Impact of long-acting octreotide in patients with early-stage MEN1-related duodeno-pancreatic neuroendocrine tumours

Clin Endocrinol (Oxf). 2014 Jun;80(6):850-5. doi: 10.1111/cen.12411. Epub 2014 Feb 19.

Abstract

Background: Somatostatin analogues (SSA) represent one of the main therapeutic option in patients affected with functioning well-differentiated neuroendocrine tumours (NETs). There are no studies specifically focusing on NETs associated with Multiple Endocrine Neoplasia type 1 (MEN1).

Aim: To evaluate the efficacy of the long-acting SSA octreotide in MEN1 patients with early-stage duodeno-pancreatic NETs.

Patients and methods: Forty patients with MEN1 were retrospectively evaluated. Twenty patients with evidence of one or more MEN1-related duodeno-pancreatic NETs < 20 mm in size (age range 26-61 years) were treated with octreotide long-acting octreotide (LAR) as first-line therapy. Treatment duration ranged 12-75 months. At the baseline radiological evaluation, multiple duodeno-pancreatic NETs (range 1-8, size 3-18 mm) were detected.

Results: An objective tumour response was observed in 10%, stable disease in 80% and progression of disease in 10% of cases. In six patients with abnormally increased CgA, gastrin and/or insulin serum concentrations, a significant clinical and hormonal response occurred in 100% of cases and was stable along the time.

Conclusions: Therapy with SSA is highly safe and effective in patients with early-stage MEN1 duodeno-pancreatic NETs, resulting in long-time suppression of tumour and hormonal activity and 10% objective response. This suggests to early start therapy with SSA in patients with MEN1-related NETs.

MeSH terms

  • Adult
  • Cell Differentiation
  • Disease Progression
  • Endocrine System / physiology
  • Female
  • Gastrins / blood
  • Humans
  • Insulin / blood
  • Male
  • Middle Aged
  • Multiple Endocrine Neoplasia Type 1 / complications
  • Multiple Endocrine Neoplasia Type 1 / drug therapy*
  • Neuroendocrine Tumors / complications
  • Neuroendocrine Tumors / drug therapy*
  • Octreotide / therapeutic use*
  • Retrospective Studies
  • Somatostatin / chemistry
  • Time Factors
  • Treatment Outcome

Substances

  • Gastrins
  • Insulin
  • Somatostatin
  • Octreotide