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A Multicenter Randomized Phase II Study of Single Agent Efficacy and Optimal Combination Sequence of Everolimus and Pasireotide LAR in Advanced Thyroid Cancer. Cancers (Basel) 2022; 14:cancers14112639. [PMID: 35681620 PMCID: PMC9179856 DOI: 10.3390/cancers14112639] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 05/24/2022] [Accepted: 05/25/2022] [Indexed: 12/10/2022] Open
Abstract
Purpose: Aberrant mTOR pathway and somatostatin receptor signaling are implicated in thyroid cancer and offer potential therapeutic targets. We assessed the clinical efficacy of everolimus and Pasireotide long-acting release (LAR) in radioiodine-refractory differentiated thyroid cancer (DTC) and medullary thyroid cancer (MTC). Patients and methods: Adults with progressive MTC and DTC untreated or treated with no more than one systemic agent were eligible. The trial was designed to establish the most promising regimen and the optimal combination sequence. Patients were randomized to start treatment with single agent everolimus (10 mg QD; Arm A), pasireotide-LAR (60 mg intramuscular injection, Q4 weeks; Arm B), or the combination (Arm C). At initial progression (PFS1), patients on Arm A or B switched to the combination and continued until progression (PFS2). Efficacy was measured by RECIST criteria. Results: Study enrolled 42 patients: median age 65 years; female 17 (40.5%); White 31 (73.8%), African American 6 (14.3%), others 5 (11.9); DTC 32 (76.2%); MTC 10 (23.8%). There was no objective response by RECIST criteria across the three arms. Median and 1-year PFS1 rates were 8.3, 1.8, 8.1 months and 49.9%, 36.4%, 25.0% for Arms A, B, C, respectively. Median and 1-year PFS2 rates were 26.3, 17.5, 8.1 months and 78.4%, 70.0%, 25% for Arms A, B, C, respectively. The most frequent adverse events were anemia, stomatitis, fatigue, hyperglycemia, and hypercholesterolemia. Conclusions: The combination of everolimus and pasireotide-LAR showed promising efficacy over single agent. The delayed combination of everolimus and pasireotide-LAR following progression on single agent everolimus appeared intriguing as a combination strategy.
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Faugeras L, Pirson AS, Donckier J, Michel L, Lemaire J, Vandervorst S, D'Hondt L. Refractory thyroid carcinoma: which systemic treatment to use? Ther Adv Med Oncol 2018; 10:1758834017752853. [PMID: 29399055 PMCID: PMC5788129 DOI: 10.1177/1758834017752853] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 12/01/2017] [Indexed: 12/21/2022] Open
Abstract
The incidence of thyroid cancer has increased markedly in recent decades, but has been stable in terms of mortality rates. For the most part, these cancers are treated with surgery, which may or may not be followed by radioactive iodine depending on the tumor subtype. Still, many of these cancers will recur and may be treated with radioactive iodine or another surgery. It is unclear what treatment is best for cases of locally advanced or metastatic thyroid cancer that are refractory to radioactive iodine. Chemotherapy has a very low response rate. However, in the past few years, several systemic therapies, primarily targeted, have emerged to improve the overall survival of these patients. Alternative treatments are also of interest, namely peptide receptor radionuclide therapy or immunotherapy.
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Affiliation(s)
- Laurence Faugeras
- Oncology Department, CHU UCL Namur, 1 rue Therasse, 5530 Yvoir, Belgium
| | | | | | - Luc Michel
- Department of General Surgery, CHU UCL Namur, Yvoir, Belgium
| | - Julien Lemaire
- Department of General Surgery, CHU UCL Namur, Yvoir, Belgium
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Salavati A, Puranik A, Kulkarni HR, Budiawan H, Baum RP. Peptide Receptor Radionuclide Therapy (PRRT) of Medullary and Nonmedullary Thyroid Cancer Using Radiolabeled Somatostatin Analogues. Semin Nucl Med 2016; 46:215-24. [DOI: 10.1053/j.semnuclmed.2016.01.010] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Traub-Weidinger T, Putzer D, von Guggenberg E, Dobrozemsky G, Nilica B, Kendler D, Bale R, Virgolini IJ. Multiparametric PET imaging in thyroid malignancy characterizing tumour heterogeneity: somatostatin receptors and glucose metabolism. Eur J Nucl Med Mol Imaging 2015; 42:1995-2001. [DOI: 10.1007/s00259-015-3114-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 06/10/2015] [Indexed: 01/22/2023]
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Lindner C, Dierneder J, Pall G, Pirich C, Hoffmann M, Raderer M, Becherer A, Niederle B, Lipp R, Lind P, Gallowitsch H, Romeder F, Virgolini I. [Treatment of patients with radioiodine refractory, differentiated thyroid carcinoma. A Consensus Statement]. Nuklearmedizin 2014; 54:125-30. [PMID: 25421138 DOI: 10.3413/nukmed-0688-14-07] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 11/11/2014] [Indexed: 02/01/2023]
Abstract
There is no clear standard therapy for patients with radioactive iodine (131I)-refractory locally advanced or metastatic differentiated thyroid cancer. The therapeutic options for this indication have expanded with the recently approved multiple kinase inhibitor sorafenib. Recommendations for the definition and the management of iodine refractory patients were worked up by an interdisciplinary expert panel, consisting of endocrine surgeons, medical oncologists and nuclear medicine specialists.
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Affiliation(s)
- Christina Lindner
- Christina Lindner, MSc, Department Life Sciences, Medizinische und Pharmazeutische Biotechnologie, IMC FH Krems, E-Mail:
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Woelfl S, Bogner S, Huber H, Salaheddin-Nassr S, Hatzl M, Decristoforo C, Virgolini I, Gabriel M. Expression of somatostatin receptor subtype 2 and subtype 5 in thyroid malignancies. Nuklearmedizin 2014; 53:179-85. [PMID: 24967740 DOI: 10.3413/nukmed-0646-14-02] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Accepted: 06/12/2014] [Indexed: 11/20/2022]
Abstract
AIM To retrospectively analyse the expression of somatostatin receptor subtypes 2 (SSTR 2) and 5 (SSTR 5) in thyroid malignancies, possibly the most relevant subtypes for targeted therapy with somatostatin peptide radioligands. In addition, findings were also correlated with the course of disease. PATIENTS, METHODS 87 consecutive patients (59 women, 28 men) with thyroid malignancy were included; 52 had papillary carcinoma, 24 follicular carcinoma, six medullary carcinoma, two poorly differentiated carcinoma and three anaplastic carcinoma. After initial therapy 70 (80.5%) patients showed complete remission, 11 (12.6%) patients partial remission with clinical and biochemical signs of residual disease and six (6.9%) patients progressive disease. The immunohistochemical staining results of the primary malignancy for SSTR 2 and SSTR 5 were semiquantitatively assessed and correlated with various outcome parameters. RESULTS In 10 of 87 (11.49%) thyroid cancer samples SSTR 2 showed positive immunohistochemical expression as compared to 75 of 87 (86.20%) for SSTR 5. All SSTR 2-positive cases expressed SSTR 5. Persistent or recurrent disease was found in 17 of 87 cases (19.54%). Fifty percent (6 /12) of SSTR 5-negative patients showed persistent disease as compared to 14.7 % (11 / 75) of SSTR 5-positive patients: seven of these were exclusively SSTR 5-positive, 4 showed dual expression of SSTR 5 and SSTR 2 (p = 0.01). No case showed only SSTR 2 expression. CONCLUSIONS SSTR 5 was shown to be the main receptor subtype in the analysed differentiated or anaplastic thyroid malignancies, whereas SSTR 2 was found only in a small percentage. Deficient SSTR expression may indicate higher risk for persistent or recurrent disease after initial therapy. For this reason immunohistochemistry can be considered a prognostic marker which should be further validated in prospective studies.
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Affiliation(s)
| | | | | | | | | | | | | | - M Gabriel
- Prof. Dr. Michael Gabriel, Department of Nuclear Medicine and Endocrinology General Hospital, Krankenhausstr. 9, 4021 Linz, Austria, Tel. +43/(0)732/78 06 61-41, Fax -65, E-mail: ,
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Puig-Domingo M, Luque RM, Reverter JL, López-Sánchez LM, Gahete MD, Culler MD, Díaz-Soto G, Lomeña F, Squarcia M, Mate JL, Mora M, Fernández-Cruz L, Vidal O, Alastrué A, Balibrea J, Halperin I, Mauricio D, Castaño JP. The truncated isoform of somatostatin receptor5 (sst5TMD4) is associated with poorly differentiated thyroid cancer. PLoS One 2014; 9:e85527. [PMID: 24465589 PMCID: PMC3897452 DOI: 10.1371/journal.pone.0085527] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Accepted: 11/28/2013] [Indexed: 01/22/2023] Open
Abstract
Somatostatin receptors (ssts) are expressed in thyroid cancer cells, but their biological significance is not well understood. The aim of this study was to assess ssts in well differentiated (WDTC) and poorly differentiated thyroid cancer (PDTC) by means of imaging and molecular tools and its relationship with the efficacy of somatostatin analog treatment. Thirty-nine cases of thyroid carcinoma were evaluated (20 PDTC and 19 WDTC). Depreotide scintigraphy and mRNA levels of sst-subtypes, including the truncated variant sst5TMD4, were carried out. Depreotide scans were positive in the recurrent tumor in the neck in 6 of 11 (54%) PDTC, and in those with lung metastases in 5/11 cases (45.4%); sst5TMD4 was present in 18/20 (90%) of PDTC, being the most densely expressed sst-subtype, with a 20-fold increase in relation to sst2. In WDTC, sst2 was the most represented, while sst5TMD4 was not found; sst2 was significantly increased in PDTC in comparison to WDTC. Five depreotide positive PDTC received octreotide for 3–6 months in a pilot study with no changes in the size of the lesions in 3 of them, and a significant increase in the pulmonary and cervical lesions in the other 2. All PDTC patients treated with octreotide showed high expression of sst5TMD4. ROC curve analysis demonstrated that only sst5TMD4 discriminates between PDTC and WDTC. We conclude that sst5TMD4 is overexpressed in PDTC and may be involved in the lack of response to somatostatin analogue treatment.
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Affiliation(s)
- Manel Puig-Domingo
- Service of Endocrinology and Nutrition, Department of Medicine, Germans Trias i Pujol Health Science Research Institute and Hospital, Universitat Autònoma de Barcelona, Badalona, Spain
- * E-mail:
| | - Raúl M. Luque
- Department of Cell Biology, Physiology and Immunology University of Córdoba, Reina Sofía University Hospital, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Córdoba, Spain
| | - Jordi L. Reverter
- Service of Endocrinology and Nutrition, Department of Medicine, Germans Trias i Pujol Health Science Research Institute and Hospital, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Laura M. López-Sánchez
- Department of Cell Biology, Physiology and Immunology University of Córdoba, Reina Sofía University Hospital, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Córdoba, Spain
| | - Manuel D. Gahete
- Department of Cell Biology, Physiology and Immunology University of Córdoba, Reina Sofía University Hospital, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Córdoba, Spain
| | | | - Gonzalo Díaz-Soto
- Service of Endocrinology, Hospital Clínico de Valladolid, Valladolid, IEN-UVa, Valladolid, Spain
| | - Francisco Lomeña
- Service of Nuclear Medicine, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Mattia Squarcia
- Service of Radiology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - José Luis Mate
- Department of Pathology, Germans Trias i Pujol Health Science Research Institute and Hospital, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Mireia Mora
- Service of Endocrinology and Nutrition, Hospital Clínic de Barcelona, Barcelona, Spain
| | | | - Oscar Vidal
- Service of Surgery, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Antonio Alastrué
- Service of General Surgery, Department of Surgery, Germans Trias i Pujol Health Science Research Institute and Hospital, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Jose Balibrea
- Service of General Surgery, Department of Surgery, Germans Trias i Pujol Health Science Research Institute and Hospital, Universitat Autònoma de Barcelona, Badalona, Spain
- Service of General Surgery, Department of Surgery, Vall d'Hebron Research Institute and Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Irene Halperin
- Service of Endocrinology and Nutrition, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Dídac Mauricio
- Service of Endocrinology and Nutrition, Department of Medicine, Germans Trias i Pujol Health Science Research Institute and Hospital, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Justo P. Castaño
- Department of Cell Biology, Physiology and Immunology University of Córdoba, Reina Sofía University Hospital, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Córdoba, Spain
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Treglia G, Rindi G, Rufini V. Expression of somatostatin receptors may guide the use of somatostatin receptor imaging and therapy in differentiated thyroid cancer. Hormones (Athens) 2012; 11:230-2. [PMID: 22908057 DOI: 10.1007/bf03401532] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ersahin D, Doddamane I, Cheng D. Targeted radionuclide therapy. Cancers (Basel) 2011; 3:3838-55. [PMID: 24213114 PMCID: PMC3763399 DOI: 10.3390/cancers3043838] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Revised: 09/27/2011] [Accepted: 09/27/2011] [Indexed: 12/22/2022] Open
Abstract
Targeted radiotherapy is an evolving and promising modality of cancer treatment. The killing of cancer cells is achieved with the use of biological vectors and appropriate radionuclides. Among the many advantages of this approach are its selectiveness in delivering the radiation to the target, relatively less severe and infrequent side effects, and the possibility of assessing the uptake by the tumor prior to the therapy. Several different radiopharmaceuticals are currently being used by various administration routes and targeting mechanisms. This article aims to briefly review the current status of targeted radiotherapy as well as to outline the advantages and disadvantages of radionuclides used for this purpose.
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Affiliation(s)
- Devrim Ersahin
- Department of Diagnostic Radiology, School of Medicine, Yale University, 333 Cedar St., New Haven, CT 06520, USA.
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Hasskarl J, Kaufmann M, Schmid HA. Somatostatin receptors in non-neuroendocrine malignancies: the potential role of somatostatin analogs in solid tumors. Future Oncol 2011; 7:895-913. [PMID: 21732759 DOI: 10.2217/fon.11.66] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Somatostatin receptors (sstrs) are G-protein-coupled receptors that mediate various physiological effects when activated by the neuropeptide somatostatin or its synthetic analogs. In addition to the well-documented antisecretory effects of sstr2-preferential somatostatin analogs octreotide and lanreotide, ligand binding to sstr initiates an inhibitory action on tumor growth. This effect may result from both indirect actions (suppression of growth factors and growth-promoting hormones [e.g., GH/IGF-1 axis] and inhibition of angiogenesis) and direct actions (activation of antigrowth activities [e.g., apoptosis]). As solid tumor cells express multiple sstrs, there is a rationale to evaluate the potential antitumor effects of pasireotide (SOM230), a multireceptor-targeted somatostatin analog with high binding affinity for sstr1–3 and sstr5. Pasireotide reduces systemic IGF-1 levels more potently than currently available somatostatin analogs and has been well tolerated in clinical trials.
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Affiliation(s)
| | - Martina Kaufmann
- Novartis Pharma AG, Forum 1, Novartis Campus, CH-4056 Basel, Switzerland
| | - Herbert A Schmid
- Novartis Pharma AG, Forum 1, Novartis Campus, CH-4056 Basel, Switzerland
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Silberstein EB. The Problem of the Patient with Thyroglobulin Elevation but Negative Iodine Scintigraphy: The TENIS Syndrome. Semin Nucl Med 2011; 41:113-20. [DOI: 10.1053/j.semnuclmed.2010.10.002] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Middendorp M, Grünwald F. Update on recent developments in the therapy of differentiated thyroid cancer. Semin Nucl Med 2010; 40:145-52. [PMID: 20113682 DOI: 10.1053/j.semnuclmed.2009.10.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
In the past decade, the management of differentiated thyroid carcinoma changed significantly and thus contributed to the improvement of the already favorable prognosis of this malignant disease. Surgical treatment techniques improved and the extent of initial surgery is more individualized. Radioiodine therapy is an essential part of therapeutic regimens in almost all cases, and the use of recombinant human thyroid-stimulating hormone has established for ablation of remnant tissue, treatment of iodine-positive cancer, and sensitive thyroglobulin measurement during follow-up. Risk stratification has become more important to plan treatment and follow-up individually, particularly to evaluate the need for thyroid-stimulating hormone suppression therapy. Especially for inoperable and radioiodine-negative thyroid carcinomas, novel treatment options such as tyrosine kinase inhibitor therapy have emerged. This article deals with the current options of optimal therapy regimens in differentiated thyroid carcinoma.
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Affiliation(s)
- Marcus Middendorp
- Department of Nuclear Medicine, Johann Wolfgang Goethe University, Frankfurt/Main, Germany
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Sancak S, Hardt A, Singer J, Klöppel G, Eren FT, Güllüoglu BM, Sen LS, Sever Z, Akalin NS, Eszlinger M, Paschke R. Somatostatin receptor 2 expression determined by immunohistochemistry in cold thyroid nodules exceeds that of hot thyroid nodules, papillary thyroid carcinoma, and Graves' disease. Thyroid 2010; 20:505-11. [PMID: 20450431 DOI: 10.1089/thy.2009.0203] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND There is a plethora of partly contradictory reports on somatostatin receptor (SSTR) expression in thyroid tumors. Therefore, our goal was to systematically determine SSTR2 expression in benign cold thyroid nodules (CNs), hot thyroid nodules (HNs), papillary carcinomas (PCs), and Graves' disease (GD) in comparison with intraindividual control tissues by means of immunohistochemistry. METHODS Tissue sections from 19 HNs, 10 CNs, 17 PCs and their surrounding tissues, and 8 GD thyroids were immunostained for SSTR2. Membranous SSTR2 staining was quantitated by evaluating 10 high-power fields (HPFs) systematically distributed along the largest diameter of the tissue section. RESULTS The area covered by thyroid epithelial cells in 10 HPFs expressed as median (in mm(2)) was 0.53 for CNs, 0.44 for HNs, 1.5 for PCs, 1.3 for GD, and 0.3 for the surrounding tissues. The SSTR2 staining density determined by dividing the area of SSTR2 positively stained thyroid epithelial cells (in mm(2)) by the area of all thyroid epithelial cells (in mm(2)) in 10 HPFs was 0.1662 for CNs, 0.0204 for HNs, 0.0369 for PCs, and 0.0386 for GD. CONCLUSIONS SSTR2 expression is inhomogeneous in thyroid disease, with the highest density detected in CNs. It remains to be determined whether this finding could be of pathophysiologic or therapeutic relevance. The high SSTR2 density in CNs should be considered in the interpretation of SSTR scintigraphy-positive findings.
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Affiliation(s)
- Seda Sancak
- Section of Endocrinology and Metabolism, Marmara Medical School, Istanbul, Turkey
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Emerging molecular therapies of advanced thyroid cancer. Mol Aspects Med 2010; 31:215-26. [DOI: 10.1016/j.mam.2010.02.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2009] [Accepted: 02/16/2010] [Indexed: 01/05/2023]
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Lincke T, Singer J, Kluge R, Sabri O, Paschke R. Relative quantification of indium-111 pentetreotide and gallium-68 DOTATOC uptake in the thyroid gland and association with thyroid pathologies. Thyroid 2009; 19:381-9. [PMID: 19355828 DOI: 10.1089/thy.2008.0389] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Recent data suggest that increased somatostatin receptor (SSTR) expression is detectable in several thyroid diseases. This raises the question as to the specificity and pathophysiologic relevance of these findings. Therefore, we systematically evaluated Indium-111 (In-111) pentetreotide scintigraphies and Gallium-68 (Ga-68) DOTA-Phe(1)-Tyr(3)-Octreotide (DOTATOC) positron emission tomography (PET) scans for thyroid radiotracer uptake. METHODS Relative binding of In-111 pentetreotide in the thyroid was measured by region of interest (ROI) technique in 4-hour and 24-hour post-injection (p.i.) planar images of 73 patients undergoing In-111 pentetreotide scintigraphy. Ga-68 DOTATOC PET scans of 77 patients were analyzed by ROI technique applied to coronal slices of 1 cm (0.39 inch) thickness with highest uptake in the thyroid region. RESULTS A basal indium In-111 and Ga-68 DOTATOC uptake was found in normal thyroid glands. Hot nodules, disseminated thyroid autonomy, and most cases of active Hashimoto's disease as well as goiters and nodular thyroids showed increased In-111 pentetreotide and/or Ga-68 DOTATOC uptake. Higher relative In-111 pentetreotide uptake in the 24-hour p.i. images as compared to the 4-hour p.i. images except for patients after thyroidectomy indicates specific receptor binding in the thyroid. CONCLUSIONS The increased In-111 pentetreotide and Ga-68 DOTATOC uptake in active Hashimoto's disease is most likely related to the lymphocytic infiltration of the thyroid. However, the physiologic or pathophysiologic relevance of the increased In-111 pentetreotide and Ga-68 DOTATOC uptake in normal thyroid glands, hot and cold nodules, and goiters and nodular thyroids remain to be determined.
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Affiliation(s)
- Thomas Lincke
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
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Pfister DG, Fagin JA. Refractory thyroid cancer: a paradigm shift in treatment is not far off. J Clin Oncol 2008; 26:4701-4. [PMID: 18541893 DOI: 10.1200/jco.2008.17.3682] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
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THYROID CANCER. Cancer Invest 2007. [DOI: 10.1080/07357900701571981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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