Oordt ◽  
Wouter W de Herder ◽  
Tessa Brabander ◽  
...  
Keyword(s):  
Middle Ear ◽  
Stable Disease ◽  
Radionuclide Therapy ◽  
Peptide Receptor Radionuclide Therapy ◽  
Somatostatin Analogues ◽  
Peptide Receptor ◽  
Pet Ct ◽  
Middle Ear Adenoma ◽  
Well Differentiated ◽  
Long Acting

Summary Middle ear adenomas with neuroendocrine features (ANEF) are rare, with an estimated 150 reported cases. They usually pursue an indolent clinical course. Four reported cases of middle ear ANEF with distant metastases were treated with surgery, external beam radiation therapy (EBRT) and chemotherapy. To date, no successful systemic treatment for malignant behaviour of this rare tumour has been reported. Long-acting somatostatin analogues (SSAs) and peptide receptor radionuclide therapy (PRRT) have been used in well-differentiated metastatic neuroendocrine tumours (NETs), but their use has never been described in cases of metastatic middle ear ANEF. We report two patients with grade 1 middle ear ANEF treated with surgery and EBRT. They had stable disease for several years, until clinical symptoms appeared and extensive metastases were detected on 68Ga-DOTA0-Tyr3-octreotate (DOTATATE) PET/CT. Treatment with long-acting SSA was started, with stable disease for 1 year. Afterwards, despite undergoing local treatments, both patients presented progressive disease. Due to high-uptake metastases at 68Ga-DOTATATE PET/CT, both cases underwent four cycles of PRRT with 177Lu-DOTATATE, which secured disease control and improvement of quality of life in both. Similar to other well-differentiated NETs, SSA and PRRT could constitute efficacious therapeutic options in metastatic middle ear ANEF. Its neuroendocrine differentiation, potential to metastasize and somatostatin receptor type 2 expression prompt consideration and management of this disease as a neuroendocrine neoplasm. Learning points Our cases oppose the 2017 WHO classification of middle ear adenoma with neuroendocrine features as a benign disease. This entity warrants long-term follow-up, as local recurrence or persistence of disease is reported in up to 18% of surgically treated patients. PET/CT scan with 68Ga-labelled somatostatin analogues (SSA) can be used for staging of metastatic middle ear adenoma with neuroendocrine features. Unlabelled SSA and peptide receptor radionuclide therapy (PRRT) with radiolabelled SSA can be the first systemic therapeutic options for patients with advanced middle ear adenoma with neuroendocrine features.

Sign in / Sign up

Export Citation Format

Share Document