Disappearing Lump-an Unusual Presentation of Large Metastatic Small Bowel Malignant Melanoma

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

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, 320) at baseline before initiation of therapy, while the mean number of BMs at 1 week time point post enterade AO was 2.9 (range, 011).

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.