Use of somatostatin analog in management of carcinoid syndrome
Tóm tắt
Carcinoid tumors are the most frequent gut neuroendocrine tumors accounting for more than 50% of all tumors of the gastroenteropancreatic (GEP) axis. These tumors appear to derive from a stem cell line capable of differentiating into a variety of malignant cells that secrete many different peptides and amines. The symptoms of carcinoid tumors are often non-specific, vague abdominal pain that may precede the diagnosis by a median of 9 years. Carcinoid syndrome occurs in <10% of patients. We evaluated the effects of SMS 201-995 in 14 such patients, 12 with diarrhea, 8 with flushing, 3 with wheezing, one with tricuspid valve incompetence, 6 with facial teleangiectasia, 3 with a pellagra type dermatosis and one with myopathy. Diarrhea was abolished or significantly reduced in 83%, flushing in 100%, wheezing in 100%, and myopathy improved in the one patient. Blood serotonin was resistant to change, urine 5HIAA fell in 75%, and most gut neuropeptide hormones apart from somatostatin were suppressed. Tumor growth appeared to be slowed in 2/3 of cases treated for up to 4 years. The analog of somatostatin appears to be a useful addition to the therapeutic armamentarium for carcinoid tumors and the symptom complex.
Tài liệu tham khảo
Davis Z, Moertel CG, Mclirath DC: The malignant carcinoid syndrome. Surg Gynec Obstet 137:637–644, 1973
Buchanan KD, Johnston CF, O'Hare MMT, et al: Neuroendocrine tumors. A European view. Am J Med 81 (Suppl 6b): 14–22, 1986
Solcia E, Capella C, Buffa R, Frigerio B, Usellini L, Fiocca R: Morphological and functional classification of endocrine cells and related growths in the gastrointestinal tract.In Gastrointestinal Hormones. GBJ Glass (ed). New York, Raven Press, 1988, pp 1–17.
Weil C: Gastroenteropancreatic endocrine tumors. Klivo 63:433–459, 1985
Simpson S, Vinik AI, Marangos PJ, Lloyd RV: Immunohistochemical localization of neuron-specific enolase in gastroentero-pancreatic neuroendocrine tumors. Correlation with tissue and serum levels of neuron-specific enolase. Cancer 54:1364, 1984
Moertel CG: Treatment of the carcinoid tumor and the malignant carcinoid syndrome. J Clin Oncol 1:727–740, 1983
Godwin JD II: Carcinoid tumors an analysis of 2837 cases. Cancer 36:560–569, 1975
Strodel W, Vinik A, Thompson N, et al: Carcinoid tumors of the small intestine.In Endocrine Surgery Update. NW Thompson, AI Vinik (eds). New York, Grune & Stratton, 1983, pp 293–320
Melmon KL, Sjoerdsma A, Oates JA, Laster L: Treatment of malabsorption and diarrhea of carcinoid syndrome with methysergide. Gastroenterology 48:18, 1965
Feldman JM: Urinary serotonin in the diagnosis of carcinoid tumor. Clin Chem 32:840–844, 1986
Sandler M, Karim SMM, William ED: Prostaglandin in amine-peptide-secreting tumors. Lancet 2:1053–1055, 1968
Alumets J, Hakanson R, Ingemannson S, Sundler F: Substance P and 5-HT in granules isolated from an intestinal argentaffin carcinoid. Histochemistry 52:217, 1977
Oates JA, Pettinger WA, Doctor RB: Evidence for the release of bradykinin in the carcinoid syndrome. J Clin Invest 45:173–178, 1966
Pernow B, Waidenstrom J: Determination of 5-hydroxytryptamine, 5 hydrosyindolacetic acid and histamine in thirtythree cases of carcinoid tumor (argentaffinoma). Am J Med 34:255–260, 1985
Wilander E, Grimelius L, Portela-Gomes G, Sloan JM: Substance P and enteroglucagon-like immunoreactivity in argentaffin and argyrophil mid gut carcinoid tumors. Scand J Gastroenterol (suppl) 14:19–25, 1979
Strodel WE, Vinik AI, Jaffe BM, Eckhauzer F, Thompson NW: Substance P in the localization of a carcinoid tumor. J Surg Oncol 27:106–111, 1984
Lucas KG, Feldman JM: Flushing in the carcinoid syndrome and plasma kallikrein. Cancer 58:2290–2293, 1986
Pernow B, Waldenstrom J: Determination of 5-hydroxytryptamine, 5-hydroxy indoleacetic acid and histamine in 33 cases of carcinoid (argentaffinoma). Am J Med 23:16–25, 1957
Feldman JM: Increased dopamine production in patients with carcinoid tumors. Metabolism 34:255–260, 1985
Theodrosson-Norheim E, Norheism KO, Brodin E, et al: Neuropeptide K: A major tachykinin in plasma and tumor tissues from carcinoid patients. Biochem Biophys Res Commun 131:77–83, 1985
Vinik AI, Strodel WM, Lloyd RV: Unusual gastroenteropancreatic tumors and their hormones.In Endocrine Surgery Update. NW Thompson, AI Vinik (eds). New York, Grune & Stratton, 1983, pp 293–320
Feldman J, O'Dorisio TM: Role of neuropeptides and serotonin in the diagnosis of carcinoid tumors. Am J Med 81(suppl 6b):41–48, 1986
Kvols LK: Metastatic carcinoid tumors and the carcinoid syndrome. A selective review of chemotherapy and hormonal therapy. Am J Med 81 (suppl 6b):49–55, 1986
Maton PN, Camilleri M, Griffin G, Hodgson H, Allison DJ, Chadwick VS: The role of hepatic arterial embolization in the carcinoid syndrome. Br Med J 287:932–935, 1983
Gyn NE, Kayasseh L, Keller IJ: VIP and watery diarrhea.In Gut Hormones, 2nd ed. SR Bloom, JM Polak (ed). Edinburgh, Churchill Livinston, 1981, pp 581–585
Sheppard M, Shapiro B, Primstone B, Kronhein S, Berelowitz M, Gregory M: Metabolic clearance and plasma half-disappearance time of exogenous somatostatin in man. J Clin Endocrinol Metab 48:50–53, 1979
Bauer W, Briner U, Doepfner W, Waller R, Huguenin R, Marbach P, Fletcher TJ, Pless T: A very potent and selective octapeptide analogue of somatostatin with prolonged action. Life Sci 31:1133–1140, 1982
Walker TP: The determination of serotonin (5-hydroytryptamine) in human blood. J Lab Clin Med 55:824–829, 1959
Davis RB: The concentration of serotonin in normal human serum as determined by an improved method. J Lab Clin Med 54:344–351, 1959
Das ML: A rapid, sensitive method for direct estimation of serotonin in whole blood. Biochem Med 6:299–309, 1972
Udenfriend C, Titus E, Weissbach H: The identification of 5-hydroxy-3-indoleacetic acid in normal urine and a method for its assay. J Biol Chem 216:499–505, 1955
Vinik AI, Achem Karam S, Owyang C: Gastrointestinal hormones in clinical medicine.In Special Topics in Endocrinology and Metabolism, Vol 4. MP Cohen, PP Foa (eds). New York. Alan R. Liss, 1982, pp 93–138
Tsai ST, Lewis E, Vinik AI: The use of a somatostatin analogue in the management of the flushing syndrome. Scand J Gastroenterol 21(suppl 119):267–274, 1985
Frohlich J, Bloomgarden Z, Oates J, et al: The carcinoid flush provocation by pentagastrin and inhibition by somatostatin. N Engl J Med 299:1055–1057, 1978
Kvols LK, Moertel CG, O'Connell MJ, Schutt AJ, Rubin J, Hahn R: Treatment of the malignant carcinoid syndrome. Evaluation of a long-acting somatostatin analogue. N Engl J Med 315:663–666, 1986
Richter G, Stockmann F, Lembeke B, Conlon JM, Creutzfeldt W: Short-term administration of somatostatin analogue SMS 20-1995 in patients with carcinoid tumors. Scand J Gastroenterol 21(suppl 119):193–198, 1986
Kvols LK, Martin JK, Marsh HM, Moertel CG: Carcinoid crisis: Rapid reversal of the life-threatening hypotension with a somatostatin analogue. N Engl J Med 313:1229, 1985
Santangelo WC, O'Dorisio TM, Kim JG, Severino G, Krejs GJ: Pancreatic cholera syndrome—effect of a synthetic somatostatin analogue on intestinal water and ion transport. Ann Intern Med 103:363–367, 1985
Vinik A, Tsai S, Moattarri A, Cheung P, Eckhauser F, Cho K: Somatostatin analogue (SMS 201-995) in the management of gastroenteropancreatic tumors and diarrhea syndromes. Am J Med 81(suppl 6b):23–40, 1986
Arnold R, Lankisch: Somatostatin and the gastrointestinal tract. Clin Gastroenterol 9:733–754, 1980
Stockmann F, Richter G, Lembcke B, Conlon JM, Creutzfeldt W: Long-term treatment of patients with endocrine gastrointestinal tumors with the somatostatin analogue SMS 201-995. Scand J Gastroenterol 21 (suppl 119):230–237, 1986
Hengl G, Prager J, Pointner H: The influence of somatostatin on the absorption of triglycerides in partially gastrectomized subjects. Acta Hepato-Gastroenterol 26:392–395, 1979
Wood SM, Kraenzlin ME, Adrian TE, Bloom SR: Treatment of patients with pancreatic endocrine tumors using a new long-acting somatostatin analogue: Symptomatic and peptide responses. Gut 26:438–444, 1985
Poole CJM: Myelopathy secondary to metastatic carcinoid tumors. J Neurol Neurosurg Psychiatr 47:1359–1360, 1984
Berry EM, Maunder C, Wilson M: Carcinoid myopathy and treatment with cyproheptadine (periactin). Gut 15:34–38, 1974
Green D, Joynt RJ, Van Allen MW: Neuromyopathy associated with a malignant carcinoid tumor. Arch Intern Med 114:494–496, 1964
Wroe SJ, Ardon M, Bouden AR: Myasthenia gravis associated with a hormone producing malignant carcinoid tumor. J Neurol Neurosurg Psychiat 48:719–720, 1985
O'Stern WK, Barnard JL Jr, Yates RD: Morphologic changes in skeletal muscle induced by serotonin treatment, a light and electron microscopy study. Exp Mol Pathol 7:145–155, 1967
Kraenzlin ME, Ching KC, Wood SM, Carr DH, Bloom SR: Long-term treatment of a VIPoma with somatostatin analogue resulting in remission of symptoms and possible shrinkage of metastases. Gastorenterology 88:185–7, 1985