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Kumar U. Somatostatin and Somatostatin Receptors in Tumour Biology. Int J Mol Sci 2023; 25:436. [PMID: 38203605 PMCID: PMC10779198 DOI: 10.3390/ijms25010436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/24/2023] [Accepted: 12/25/2023] [Indexed: 01/12/2024] Open
Abstract
Somatostatin (SST), a growth hormone inhibitory peptide, is expressed in endocrine and non-endocrine tissues, immune cells and the central nervous system (CNS). Post-release from secretory or immune cells, the first most appreciated role that SST exhibits is the antiproliferative effect in target tissue that served as a potential therapeutic intervention in various tumours of different origins. The SST-mediated in vivo and/or in vitro antiproliferative effect in the tumour is considered direct via activation of five different somatostatin receptor subtypes (SSTR1-5), which are well expressed in most tumours and often more than one receptor in a single cell. Second, the indirect effect is associated with the regulation of growth factors. SSTR subtypes are crucial in tumour diagnosis and prognosis. In this review, with the recent development of new SST analogues and receptor-specific agonists with emerging functional consequences of signaling pathways are promising therapeutic avenues in tumours of different origins that are discussed.
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Affiliation(s)
- Ujendra Kumar
- Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada
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Karls S, Gold R, Kravets S, Wang Y, Cheng S, Perez K, Chan J, Jacene H. Correlation of 68Ga-DOTATATE uptake on PET/CT with pathologic features of cellular proliferation in neuroendocrine neoplasms. Ann Nucl Med 2021; 35:1066-1077. [PMID: 34146243 DOI: 10.1007/s12149-021-01642-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 06/08/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE 68Ga-DOTATATE positron emission tomography/computed tomography (PET/CT) is a useful tool for diagnosing and staging neuroendocrine neoplasms (NEN). Unlike other PET tracers like FDG, the meaningfulness and use of standardized uptake values (SUVs) of 68Ga-DOTATATE is not well-established. This study aimed to determine if a correlation exists between intensity of 68Ga-DOTATATE uptake and markers of cellular proliferation. METHODS This retrospective study included 79 patients with positive 68Ga-DOTATATE PET/CT and Ki-67 and/or mitotic index (MI) available on pathology report. SUVmax of the most intense lesion and the most intense organ-matched lesion were determined. Demographics and pathology results for Ki-67 and MI were collected from the electronic medical record. Correlations and trends for correlations of SUVmax to Ki-67 and MI were performed using Kruskal-Wallis and Cuzick trend tests. RESULTS A trend for an association between SUVmax and Ki-67 grade was found; median SUVmax of Ki-67 < 3%, 3-20%, and > 20% was 35.2, 31.8, and 12.8 (p = 0.077), respectively. There was also a trend between SUVmax and Ki-67 categories in organ-matched lesions (p = 0.08). The median organ-matched SUVmax of MI < 2, 2-20, and > 20 lesions was 34.2, 18, and 21.7, respectively, (Cuzick trend test p = 0.066). The median SUVmax for small bowel, pancreatic, and other primary locations was 27.6, 46.9, and 9.3 (p < 0.01), respectively. CONCLUSIONS The association between 68Ga-DOTATATE SUVmax, histologic grade, and primary site of NEN demonstrates its potential use for prognostication, or potentially as a surrogate for histologic grading when biopsy is not possible.
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Affiliation(s)
- Shawn Karls
- Department of Imaging, Dana-Farber Cancer Institute, 450 Brookline Avenue, DL203, Boston, MA, 02215, USA
- Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Richard Gold
- St. Georges University, School of Medicine, St. George, Grenada
| | - Sasha Kravets
- Division of Biostatistics, Department of Data Science, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Yating Wang
- Division of Biostatistics, Department of Data Science, Dana-Farber Cancer Institute, Boston, MA, USA
| | - SuChun Cheng
- Division of Biostatistics, Department of Data Science, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Kimberly Perez
- Program in Neuroendocrine and Carcinoid Tumors, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Jennifer Chan
- Program in Neuroendocrine and Carcinoid Tumors, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Heather Jacene
- Department of Imaging, Dana-Farber Cancer Institute, 450 Brookline Avenue, DL203, Boston, MA, 02215, USA.
- Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
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Prospective study of dynamic whole-body 68Ga-DOTATOC-PET/CT acquisition in patients with well-differentiated neuroendocrine tumors. Sci Rep 2021; 11:4727. [PMID: 33649421 PMCID: PMC7921579 DOI: 10.1038/s41598-021-83965-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 02/04/2021] [Indexed: 12/04/2022] Open
Abstract
To present the feasibility of a dynamic whole-body (DWB) 68Ga-DOTATOC-PET/CT acquisition in patients with well-differentiated neuroendocrine tumors (WD-NETs). Sixty-one patients who underwent a DWB 68Ga-DOTATOC-PET/CT for a histologically proven/highly suspected WD-NET were prospectively included. The acquisition consisted in single-bed dynamic acquisition centered on the heart, followed by the DWB and static acquisitions. For liver, spleen and tumor (1–5/patient), Ki values (in ml/min/100 ml) were calculated according to Patlak's analysis and tumor-to-liver (TLR-Ki) and tumor-to-spleen ratios (TSR-Ki) were recorded. Ki-based parameters were compared to static parameters (SUVmax/SUVmean, TLR/TSRmean, according to liver/spleen SUVmean), in the whole-cohort and according to the PET system (analog/digital). A correlation analysis between SUVmean/Ki was performed using linear and non-linear regressions. Ki-liver was not influenced by the PET system used, unlike SUVmax/SUVmean. The regression analysis showed a non-linear relation between Ki/SUVmean (R2 = 0.55,0.68 and 0.71 for liver, spleen and tumor uptake, respectively) and a linear relation between TLRmean/TLR-Ki (R2 = 0.75). These results were not affected by the PET system, on the contrary of the relation between TSRmean/TSR-Ki (R2 = 0.94 and 0.73 using linear and non-linear regressions in digital and analog systems, respectively). Our study is the first showing the feasibility of a DWB 68Ga-DOTATOC-PET/CT acquisition in WD-NETs.
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Somatostatin-Dopamine Chimeric Molecules in Neuroendocrine Neoplasms. J Clin Med 2021; 10:jcm10030501. [PMID: 33535394 PMCID: PMC7867079 DOI: 10.3390/jcm10030501] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/25/2021] [Accepted: 01/26/2021] [Indexed: 12/12/2022] Open
Abstract
Neuroendocrine neoplasms (NENs) are a widely heterogeneous family of neoplasms arising from neuroendocrine cells, which are interspersed throughout the body. Despite NENs are relatively rare, their incidence and prevalence are constantly increasing probably due to the improvement in earlier diagnosis and patients’ management. When surgery is not curative, particularly for patients with metastatic disease, several medical options are available. Somatostatin analogues (SSA) are the first-line medical therapy for well-differentiated NENs. Interestingly, the heterodimerization of somatostatin receptors (SSTs) with dopamine receptors (DRs) has been discovered in NENs. This phenomenon results in hybrid receptors with enhanced functional activity. On these bases, chimeric molecules embracing somatostatin and dopamine features have been recently developed. The aim of this review is to provide a comprehensive overview of the available preclinical and clinical data regarding chimeric somatostatin-dopamine agonists as a new class of “magic bullet” in the therapy of NENs.
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Hu Y, Ye Z, Wang F, Qin Y, Xu X, Yu X, Ji S. Role of Somatostatin Receptor in Pancreatic Neuroendocrine Tumor Development, Diagnosis, and Therapy. Front Endocrinol (Lausanne) 2021; 12:679000. [PMID: 34093445 PMCID: PMC8170475 DOI: 10.3389/fendo.2021.679000] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 04/27/2021] [Indexed: 12/02/2022] Open
Abstract
Pancreatic neuroendocrine tumors (pNETs) are rare and part of the diverse family of neuroendocrine neoplasms (NENs). Somatostatin receptors (SSTRs), which are widely expressed in NENs, are G-protein coupled receptors that can be activated by somatostatins or its synthetic analogs. Therefore, SSTRs have been widely researched as a diagnostic marker and therapeutic target in pNETs. A large number of studies have demonstrated the clinical significance of SSTRs in pNETs. In this review, relevant literature has been appraised to summarize the most recent empirical evidence addressing the clinical significance of SSTRs in pNETs. Overall, these studies have shown that SSTRs have great value in the diagnosis, treatment, and prognostic prediction of pNETs; however, further research is still necessary.
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Affiliation(s)
- Yuheng Hu
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Shanghai Pancreatic Cancer Institute, Shanghai, China
- Pancreatic Cancer Institute, Fudan University, Shanghai, China
| | - Zeng Ye
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Shanghai Pancreatic Cancer Institute, Shanghai, China
- Pancreatic Cancer Institute, Fudan University, Shanghai, China
| | - Fei Wang
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Shanghai Pancreatic Cancer Institute, Shanghai, China
- Pancreatic Cancer Institute, Fudan University, Shanghai, China
| | - Yi Qin
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Shanghai Pancreatic Cancer Institute, Shanghai, China
- Pancreatic Cancer Institute, Fudan University, Shanghai, China
| | - Xiaowu Xu
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Shanghai Pancreatic Cancer Institute, Shanghai, China
- Pancreatic Cancer Institute, Fudan University, Shanghai, China
| | - Xianjun Yu
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Shanghai Pancreatic Cancer Institute, Shanghai, China
- Pancreatic Cancer Institute, Fudan University, Shanghai, China
- *Correspondence: Xianjun Yu, ; Shunrong Ji,
| | - Shunrong Ji
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Shanghai Pancreatic Cancer Institute, Shanghai, China
- Pancreatic Cancer Institute, Fudan University, Shanghai, China
- *Correspondence: Xianjun Yu, ; Shunrong Ji,
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Lee H, Eads JR, Pryma DA. 68 Ga-DOTATATE Positron Emission Tomography-Computed Tomography Quantification Predicts Response to Somatostatin Analog Therapy in Gastroenteropancreatic Neuroendocrine Tumors. Oncologist 2021; 26:21-29. [PMID: 32886441 PMCID: PMC7794177 DOI: 10.1634/theoncologist.2020-0165] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 08/04/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Somatostatin analogs (SSAs) are the frontline antitumor therapy in advanced well-differentiated gastroenteropancreatic neuroendocrine tumors (GEP-NETs). A subset of patients demonstrate early disease progression on SSA therapy, yet the currently known predictors for treatment failure lack specificity to affect therapeutic decision. SSAs target tumor somatostatin receptors, the level of which can be quantitatively assessed with 68 Ga-DOTATATE positron emission tomography-computed tomography (PET/CT). We investigated the ability of 68 Ga-DOTATATE PET/CT to predict response to SSA therapy. MATERIALS AND METHODS The records of 108 consecutive patients with well-differentiated grade 1-2 GEP-NETs on SSA monotherapy who received 68 Ga-DOTATATE PET/CT scans were retrospectively reviewed to obtain baseline characteristics, 68 Ga-DOTATATE maximum standardized uptake value (SUVmax), and progression-free survival (PFS) data. The optimal SUVmax cutoff for patient stratification was obtained with receiver operating characteristic curve analysis. PFS in the high versus low SUVmax groups was compared with Kaplan-Meier survival analysis. The effects of baseline characteristics and SUVmax on PFS were examined with univariate and multivariate Cox regression. RESULTS 68 Ga-DOTATATE SUVmax predicted therapeutic failure with sensitivity and specificity of 39% and 98%, respectively. SUVmax of <18.35 was associated with shorter PFS, which was reproduced in the subgroup analysis of SSA-naïve patients. Low SUVmax was the only predictor of early treatment failure (hazard ratio, 6.85) in multivariate analysis, as well as in the subgroup analysis of grade 2 GEP-NETs. CONCLUSION Low SUVmax on 68 Ga-DOTATATE PET/CT independently predicts early failure on SSA monotherapy in patients with well-differentiated grade 1-2 GEP-NET. Patients with lack of expected benefit from SSA therapy can be readily identified using routine 68 Ga-DOTATATE PET/CT with very high specificity. IMPLICATIONS FOR PRACTICE Based on 68 Ga-DOTATATE positron emission tomography-computed tomography imaging, clinicians can better inform patients on the expected benefit of somatostatin analog therapy for gastroenteropancreatic neuroendocrine tumors, especially when access to the therapy is difficult, and offer proactive discussion on alternative management options.
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Affiliation(s)
- Hwan Lee
- Department of Radiology, University of Pennsylvania Perelman School of MedicinePhiladelphiaPennsylvaniaUSA
| | - Jennifer R. Eads
- Department of Medicine, University of Pennsylvania Perelman School of MedicinePhiladelphiaPennsylvaniaUSA
| | - Daniel A. Pryma
- Department of Radiology, University of Pennsylvania Perelman School of MedicinePhiladelphiaPennsylvaniaUSA
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Thuillier P, Bourhis D, Karakatsanis N, Schick U, Metges JP, Salaun PY, Kerlan V, Abgral R. Diagnostic performance of a whole-body dynamic 68GA-DOTATOC PET/CT acquisition to differentiate physiological uptake of pancreatic uncinate process from pancreatic neuroendocrine tumor. Medicine (Baltimore) 2020; 99:e20021. [PMID: 32871968 PMCID: PMC7437793 DOI: 10.1097/md.0000000000020021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
To evaluate the diagnostic performance of net influx rate (Ki) values from a whole-body dynamic (WBD) Ga-DOTATOC-PET/CT acquisition to differentiate pancreatic neuroendocrine tumors (pNETs) from physiological uptake of pancreatic uncinate process (UP).Patients who were benefited from a WBD acquisition for the assessment of a known well-differentiated neuroendocrine tumor (NET)/suspicion of disease in the prospective GAPET-NET cohort were screened. Only patients with a confirmed pNET/UP as our gold standard were included. The positron emission tomography (PET) procedure consisted in a single-bed dynamic acquisition centered on the heart, followed by a whole-body dynamic acquisition and then a static acquisition. Dynamic (Ki calculated according to Patlak method), static (SUVmax, SUVmean, SUVpeak) parameters, and tumor-to-liver and tumor-to-spleen ratio (TLRKi and TSRKi (according to hepatic/splenic Ki)), tumor SUVmax to liver SUVmax (TM/LM), tumor SUVmax to liver SUVmean (TM/Lm), tumor SUVmax to spleen SUVmax (TM/SM), and tumor SUVmax to spleen SUVmean (TM/Sm) (according to hepatic/splenic SUVmax and SUVmean respectively) were calculated. A Receiver Operating Characteristic (ROC) analysis was performed to evaluate their diagnostic performance to distinguish UP from pNET.One hundred five patients benefited from a WBD between July 2018 and July 2019. Eighteen (17.1%) had an UP and 26 (24.8%) a pNET. For parameters alone, the Ki and SUVpeak had the best sensitivity (88.5%) while the Ki, SUVmax, and SUVmean had the best specificity (94.4%). The best diagnostic accuracy was obtained with Ki (90.9%). For ratios, the TLRKi and the TSRKi had the best sensitivity (95.7%) while the TM/SM and TM/Sm the best specificity (100%). TLRKi had the best diagnostic accuracy (95.1%) and the best area under the curve (AUC) (0.990).Our study is the first one to evaluate the interest of a WBD acquisition to differentiate UP from pNETs and shows excellent diagnostic performances of the Ki approach.
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Affiliation(s)
| | - David Bourhis
- EA GETBO 3878
- Department of Nuclear Medicine, University Hospital of Brest, France
| | - Nicolas Karakatsanis
- Division of Radiopharmaceutical Sciences, Department of Radiology, Weil Cornell Medical College of Cornell University, New York, NY, USA
| | | | | | - Pierre-Yves Salaun
- EA GETBO 3878
- Department of Nuclear Medicine, University Hospital of Brest, France
| | | | - Ronan Abgral
- EA GETBO 3878
- Department of Nuclear Medicine, University Hospital of Brest, France
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8
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Gut P. Oncological management of advanced neuroendocrine tumours (Review). Mol Clin Oncol 2020; 13:8. [PMID: 32754322 DOI: 10.3892/mco.2020.2078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 06/02/2020] [Indexed: 11/06/2022] Open
Abstract
The oncological principles of managing patients with gastroenteropancreatic neuroendocrine tumours (GEP-NETs) depends on a number of factors and requires a multidisciplinary approach. Recent data have provided additional therapeutic options, including biotherapy, traditional chemotherapy and novel targeted agents. Somatostatin analogues (SSAs) inhibit multiple cellular functions, including secretion, motility and proliferation. Interferon appears to act through several mechanisms, with antisecretory effects, immunomodulatory effects and antiproliferative functions, the latter inhibiting direct growth or attenuating angiogenesis. Opinions on when to commence chemotherapy for well differentiated GEP-NETs varies among experts. In previous years, reserving chemotherapy for patients with progressive disease (well differentiated, inoperable and/or metastatic GEP-NETs) was reasonably well argued for. Most well differentiated endocrine tumours are richly vascular and many express vascular endothelial growth factor (VEGF) receptors. In a xenograft model of a human carcinoid, treatment with an anti-VEGF monoclonal antibody was revealed to inhibit tumour growth and metastasis. As the role of angiogenesis and hypoxic-associated factors appears to be associated with tumour aggressiveness, strategies using agents which target angiogenesis have been developed. Mammalian target of rapamycin (mTOR) is a conserved serine-threonine kinase that regulates the cell cycle and metabolism in response to environmental factors. In addition, mTOR inhibition suppression was demonstrated to suppress NET growth. Each patient requires an individual approach to the choice of therapy, which should be selected depending on the severity of disease.
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Affiliation(s)
- Paweł Gut
- Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, Poznań 60-355, Poland
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Yu J, Li N, Li J, Lu M, Leal JP, Tan H, Su H, Fan Y, Zhang Y, Zhao W, Zhu H, Pomper MG, Zhou Y, Yang Z. The Correlation Between [ 68Ga]DOTATATE PET/CT and Cell Proliferation in Patients With GEP-NENs. Mol Imaging Biol 2020; 21:984-990. [PMID: 30796708 DOI: 10.1007/s11307-019-01328-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE Objectives of the study are to analyze the correlation between [68Ga]DOTATATE positron emission tomography (PET)/X-ray computed tomography (CT) measurements and various biological characteristics of gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs), and to determine optimal cutoff value of SUVmax (standard uptake value) to differentiate neuroendocrine tumors (NETs) and neuroendocrine cancers (NECs). PROCEDURES Of the GEP-NEN cases (73 males, 53 females; age 18-77 years) with pathologically proven primary and/or metastatic lesions, 126 were studied. All of the short axes of lesions were larger than 0.5 cm in order to avoid the partial volume effect. Patients fasted for 6 h before the PET/CT scans. The dose of [68Ga]DOTATATE was 100-200 MBq and the acquisition began at 1 h after injection. The lesion with the highest SUVmax in each patient was analyzed. RESULTS In the total sample, the sensitivity of [68Ga]DOTATATE was 69.05 %. The sensitivities were significantly different among G1, G2, and G3 groups (72.22 %, 91.53 %, and 40.82 %, respectively; p < 0.01). The SUVmax of the G3 group was lowest. We also found that the sensitivity and SUVmax were significantly higher (p < 0.05) in patients with pancreatic NENs (Pan-NENs) than in patients with gastrointestinal NENs (Gi-NENs) and unknown primary NENs (Up-NENs). A significant negative correlation between SUVmax and Ki-67 was found (r = - 0.429, p < 0.01). Using SUVmax to differentiate neuroendocrine tumors (NETs) and neuroendocrine cancers (NECs), the area under the ROC curve (AUC) was 0.771 and the cutoff value of SUVmax was 11.25 (sensitivity 79.2 %, specificity 65.3 %). However, Pan-NENs did not show any statistical significance results in correlation and ROC analysis. CONCLUSION [68Ga]DOTATATE PET/CT results showed a negative correlation with GEP-NEN cell proliferation and were complementary to Ki-67. Pan-NENs were different from Gi-NENs and Up-NENs when compared to somatostatin receptor expression.
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Affiliation(s)
- Jiangyuan Yu
- Department of Nuclear Medicine, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, 100142, China
| | - Nan Li
- Department of Nuclear Medicine, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, 100142, China
| | - Jie Li
- Department of Gastrointestinal Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China
| | - Ming Lu
- Department of Gastrointestinal Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China
| | - Jeffrey P Leal
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Huangying Tan
- Department of Integrative Oncology, China-Japan Friendship Hospital, Beijing, China
| | - Hua Su
- Department of Nuclear Medicine, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, 100142, China
| | - Yang Fan
- Department of Nuclear Medicine, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, 100142, China
| | - Yan Zhang
- Department of Nuclear Medicine, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, 100142, China
| | - Wei Zhao
- Department of Nuclear Medicine, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, 100142, China
| | - Hua Zhu
- Department of Nuclear Medicine, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, 100142, China
| | - Martin G Pomper
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Yun Zhou
- Department of Radiology, Washington University School of Medicine, Campus Box 8225, 510 S. Kingshighway Blvd, St Louis, MO, 63110, USA.
| | - Zhi Yang
- Department of Nuclear Medicine, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, 100142, China.
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10
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Jullien M, Reichert T, D'Anella P, Castinetti F, Barlier A, Brue T, Taieb D, Cuny T. Comparison of 68Ga-Dotatate PET/CT and 18F-FDOPA PET/CT for the diagnosis of pancreatic neuroendocrine tumors in a MEN1 patient. ANNALES D'ENDOCRINOLOGIE 2019; 81:39-43. [PMID: 31982106 DOI: 10.1016/j.ando.2019.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 11/01/2019] [Accepted: 11/16/2019] [Indexed: 01/20/2023]
Abstract
CONTEXT Pancreatic neuroendocrine tumors (PNETs) occur in more than 80% of patients with multiple endocrine neoplasia type 1 (MEN1) syndrome, with predominance of small (<1cm) non-functioning tumors, followed by gastrinomas and insulinomas. Due to their small size, the diagnostic performance of conventional MRI and CT imaging is highly variable, with a real risk of false-negatives. Functional imaging on 111In-DTPA-Octreotide SPECT somatostatin receptor scintigraphy (Octreoscan®) is the modality of choice, but shows only 80% sensitivity. Alternatively, 18F-fluorodihydroxyphenylalanine (FDOPA) and, more recently, 68Ga-Dotatate PET/CT imaging are valuable options in case of negative Octreoscan®. CASE REPORT A 55 old-year woman diagnosed with MEN1 syndrome, presented with multiple asymptomatic but progressive PNETs revealed on ultrasound endoscopy. Octreoscan® was negative, as was 18F-FDOPA PET/CT, whereas 68Ga-Dotatate PET/CT detected all PNETs found on endoscopy. CONCLUSION We here report the first case of a MEN1 patient who successfully underwent a 68Ga-Dotatate PET/CT for detection and follow-up of PNETs, while both Octreoscan® and 18F-FDOPA PET/CT were negative.
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Affiliation(s)
- Marine Jullien
- Inserm U1251, service d'endocrinologie, Marseille Medical Genetics, Hôpital de la Conception, Aix-Marseille Université, AP-HM, Marseille, France
| | - Thibault Reichert
- Service de médecine nucléaire, hôpital de la Timone, Aix-Marseille Université, AP-HM, Marseille, France
| | - Pascal D'Anella
- Service d'endocrinologie, centre hospitalier d'Avignon, Avignon, France
| | - Frédéric Castinetti
- Inserm U1251, service d'endocrinologie, Marseille Medical Genetics, Hôpital de la Conception, Aix-Marseille Université, AP-HM, Marseille, France
| | - Anne Barlier
- Inserm U1251, laboratoire de biologie moléculaire, Marseille Medical Genetics, Hôpital de la Conception, Aix-Marseille Université, AP-HM, Marseille, France
| | - Thierry Brue
- Inserm U1251, service d'endocrinologie, Marseille Medical Genetics, Hôpital de la Conception, Aix-Marseille Université, AP-HM, Marseille, France
| | - David Taieb
- Service de médecine nucléaire, hôpital de la Timone, Aix-Marseille Université, AP-HM, Marseille, France
| | - Thomas Cuny
- Inserm U1251, service d'endocrinologie, Marseille Medical Genetics, Hôpital de la Conception, Aix-Marseille Université, AP-HM, Marseille, France.
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Cuccurullo V, Di Stasio GD, Mansi L. Physiopathological Premises to Nuclear Medicine Imaging of Pancreatic Neuroendocrine Tumours. Curr Radiopharm 2019; 12:98-106. [DOI: 10.2174/1874471012666190206094555] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 02/19/2018] [Accepted: 10/29/2018] [Indexed: 02/07/2023]
Abstract
Background:
Pancreatic Neuroendocrine Tumors (P-NETs) are a challenge in terms of both
diagnosis and therapy; morphological studies need to be frequently implemented with nonstandard
techniques such as Endoscopic Ultrasounds, Dynamic CT, and functional Magnetic Resonance.
Discussion:
The role of nuclear medicine, being scarcely sensitive F-18 Fluorodeoxyglucose, is mainly
based on the over-expression of Somatostatin Receptors (SSTR) on neuroendocrine tumor cells surface.
Therefore, SSTR can be used as a target for both diagnosis, using radiotracers labeled with gamma or
positron emitters, and therapy. SSTRs subtypes are capable of homo and heterodimerization in specific
combinations that alter both the response to ligand activation and receptor internalization.
Conclusion:
Although agonists usually provide efficient internalization, also somatostatin antagonists
(SS-ANTs) could be used for imaging and therapy. Peptide Receptor Radionuclide Therapy (PRRT)
represents the most successful option for targeted therapy. The theranostic model based on SSTR does
not work in insulinoma, in which different radiotracers such as F-18 FluoroDOPA or tracers for the
glucagon-like peptide-1 receptor have to be preferred.
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Affiliation(s)
- Vincenzo Cuccurullo
- Nuclear Medicine Unit, Department of Clinical and Experimental Medicine "F.Magrassi, A.Lanzara" – Universita della Campania "Luigi Vanvitelli", Napoli, Italy
| | - Giuseppe Danilo Di Stasio
- Nuclear Medicine Unit, Department of Clinical and Experimental Medicine "F.Magrassi, A.Lanzara" – Universita della Campania "Luigi Vanvitelli", Napoli, Italy
| | - Luigi Mansi
- Nuclear Medicine Unit, Department of Clinical and Experimental Medicine "F.Magrassi, A.Lanzara" – Universita della Campania "Luigi Vanvitelli", Napoli, Italy
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Herrera-Martínez AD, van den Dungen R, Dogan-Oruc F, van Koetsveld PM, Culler MD, de Herder WW, Luque RM, Feelders RA, Hofland LJ. Effects of novel somatostatin-dopamine chimeric drugs in 2D and 3D cell culture models of neuroendocrine tumors. Endocr Relat Cancer 2019; 26:585-599. [PMID: 30939452 DOI: 10.1530/erc-19-0086] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 04/02/2019] [Indexed: 12/14/2022]
Abstract
Control of symptoms related to hormonal hypersecretion by functioning neuroendocrine tumors (NETs) is challenging. New therapeutic options are required. Since novel in vitro tumor models seem to better mimic the tumor in vivo conditions, we aimed to study the effect of somatostatin and dopamine receptor agonists (octreotide and cabergoline, respectively) and novel somatostatin-dopamine chimeric multi-receptor drugs (BIM-065, BIM-23A760) using 2D (monolayer) and 3D (spheroids) cultures. Dose-response studies in 2D and 3D human pancreatic NET cell cultures (BON-1 and QGP-1) were performed under serum-containing and serum-deprived conditions. Cell proliferation, somatostatin and dopamine receptor expression (SSTs and D2R), apoptosis, lactate dehydrogenase, as well as serotonin and chromogranin A (CgA) release were assessed. The following results were obtained. 3D cultures of BON-1/QGP-1 allowed better cell survival than 2D cultures in serum-deprived conditions. SSTs and D2R mRNA levels were higher in the 3D model vs 2D model. Octreotide/cabergoline/BIM-065/BIM-23A760 treatment did not affect cell growth or spheroid size. In BON-1 2D-cultures, only BIM-23A760 significantly inhibited CgA release -this effect being more pronounced in 3D cultures. In BON-1 2D cultures, cabergoline/BIM-065/BIM-23A760 treatment decreased serotonin release (maximal effect up to 40%), being this effect again more potent in 3D cultures (up to 67% inhibition; with BIM-23A760 having the most potent effects). In QGP-1, cabergoline/BIM-065 treatment decreased serotonin release only in the 3D model. In conclusion, cultures of NET 3D spheroids represent a promising method for evaluating cell proliferation and secretion in NET cell-line models. Compared to 2D models, 3D models grow relatively serum independent. In 3D model, SST-D2R multi-receptor targeting drugs inhibit CgA and serotonin secretion, but not NET cell growth.
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Affiliation(s)
- Aura D Herrera-Martínez
- Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, Rotterdam, the Netherlands
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Córdoba, Spain
- Reina Sofia University Hospital, Córdoba, Spain
| | - Rosanna van den Dungen
- Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Fadime Dogan-Oruc
- Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Peter M van Koetsveld
- Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, Rotterdam, the Netherlands
| | | | - Wouter W de Herder
- Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Raúl M Luque
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Córdoba, Spain
- Reina Sofia University Hospital, Córdoba, Spain
- Department of Cell Biology, Physiology, and Immunology, University of Córdoba, Córdoba, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Córdoba, Spain
| | - Richard A Feelders
- Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Leo J Hofland
- Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, Rotterdam, the Netherlands
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13
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Clinical and Prognostic Value of PET/CT Imaging with Combination of 68Ga-DOTATATE and 18F-FDG in Gastroenteropancreatic Neuroendocrine Neoplasms. CONTRAST MEDIA & MOLECULAR IMAGING 2018; 2018:2340389. [PMID: 29681780 PMCID: PMC5846381 DOI: 10.1155/2018/2340389] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 10/22/2017] [Accepted: 01/16/2018] [Indexed: 02/06/2023]
Abstract
Background To evaluate the clinical and prognostic value of PET/CT with combination of 68Ga-DOTATATE and 18F-FDG in gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs). Method 83 patients of GEP-NENs who underwent 68Ga-DOTATATE and 18F-FDG PET/CT were enrolled between June 2013 and December 2016. Well-differentiated (WD) NETs are divided into group A (Ki-67 < 10%) and group B (Ki-67 ≥ 10%), and poorly differentiated (PD) NECs are defined as group C. The relationship between PET/CT results and clinicopathological characteristics was retrospectively investigated. Result For groups A/B/C, the sensitivities of 68Ga-DOTATATE and 18F-FDG were 78.8%/83.3%/37.5% and 52.0%/72.2%/100.0%. A negative correlation between Ki-67 and SUVmax of 68Ga-DOTATATE (R = −0.415; P ≤ 0.001) was observed, while a positive correlation was noted between Ki-67 and SUVmax of 18F-FDG (R = 0.683; P ≤ 0.001). 62.5% (5/8) of patients showed significantly more lesions in the bone if 68Ga-DOTATATE was used, and 22.7% (5/22) of patients showed more lymph node metastases if 18F-FDG was used. Conclusions The sensitivity of dual tracers was correlated with cell differentiation, and a correlation between Ki-67 and both SUVmax of PET-CTs could be observed. 68Ga-DOTATATE is suggested for WD-NET and 18F-FDG is probably suitable for patients with Ki-67 ≥ 10%.
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14
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Herrera-Martínez AD, Gahete MD, Pedraza-Arevalo S, Sánchez-Sánchez R, Ortega-Salas R, Serrano-Blanch R, Luque RM, Gálvez-Moreno MA, Castaño JP. Clinical and functional implication of the components of somatostatin system in gastroenteropancreatic neuroendocrine tumors. Endocrine 2018; 59:426-437. [PMID: 29196939 DOI: 10.1007/s12020-017-1482-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Accepted: 11/20/2017] [Indexed: 02/06/2023]
Abstract
PURPOSE Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) comprise a heterogeneous group of malignancies often presenting with metastasis at diagnosis and whose clinical outcome is difficult to predict. Somatostatin (SST) analogs (SSAs) provide a valuable pharmacological tool to palliate hormonal symptoms, and control progression in some NETs. However, many patients do not respond to SSAs or develop resistance, and there are many uncertainties regarding pathophysiology of SST and its receptors (sst1-sst5) in GEP-NETs. METHODS The expression of SST system components in GEP-NETs was determined, compared with that of non-tumor adjacent and normal tissues and correlated with clinical and histological characteristics. Specifically, 58 patients with GEP-NETs and 14 normal samples were included. Cell viability in NET cell lines was determined in response to specific SSAs. RESULTS Normal samples and non-tumor adjacent tissues presented a similar expression profile, with appreciable expression of sst2 and sst3, and a lower expression of the other receptors. In contrast, cortistatin, sst1, sst4, and sst5 were overexpressed in tumors, while sst3 and sst4 seemed overexpressed in less differentiated tumors. Some SST system components were related to vascular/nerve invasion and metastasis. In vitro, sst1 and sst3 agonists reduced viability in BON-1 cells, while they, similar to octreotide and pasireotide, increased viability in QGP-1 cells. CONCLUSIONS These results provide novel information on SST system pathophysiology in GEP-NETs, including relevant associations with clinical-histological parameters, which might help to better understand the intrinsic heterogeneity of NETs and to identify novel biomarkers and/or targets with potential prognostic and/or therapeutic value for GEP-NETs patients.
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Affiliation(s)
- Aura D Herrera-Martínez
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Córdoba, Spain
- Endocrinology and Nutrition Service, Reina Sofia University Hospital, Córdoba, Spain
| | - Manuel D Gahete
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Córdoba, Spain
- Department of Cell Biology, Physiology, and Immunology, University of Córdoba, Córdoba, Spain
- Reina Sofia University Hospital, Córdoba, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Córdoba, Spain
- Campus de Excelencia Internacional Agroalimentario (ceiA3), Córdoba, Spain
| | - Sergio Pedraza-Arevalo
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Córdoba, Spain
- Department of Cell Biology, Physiology, and Immunology, University of Córdoba, Córdoba, Spain
- Reina Sofia University Hospital, Córdoba, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Córdoba, Spain
- Campus de Excelencia Internacional Agroalimentario (ceiA3), Córdoba, Spain
| | - Rafael Sánchez-Sánchez
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Córdoba, Spain
- Pathology Service, Reina Sofia University Hospital, Córdoba, Spain
| | - Rosa Ortega-Salas
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Córdoba, Spain
- Pathology Service, Reina Sofia University Hospital, Córdoba, Spain
| | - Raquel Serrano-Blanch
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Córdoba, Spain
- Medical Oncology Service, Reina Sofia University Hospital, Córdoba, Spain
| | - Raúl M Luque
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Córdoba, Spain.
- Department of Cell Biology, Physiology, and Immunology, University of Córdoba, Córdoba, Spain.
- Reina Sofia University Hospital, Córdoba, Spain.
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Córdoba, Spain.
- Campus de Excelencia Internacional Agroalimentario (ceiA3), Córdoba, Spain.
| | - María A Gálvez-Moreno
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Córdoba, Spain.
- Endocrinology and Nutrition Service, Reina Sofia University Hospital, Córdoba, Spain.
| | - Justo P Castaño
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Córdoba, Spain.
- Department of Cell Biology, Physiology, and Immunology, University of Córdoba, Córdoba, Spain.
- Reina Sofia University Hospital, Córdoba, Spain.
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Córdoba, Spain.
- Campus de Excelencia Internacional Agroalimentario (ceiA3), Córdoba, Spain.
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Abstract
The discovery of the new properties of SSRs and DRs has led to a renewed interest in agents targeting these receptors and has opened new perspectives for medical treatment of patients with pituitary and neuroendocrine tumors resistant to the “classical”, currently available analogs. Moreover, SSRs and DRs crosstalk at membrane level may trigger alternative intracellular pathways or enhance the signalling for the control of cell growth. New somatostatin analogs and hybrid molecules, which display a broader and different spectrum of activities compared to conventional analogs, seem to be a promising therapeutic alternative for the control of hormone secretion and, hopefully, to reduce tumor burden. Receptor profile characterization is crucial for the accurate selection of patients potentially responsive to a given therapy. Free full text available at www.tumorionline.it
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Affiliation(s)
- Diego Ferone
- Department of Endocrinology & Medical Sciences (DiSEM), University of Genoa, Genoa, Italy
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16
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Mazziotti G, Mosca A, Frara S, Vitale G, Giustina A. Somatostatin analogs in the treatment of neuroendocrine tumors: current and emerging aspects. Expert Opin Pharmacother 2017; 18:1679-1689. [PMID: 29067877 DOI: 10.1080/14656566.2017.1391217] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Neuroendocrine tumors (NETs) harbor somatostatin receptors and there is a strong rationale for using somatostatin analogs (SSAs) for treatment of NETs. Areas covered: This article discusses i) pharmacology of somatostatin and its analogs; ii) antisecretory and anti-proliferative effects of SSAs in NETs; iii) efficacy and safety of emerging therapeutic regimens with first generation SSAs administered at either high doses or in combination with antineoplastic drugs; iv) efficacy and safety of pasireotide and chimeric molecules; v) efficacy of radionuclide therapy of NETs using SSAs. Expert opinion: SSAs are the first-line medical therapy for functioning and non-functioning well-differentiated NETs. In patients not responder to first generation SSAs, the increase of drug dose over the conventional regimens, the combination of SSAs with other biotherapies or molecular targeted therapies, the switch to pasireotide or the use of SSAs in radionuclide therapy may improve the therapeutic success.
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Affiliation(s)
| | - Alessandra Mosca
- b Medical Oncology , 'Maggiore della Carità' University Hospital , Novara , Italy
| | - Stefano Frara
- c Chair of Endocrinology , San Raffaele Vita-Salute University , Milan , Italy
| | - Giovanni Vitale
- d Department of Clinical Sciences and Community Health (DISCCO) , University of Milan , Milan , Italy.,e Laboratory of Geriatric and Oncologic Neuroendocrinology Research , Istituto Auxologico Italiano IRCCS , Milan , Italy
| | - Andrea Giustina
- c Chair of Endocrinology , San Raffaele Vita-Salute University , Milan , Italy
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17
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Carmona-Bayonas A, Jiménez-Fonseca P, Custodio A, Grande E, Capdevila J, López C, Teule A, Garcia-Carbonero R. Optimizing Somatostatin Analog Use in Well or Moderately Differentiated Gastroenteropancreatic Neuroendocrine Tumors. Curr Oncol Rep 2017; 19:72. [PMID: 28920153 DOI: 10.1007/s11912-017-0633-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Somatostatin analogues, aiming to control tumor secretion or growth, constitute the most attractive therapeutic option for patients with well-differentiated gastroenteropancreatic neuroendocrine tumors (GEP-NETs). The objective of this article is to provide a comprehensive review of the current state-of-the-art knowledge gaps and potential opportunities for future development and optimization of this therapeutic modality. METHOD A contextualized systematic review with a narrative component was conducted using PubMed, The Cochrane Library, EMBASE, and Google Scholar. Titles were screened, and non-English, duplicate, or irrelevant entries were excluded. Selection criteria for articles included the following: publication in English between 1995 and 2016, patients with GEP-NETs, analysis of efficacy, safety, practical management considerations, predictive factors, and/or strategies for overcoming resistance, concerning somatostatin analogs. RESULTS Ninety-seven studies out of 2771 screened publications met the inclusion criteria (16 randomized clinical trials, 27 phase II trials, 3 phase I trials, 3 subgroup analyses of clinical trials, 1 open-label extension of a randomized trial, 1 phase IV trial, 32 observational studies, and 14 basic research articles). The nature and scope of literature was diverse with most articles dedicated to drug efficacy or indications of use (n = 49), pharmacological issues (n = 8), assessment or predictors of response (n = 4), practical management (n = 11), combination therapy or other means to overcome resistance (n = 19), receptors and signaling pathways (n = 3), and subgroup analyses (n = 3). CONCLUSION In this appraisal, we have found some practical aspects that can help to the optimization of somatostatin analog (SSA) therapy in patients with well-differentiated GEP-NETs. We have also identified areas of uncertainty in an effort to guide clinical research in the coming years.
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Affiliation(s)
- Alberto Carmona-Bayonas
- Department of Hematology and Medical Oncology, Morales Meseguer University Hospital, Calle Marqués de los Vélez, s/n, CP 30008, Murcia, Spain.
| | | | - Ana Custodio
- Department of Medical Oncology, La Paz University Hospital, Madrid, Spain
| | - Enrique Grande
- Department of Medical Oncology, Ramón y Cajal University Hospital, Madrid, Spain
| | - Jaume Capdevila
- Department of Medical Oncology, Vall D'Hebrón University Hospital, Vall D'Hebrón Institute of Oncology (VHIO), Universitat Autònoma de Barcelona, center affiliated with the Red Temática de Investigación Cooperativa en Cáncer (RTICC), Instituto Carlos III, Spanish Ministry of Science and Innovation, Barcelona, Spain
| | - Carlos López
- Department of Medical Oncology, Marqués de Valdecilla University Hospital, Santander, Spain
| | - Alex Teule
- Department of Medical Oncology, Institut Català d'Oncologia, L'Hospitalet de Llobregat, center affiliated with the Red Temática de Investigación Cooperativa en Cáncer (RTICC), Instituto Carlos III, Spanish Ministry of Science and Innovation, Barcelona, Spain
| | - Rocío Garcia-Carbonero
- Department of Medical Oncology, Doce de Octubre University Hospital, center affiliated with the Red Temática de Investigación Cooperativa en Cáncer (RTICC), Instituto Carlos III, Spanish Ministry of Science and Innovation, Madrid, Spain
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18
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Couvelard A, Pélaprat D, Dokmak S, Sauvanet A, Voisin T, Couvineau A, Ruszniewski P. Antisecretory Effects of Chimeric Somatostatin/Dopamine Receptor Ligands on Gastroenteropancreatic Neuroendocrine Tumors. Pancreas 2017; 46:631-638. [PMID: 28375946 DOI: 10.1097/mpa.0000000000000813] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVES The recent finding that gastroenteropancreatic neuroendocrine tumors expressed the dopaminergic D2 receptor in addition to somatostatin (sst) receptors suggested that multiple targeting approaches might decrease hormone hypersecretion more effectively than sst agonists alone. METHODS To test this hypothesis, (i) we measured the expression of sst receptor type 2 (sst2 receptor) and D2 receptor in 11 gastroenteropancreatic neuroendocrine tumors and (ii) we compared the ability of lanreotide, cabergoline, their combination, and sst/D2 chimeric ligands to decrease chromogranin A (CgA), gastrin, or serotonin release in primary cultures derived from these tumors. RESULTS Moderate to high positivity was observed for sst2 receptor and D2 receptor, the latter being more expressed in pancreatic tumors. Lanreotide decreased CgA secretion in all cultures, but only 3 tumors responded to cabergoline. No additivity was observed in lanreotide. BIM 23A781 decreased CgA release to the same extent as lanreotide, whereas the other chimeric ligands were less efficient. However, BIM 23A781 was 50 times less potent than lanreotide. Similar patterns were found for gastrin or serotonin. CONCLUSION No improvement was brought by the sst/D2 combination or chimeric ligands. Factors that underlie these tissue-specific differences remain to be elucidated.
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Affiliation(s)
- Anne Couvelard
- From the *Faculté de Médecine Xavier Bichat, INSERM U1149, Centre de Recherche sur l'Inflammation (CRI), DHU Unity, Université Paris Diderot; †Université Paris Diderot; ‡Département de Pathologie Beaujon-Bichat, Hôpital Bichat, DHU UNITY, AP-HP, Paris; and §Département de Chirurgie Pancréatico-Biliaire and ∥Département de Gastroentérologie-Pancréatologie, Hôpital Beaujon, DHU UNITY, AP-HP, Clichy, France
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19
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Abstract
OBJECTIVE Somatostatin receptors (SSTRs), products of gene superfamily SSTR1-5, are commonly expressed in neuroendocrine tumors (NETs). Somatostatin analogs (SSAs) bind to SSTRs and are used as therapeutic agents in patients with advanced NETs. We hypothesized that tumor SSTR expression status would be associated with clinical outcomes in NET. METHODS Expression of the 5 SSTRs was evaluated by immunohistochemistry, using tissue microarrays comprising 173 primary NETs, 24 matched metastases, and 22 metastatic NETs from 195 patients. Cox proportional hazards regression analysis was used to assess the association of SSTR expression status (high vs low) with clinical outcomes, adjusting for potential confounders. RESULTS High expression of SSTR2 was associated with longer overall survival (OS) in the cohort overall (multivariate hazard ratio, 0.42; 95% confidence interval, 0.21-0.84; P = 0.013). In a subgroup of patients with metastatic small intestine NET treated with SSAs and evaluable for progression, SSTR2 expression was associated with both longer progression-free survival (PFS) and OS. No associations with PFS or OS were observed with expression of other SSTRs. CONCLUSIONS Our study demonstrated that expression of SSTR2, but not other SSTRs, is associated with longer OS. In patients treated with SSAs, expression of SSTR2 is associated with longer PFS survival.
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20
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Huang H, Wu K, Ma J, Du Y, Cao C, Nie Y. Dopamine D2 receptor suppresses gastric cancer cell invasion and migration via inhibition of EGFR/AKT/MMP-13 pathway. Int Immunopharmacol 2016; 39:113-120. [PMID: 27468100 DOI: 10.1016/j.intimp.2016.07.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 06/06/2016] [Accepted: 07/04/2016] [Indexed: 02/07/2023]
Abstract
Dopamine (DA), an important neurotransmitter, has been reported to play a negative role in tumor progression. DA acts its role via dopamine receptors (DRs), which can be divided into five receptor subtypes (D1R-D5R). Among these receptor subtypes, D2R has been found to inhibit IGF-I-induced gastric cancer cell growth. However, the functions of D2R in gastric cancer cell invasion remain elusive. Here, we found that D2R expression was decreased in gastric cancer cells. DA treatment dose-dependently inhibited EGF-mediated gastric cancer cell invasion and migration via D2R. Furthermore, D2R decreased EGF-mediated MMP-13 production, and attenuated EGFR and AKT activation. Together with the results that EGF promoted gastric cancer cell invasion and migration via EGFR/AKT pathway, these data indicate that DA treatment, acting via D2R, suppresses gastric cancer cell invasion and migration via inhibition of EGFR/AKT/MMP-13 pathway. Thus, our findings suggest that use of D2R agonist may have a potential therapeutic effect on gastric cancer.
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Affiliation(s)
- Hongli Huang
- Department of Gastroenterology, Guangzhou Digestive Disease Center, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou 510180, China
| | - Kaiming Wu
- Gastrointestinal Surgery Center, The first Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, China
| | - Jun Ma
- Department of Thoracic Surgery, The first Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, China
| | - Yanlei Du
- Department of Gastroenterology, Guangzhou Digestive Disease Center, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou 510180, China
| | - Chuangyu Cao
- Department of Gastroenterology, Guangzhou Digestive Disease Center, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou 510180, China
| | - Yuqiang Nie
- Department of Gastroenterology, Guangzhou Digestive Disease Center, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou 510180, China.
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21
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Veenstra MJ, van Koetsveld PM, Dogan F, Farrell WE, Feelders RA, Lamberts SWJ, de Herder WW, Vitale G, Hofland LJ. Epidrug-induced upregulation of functional somatostatin type 2 receptors in human pancreatic neuroendocrine tumor cells. Oncotarget 2016; 9:14791-14802. [PMID: 29599907 PMCID: PMC5871078 DOI: 10.18632/oncotarget.9462] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 04/24/2016] [Indexed: 12/13/2022] Open
Abstract
Somatostatin receptors are a pivotal target for treatment of pancreatic neuroendocrine tumors (pNET), either with somatostatin analogues (SSA) or radiolabeled SSA. The highest affinity target for the most commonly used SSA is the somatostatin receptor type 2 (sst2 ). An important factor that may complicate treatment efficacy, is the variable number of receptors expressed on pNETs. Gene expression is subject to complex regulation, in which epigenetics has a central role. In this study we explored the possible role of epigenetic modifications in the variations in sst2 expression levels in two human pNET cell lines, BON-1 and QGP-1. We found upregulation of sst2 mRNA after treatment with the epidrugs 5-aza-2'-deoxycytidine (5-aza-dC) and valproic acid (VPA), an increased uptake of radiolabeled octreotide, as well as increased sensitivity to the SSA octreotide in functional cAMP inhibition. At epigenetic level we observed low methylation levels of the sst2 gene promoter region irrespective of expression. Activating histone mark H3K9Ac can be regulated with epidrug treatment, with an angle of effect corresponding to the effect on mRNA expression. Repressive histone mark H3K27me3 is not regulated by either 5-aza-dC or VPA. We conclude that epidrug treatment, in particular with combined 5-aza-dC and VPA treatment, might hold promise for improving and adding to current SSA treatment strategies of patients with pNETs.
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Affiliation(s)
- Marije J Veenstra
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, Rotterdam, The Netherlands
| | - Peter M van Koetsveld
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, Rotterdam, The Netherlands
| | - Fadime Dogan
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, Rotterdam, The Netherlands
| | - William E Farrell
- Department Human Disease and Genomics Group, Institute of Science and Technology in Medicine, School of Medicine, Keele University, Keele, United Kingdom
| | - Richard A Feelders
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, Rotterdam, The Netherlands
| | - Steven W J Lamberts
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, Rotterdam, The Netherlands
| | - Wouter W de Herder
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, Rotterdam, The Netherlands
| | - Giovanni Vitale
- Laboratory of Endocrine and Metabolic Research, Istituto Auxologico Italiano IRCCS, Milan, Italy.,Department of Clinical Sciences and Community Health (DISCCO), University of Milan, Milan, Italy
| | - Leo J Hofland
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, Rotterdam, The Netherlands
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Pezzilli R, Partelli S, Cannizzaro R, Pagano N, Crippa S, Pagnanelli M, Falconi M. Ki-67 prognostic and therapeutic decision driven marker for pancreatic neuroendocrine neoplasms (PNENs): A systematic review. Adv Med Sci 2016; 61:147-53. [PMID: 26774266 DOI: 10.1016/j.advms.2015.10.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 09/19/2015] [Accepted: 10/08/2015] [Indexed: 12/14/2022]
Abstract
BACKGROUND We systematically evaluate the current evidence regarding Ki-67 as a prognostic factor in pancreatic neuroendocrine neoplasms to evaluate the differences of this marker in primary tumors and in distant metastases as well as the values of Ki-67 obtained by fine needle aspiration and by histology. METHODS The literature search was carried out using the MEDLINE/PubMed database, and only papers published in the last 10 years were selected. RESULTS The pancreatic tissue suitable for Ki-67 evaluation was obtained from surgical specimens in the majority of the studies. There was a concordance of 83% between preoperative and postoperative Ki-67 evaluation. Pooling the data of the studies which compared the Ki-67 values obtained in both cytological and surgical specimens, we found that they were not related. The assessment of Ki-67 was manual in the majority of the papers considered for this review. In order to eliminate manual counting, several imaging methods have been developed but none of them are routinely used at present. Twenty-two studies also explored the role of Ki-67 utilized as a prognostic marker for pancreatic neuroendocrine neoplasms and the majority of them showed that Ki-67 is a good prognostic marker of disease progression. Three studies explored the Ki-67 value in metastatic sites and one study demonstrated that, in metachronous and synchronous liver metastases, there was no significant variation in the index of proliferation. CONCLUSIONS Ki-67 is a reliable prognostic marker for pancreatic neuroendocrine neoplasms.
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van Adrichem RCS, de Herder WW, Kamp K, Brugts MP, de Krijger RR, Sprij-Mooij DM, Lamberts SWJ, van Koetsveld PM, Janssen JAMJL, Hofland LJ. Effects of Somatostatin Analogs and Dopamine Agonists on Insulin-Like Growth Factor 2-Induced Insulin Receptor Isoform A Activation by Gastroenteropancreatic Neuroendocrine Tumor Cells. Neuroendocrinology 2016; 103:815-25. [PMID: 26836610 DOI: 10.1159/000444280] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 01/17/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) express insulin-like growth factor (IGF)-related factors [IGF1, IGF2; insulin receptor (IR)-A, IR-B; IGF-binding protein (IGFBP) 1-3] as well as somatostatin (SSTRs) and dopamine D2 receptors (D2Rs). OBJECTIVES To (1) compare mRNA expression of IGF-related factors in human pancreatic NET (panNET) cell lines with that in human GEP-NETs to evaluate the usefulness of these cells as a model for studying the IGF system in GEP-NETs, (2) determine whether panNET cells produce growth factors that activate IR-A, and (3) investigate whether somatostatin analogs (SSAs) and/or dopamine agonists (DAs) influence the production of these growth factors. METHODS In panNET cells (BON-1 and QGP-1) and GEP-NETs, mRNA expression of IGF-related factors was measured by quantitative real-time PCR. Effects of the SSAs octreotide and pasireotide (PAS), the DA cabergoline (CAB), and the dopastatin BIM-23A760 (all 100 nM) were evaluated at the IGF2 mRNA and protein level (by ELISA) and regarding IR-A bioactivity (by kinase receptor activation assay) in panNET cells. RESULTS panNET cells and GEP-NETs had comparable expression profiles of IGF-related factors. Especially in BON-1 cells, IGF2 and IR-A were most highly expressed. PAS + CAB inhibited IGF2 (-29.5 ± 4.9%, p < 0.01) and IGFBP3 (-20.0 ± 4.0%, p < 0.01) mRNA expression in BON-1 cells. In BON-1 cells, IGF2 protein secretion was significantly inhibited with BIM-23A760 (-23.7 ± 3.8%). BON-1- but not QGP-1- conditioned medium stimulated IR-A bioactivity. In BON-1 cells, IR-A bioactivity was inhibited by BIM-23A760 and PAS + CAB (-37.8 ± 2.1% and -30.9 ± 4.1%, respectively, p < 0.0001). CONCLUSIONS (1) The BON-1 cell line is a representative model for studying the IGF system in GEP-NETs, (2) BON-1 cells produce growth factors (IGF2) activating IR-A, and (3) combined SSTR and D2R targeting with PAS + CAB and BIM-23A760 suppresses IGF2-induced IR-A activation.
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MESH Headings
- Antigens, CD/genetics
- Antigens, CD/metabolism
- Cell Line, Tumor/chemistry
- Culture Media, Conditioned/pharmacology
- Dopamine/analogs & derivatives
- Dopamine/pharmacology
- Dopamine Agonists/pharmacology
- Enzyme-Linked Immunosorbent Assay
- Gene Expression Regulation, Neoplastic/drug effects
- HEK293 Cells
- Humans
- Insulin-Like Growth Factor II/metabolism
- Intestinal Neoplasms/pathology
- Neuroendocrine Tumors/pathology
- Pancreatic Neoplasms/pathology
- RNA, Messenger/metabolism
- Receptor, Insulin/genetics
- Receptor, Insulin/metabolism
- Receptors, Dopamine D2/genetics
- Receptors, Dopamine D2/metabolism
- Receptors, Somatostatin/genetics
- Receptors, Somatostatin/metabolism
- Somatostatin/analogs & derivatives
- Somatostatin/pharmacology
- Stomach Neoplasms/pathology
- Transfection
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Affiliation(s)
- Roxanne C S van Adrichem
- Division of Endocrinology, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
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24
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Drastikova M, Beranek M, Gabalec F, Netuka D, Masopust V, Cesak T, Marek J, Palicka V, Cap J. Expression profiles of somatostatin, dopamine, and estrogen receptors in pituitary adenomas determined by means of synthetic multilocus calibrators. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2015; 160:238-43. [PMID: 26607296 DOI: 10.5507/bp.2015.058] [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: 06/23/2015] [Accepted: 11/11/2015] [Indexed: 01/09/2023] Open
Abstract
AIMS Pituitary adenomas (PA) are non-invasive benign tumors with a high autopsy prevalence. They are classified according to the type of hormone secreted (prolactin, growth hormone, adrenocorticotropin, thyrotropin, folitropin, or luteinizing hormone). Clinically non-functioning adenomas (CNFA) lacking the typical hypersecretion of hormones make up a significant portion of PA. The aim of the study was to determine the complete expression profiles of somatostatin receptors (SSTR1-SSTR5), dopamine receptors type 2 (D2R), and estrogen receptors (ER1) in various types of PA. METHODS Adenoma specimens were obtained from 206 patients during transsphenoidal resection. For quantitative analysis, reverse transcription and consequent real-time PCR with synthetic multilocus calibrators (SMC) were used. The obtained data were normalized to the number of transcripts of the beta-glucuronidase gene. RESULTS The use of SMC enabled the alignment of individual calibration functions for all the receptors. No relationships between the expression of the receptors and the tumor size, site of extension, gender or age at diagnosis were significant. In growth hormone-secreting adenomas, D2R and SSTR2 transcripts were extensively expressed, followed by ER1, SSTR5, SSTR3, and SSTR1. In patients with macroprolactinomas, transsphenoidal resection was indicated because dopamine agonists did not normalize prolactin levels. D2R, ER1 and SSTR1 transcripts were significantly transcribed. Corticotroph adenomas showed high levels of D2R and ER1 transcripts and lower amounts of SSTR2 and SSTR1 transcripts. SSTR5 transcripts were very low. Subjects with CNFA dominantly expressed D2R and ER1, followed by SSTR2 and SSTR3 mRNA. CONCLUSION We evaluated SSTR1-SSTR5, D2R, and ER1 expressions in a large group of pituitary adenomas and we found that determining their individual expression profiles could help when choosing the optimal postoperative treatment.
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Affiliation(s)
- Monika Drastikova
- Institute of Clinical Biochemistry and Diagnostics, Faculty of Medicine in Hradec Kralove, Charles University in Prague and University Hospital Hradec Kralove, Czech Republic
| | - Martin Beranek
- Institute of Clinical Biochemistry and Diagnostics, Faculty of Medicine in Hradec Kralove, Charles University in Prague and University Hospital Hradec Kralove, Czech Republic.,Department of Biochemical Sciences, Faculty of Pharmacy in Hradec Kralove, Charles University in Prague
| | - Filip Gabalec
- 4th Department of Internal Medicine - Hematology, Faculty of Medicine in Hradec Kralove, Charles University in Prague and University Hospital Hradec Kralove
| | - David Netuka
- Department of Neurosurgery, 1st Faculty of Medicine, Charles University in Prague and Central Military Hospital Prague
| | - Vaclav Masopust
- Department of Neurosurgery, 1st Faculty of Medicine, Charles University in Prague and Central Military Hospital Prague
| | - Tomas Cesak
- Department of Neurosurgery, Faculty of Medicine in Hradec Kralove, Charles University in Prague and University Hospital Hradec Kralove
| | - Josef Marek
- 3rd Department of Internal Medicine, 1st Faculty of Medicine, Charles University in Prague
| | - Vladimir Palicka
- Institute of Clinical Biochemistry and Diagnostics, Faculty of Medicine in Hradec Kralove, Charles University in Prague and University Hospital Hradec Kralove, Czech Republic
| | - Jan Cap
- 4th Department of Internal Medicine - Hematology, Faculty of Medicine in Hradec Kralove, Charles University in Prague and University Hospital Hradec Kralove
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25
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Ambrosini V, Campana D, Polverari G, Peterle C, Diodato S, Ricci C, Allegri V, Casadei R, Tomassetti P, Fanti S. Prognostic Value of 68Ga-DOTANOC PET/CT SUVmax in Patients with Neuroendocrine Tumors of the Pancreas. J Nucl Med 2015; 56:1843-8. [DOI: 10.2967/jnumed.115.162719] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 09/14/2015] [Indexed: 01/19/2023] Open
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26
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In vivo and in vitro evidence of somatostatin receptors expression in a dedifferentiated retroperitoneal liposarcoma. Clin Nucl Med 2015; 39:892-3. [PMID: 24566397 DOI: 10.1097/rlu.0000000000000374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A 62-year-old patient presented with mildly elevated catecholamines and an abdominal painless mass. Abdominal CT revealed an 18 × 12 cm tumor in the right retroperitoneum with intense contrast enhancement. Somatostatin receptor scintigraphy (SRS) showed pathologic uptake by the lesion. Given the suspicion of paraganglioma, the patient was referred to surgery for tumor removal. Surprisingly, the histopathological examination revealed a dedifferentiated liposarcoma. Somatostatin receptors of type 2 were identified and quantified by reverse transcription polymerase chain reaction. The unexpected presentation of our patient draws clinicians' attention when performing diagnostic procedure for retroperitoneal lesions, even though hormone secretion and positive SRS strongly suggest paraganglioma.
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27
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Specht E, Kaemmerer D, Sänger J, Wirtz RM, Schulz S, Lupp A. Comparison of immunoreactive score, HER2/neu score and H score for the immunohistochemical evaluation of somatostatin receptors in bronchopulmonary neuroendocrine neoplasms. Histopathology 2015; 67:368-77. [PMID: 25641082 DOI: 10.1111/his.12662] [Citation(s) in RCA: 114] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 01/28/2015] [Indexed: 01/14/2023]
Abstract
AIMS Due to the growing number of somatostatin receptor (SSTR) targeting analogues and radiopeptides used for the diagnosis and therapy of neuroendocrine neoplasms (NEN), the assessment of SSTR subtype status has increasingly gained predictive value. In pathology, the SSTR protein levels are detected routinely by immunohistochemistry (IHC); however, a lack of a standardized evaluation system persists. Thus, in the present investigation, three well-established semi-quantitative scoring systems [immunoreactive score (IRS), human epidermal growth factor receptor 2 (HER2)/neu score, H score] used commonly for SSTR-IHC evaluation in NEN were compared. METHODS AND RESULTS A total of 240 formalin-fixed, paraffin-embedded tumour samples from 90 patients with bronchopulmonary NEN were examined by IHC and quantitative reverse transcription-polymerase chain reaction (qRT-PCR) for SSTR1, 2A, 3, 4 and 5 expression. Using both methods, SSTR1, 2A and 5 were the most frequently expressed subtypes. For all SSTR subtypes, all three scores correlated well with each other and with qRT-PCR data. However, the IRS was the most meaningful score with the best correlation to mRNA levels. CONCLUSIONS Because a unified IHC scoring system for SSTR analysis is needed urgently to optimize the theranostics of NEN, among the scores tested, the IRS seems to be the most suitable according to our results. It provides sufficient accuracy combined with high practicability.
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Affiliation(s)
- Elisa Specht
- Institute of Pharmacology and Toxicology, Jena University Hospital, Friedrich Schiller University, Jena, Germany
| | - Daniel Kaemmerer
- Department of General and Visceral Surgery, Zentralklinik Bad Berka, Bad Berka, Germany
| | - Jörg Sänger
- Laboratory of Pathology and Cytology, Bad Berka, Germany
| | | | - Stefan Schulz
- Institute of Pharmacology and Toxicology, Jena University Hospital, Friedrich Schiller University, Jena, Germany
| | - Amelie Lupp
- Institute of Pharmacology and Toxicology, Jena University Hospital, Friedrich Schiller University, Jena, Germany
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Abstract
Neuroendocrine tumours (NETs) represent a less frequent and heterogeneous group of tumours, which has experienced, in recent years, a significant increase in effective therapeutic possibilities overcoming the disappointing results from chemotherapy. Initial improvements in treatment strategies came from somatostatin analogues (SSAs) that have widely demonstrated a significant improvement in symptomatic relief and tumour control growth by a complex mechanism of action over cell survival, angiogenesis and immunomodulation. Recent investigations have pointed out novel SSAs with a wider binding profile (pasireotide), chimeric molecules against somatostatin receptors and dopamine receptors and the combination with targeted agents, such as mTOR inhibitors or antiangiogenic agents. Immunotherapy is the second cornerstone in NET treatment and has been represented with interferon alpha for a long time, with a demonstrated activity on tumour and clinical response. Its less manageable adverse events have limited its usage. However, different checkpoints in immune system regulation have been effectively targeted in different solid tumours, and novel approaches are currently arising in NETs. In conclusion, biotherapy remains an active treatment strategy for initial approach in patients with NETs. Further investigation on patients' selection, molecular profiles, treatment sequence or combination and optimisation of current and novel biotherapy agents is required.
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Affiliation(s)
- T Alonso-Gordoa
- Medical Oncology DepartmentRamón y Cajal University Hospital, Carretera de Colmenar Km 9,100, 28034 Madrid, SpainMedical Oncology DepartmentVall d'Hebrón University Hospital, Passeig de la Vall d'Hebrón, 119-129, 08035 Barcelona, Spain
| | - J Capdevila
- Medical Oncology DepartmentRamón y Cajal University Hospital, Carretera de Colmenar Km 9,100, 28034 Madrid, SpainMedical Oncology DepartmentVall d'Hebrón University Hospital, Passeig de la Vall d'Hebrón, 119-129, 08035 Barcelona, Spain
| | - E Grande
- Medical Oncology DepartmentRamón y Cajal University Hospital, Carretera de Colmenar Km 9,100, 28034 Madrid, SpainMedical Oncology DepartmentVall d'Hebrón University Hospital, Passeig de la Vall d'Hebrón, 119-129, 08035 Barcelona, Spain
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29
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Kanakis G, Grimelius L, Spathis A, Tringidou R, Rassidakis GZ, Öberg K, Kaltsas G, Tsolakis AV. Expression of Somatostatin Receptors 1-5 and Dopamine Receptor 2 in Lung Carcinoids: Implications for a Therapeutic Role. Neuroendocrinology 2015; 101:211-22. [PMID: 25765100 DOI: 10.1159/000381061] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 02/18/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The expression of somatostatin receptors (SSTRs) and dopamine receptor 2 (DR2) in neuroendocrine tumors is of clinical importance as somatostatin analogues and dopamine agonists can be used for their localization and/or treatment. The objective of this study is to examine the expression of the five SSTR subtypes and DR2 in lung carcinoids (LCs). METHODS We conducted a retrospective study of 119 LCs from 106 patients [typical carcinoids (TCs): n = 100, and atypical carcinoids (ACs): n = 19]. The expression of all five SSTR subtypes and DR2 was evaluated immunohistochemically and correlated to clinicopathological data. In a subgroup of cases, receptor expression was further analyzed using semiquantitative RT-PCR. RESULTS SSTR2A was the SSTR subtype most frequently expressed immunohistochemically (72%), followed by SSTR1 (63%), SSTR5 (40%), and SSTR3 (20%), whereas SSTR4 was negative. DR2 was expressed in 74% and co-expressed with SSTR1 in 56%, with SSTR2A in 59%, with SSTR3 in 19%, and with SSTR5 in 37% of the tumors. Receptor expression was not related to the histological subtype, tumor aggressiveness (disease extent/grading) or functionality; however, DR2 was expressed more frequently in ACs than TCs (95 vs. 70%, p = 0.017). In a subset of patients, RT-PCR findings highly suggested that the expression of SSTR2A, SSTR3, DR2, and to a lesser extent that of SSTR1 and SSTR5 is the outcome of increased gene transcription. CONCLUSIONS The high and variable immunohistochemical expression of the majority of SSTRs along with their co-expression with DR2 in LCs provides a rationale for their possible treatment with agents that target these receptors.
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Affiliation(s)
- George Kanakis
- Endocrine Unit, Department of Pathophysiology, University of Athens Medical School, Athens, Greece
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30
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Gabalec F, Drastikova M, Cesak T, Netuka D, Masopust V, Machac J, Marek J, Cap J, Beranek M. Dopamine 2 and somatostatin 1-5 receptors coexpression in clinically non-functioning pituitary adenomas. Physiol Res 2014; 64:369-77. [PMID: 25536318 DOI: 10.33549/physiolres.932821] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
This study investigated quantitated expression of dopamine 2 receptor (D2R) and somatostatin receptors of the five types (SSTR1-SSTR5) in a large series of clinically non-functioning pituitary adenomas (CNFAs). Co-expression of these receptors in individual adenomas was studied as well as correlation between receptor types. Adenoma tissue from 198 patients who underwent surgery for CNFAs was analyzed by immunohistochemistry and quantitative real-time PCR. D2R and SSTR1-3 mRNA was expressed in all 198 adenomas. SSTR4 and SSTR5 were detectable in 85 % and 61 % of adenomas, respectively. Expression of D2R was significantly higher than that of the somatostatin receptors. The median relative expressions were as follows from highest D2R >> SSTR3 > SSTR2 > SSTR1 > SSTR5 > SSTR4. High relative expression (ratio to beta-glucuronidase mRNA > 1) of D2R was found in 60 % of tumors, high expression of SSTR1 in 7.5 %, SSTR2 in 7 %, SSTR3 in 4 % and SSTR5 in 0.5 %. The quantity of D2R correlated positively with expression of SSTR2 and SSTR3, and negatively with SSTR1 and SSTR5. Among histological adenoma types, SSTR1 was significantly higher in null-cell adenomas and SSTR3 was lower in silent corticotroph adenomas. In conclusions, in CNFAs, high expression of somatostatin receptors is much less common than that of D2R, and co-expression of both these receptors is exceptional. D2R and SSTR3 seem to be the most promising targets for pharmacological treatment.
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Affiliation(s)
- F Gabalec
- Fourth Department of Internal Medicine - Hematology, Institute of Clinical Biochemistry and Diagnostics, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.
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31
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Mohamed A, Blanchard MP, Albertelli M, Barbieri F, Brue T, Niccoli P, Delpero JR, Monges G, Garcia S, Ferone D, Florio T, Enjalbert A, Moutardier V, Schonbrunn A, Gerard C, Barlier A, Saveanu A. Pasireotide and octreotide antiproliferative effects and sst2 trafficking in human pancreatic neuroendocrine tumor cultures. Endocr Relat Cancer 2014; 21:691-704. [PMID: 25012983 DOI: 10.1530/erc-14-0086] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) raise difficult therapeutic problems despite the emergence of targeted therapies. Somatostatin analogs (SSA) remain pivotal therapeutic drugs. However, the tachyphylaxis and the limited antitumoral effects observed with the classical somatostatin 2 (sst2) agonists (octreotide and lanreotide) led to the development of new SSA, such as the pan sst receptor agonist pasireotide. Our aim was to compare the effects of pasireotide and octreotide on cell survival, chromogranin A (CgA) secretion, and sst2 phosphorylation/trafficking in pancreatic NET (pNET) primary cells from 15 tumors. We established and characterized the primary cultures of human pancreatic tumors (pNETs) as powerful preclinical models for understanding the biological effects of SSA. At clinically relevant concentrations (1-10 nM), pasireotide was at least as efficient as octreotide in inhibiting CgA secretion and cell viability through caspase-dependent apoptosis during short treatments, irrespective of the expression levels of the different sst receptors or the WHO grade of the parental tumor. Interestingly, unlike octreotide, which induces a rapid and persistent partial internalization of sst2 associated with its phosphorylation on Ser341/343, pasireotide did not phosphorylate sst2 and induced a rapid and transient internalization of the receptor followed by a persistent recycling at the cell surface. These results provide the first evidence, to our knowledge, of striking differences in the dynamics of sst2 trafficking in pNET cells treated with the two SSAs, but with similar efficiency in the control of CgA secretion and cell viability.
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Affiliation(s)
- Amira Mohamed
- Aix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USAAix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USA
| | - Marie-Pierre Blanchard
- Aix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USA
| | - Manuela Albertelli
- Aix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USA
| | - Federica Barbieri
- Aix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USA
| | - Thierry Brue
- Aix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USAAix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USA
| | - Patricia Niccoli
- Aix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USA
| | - Jean-Robert Delpero
- Aix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USA
| | - Genevieve Monges
- Aix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USA
| | - Stephane Garcia
- Aix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USA
| | - Diego Ferone
- Aix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USA
| | - Tullio Florio
- Aix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USA
| | - Alain Enjalbert
- Aix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USAAix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USA
| | - Vincent Moutardier
- Aix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USA
| | - Agnes Schonbrunn
- Aix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USA
| | - Corinne Gerard
- Aix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USA
| | - Anne Barlier
- Aix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USAAix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USA
| | - Alexandru Saveanu
- Aix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USAAix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USA
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Marciello F, Di Somma C, Del Prete M, Marotta V, Ramundo V, Carratù A, de Luca di Roseto C, Camera L, Colao A, Faggiano A. Combined biological therapy with lanreotide autogel and cabergoline in the treatment of MEN-1-related insulinomas. Endocrine 2014; 46:678-81. [PMID: 24385268 DOI: 10.1007/s12020-013-0145-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 12/04/2013] [Indexed: 01/01/2023]
Abstract
Multiple endocrine neoplasia type 1 (MEN1) is a hereditary syndrome associated with the development of many endocrine tumors, involving mainly pituitary, parathyroids, pancreas, although a proliferative state interests all neuroendocrine system. MEN1 pancreatic neuroendocrine tumors (pNETs) are multiples and can secrete different hormones. The therapeutic approach is based on surgery which usually is followed by tumor relapse or persistence unless to be highly aggressive. Biotherapy with somatostatin analogs and dopamine agonists could be of great benefit to manage these patients without altering their life quality. We report a case of a 36-year-old MEN1 man affected with multicentric pNETs associated with insulinoma syndrome. Therapy with symptomatic agents (diazoxide), as well as biotherapy (lanreotide, cabergoline) was started. At 6-month follow-up, symptomatic agents were stopped and disease control was only based on lanreotide plus cabergoline. This combined biotherapy was able to control endocrine syndromes and tumor growth. Subsequently, a safer and selective surgical intervention on pNETs was performed. An excellent response to therapy with lanreotide autogel and cabergoline has been observed in a MEN1 patient with pNETs associated with insulinoma syndrome. The potential synergistic effects of lanreotide autogel and cabergoline on insulin-secreting neuroendocrine tumors are discussed.
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Affiliation(s)
- Francesca Marciello
- Division of Endocrinology, Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy,
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Giustina A, Mazziotti G, Maffezzoni F, Amoroso V, Berruti A. Investigational drugs targeting somatostatin receptors for treatment of acromegaly and neuroendocrine tumors. Expert Opin Investig Drugs 2014; 23:1619-35. [DOI: 10.1517/13543784.2014.942728] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Koch W, Auernhammer CJ, Geisler J, Spitzweg C, Cyran CC, Ilhan H, Bartenstein P, Haug AR. Treatment with Octreotide in Patients with Well-Differentiated Neuroendocrine Tumors of the Ileum: Prognostic Stratification with Ga-68-DOTA-TATE Positron Emission Tomography. Mol Imaging 2014. [DOI: 10.2310/7290.2014.00009] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Walter Koch
- From the Departments of Nuclear Medicine and Internal Medicine 2 and Institute of Clinical Radiology, University of Munich, Munich, Germany
| | - Christoph J. Auernhammer
- From the Departments of Nuclear Medicine and Internal Medicine 2 and Institute of Clinical Radiology, University of Munich, Munich, Germany
| | - Julia Geisler
- From the Departments of Nuclear Medicine and Internal Medicine 2 and Institute of Clinical Radiology, University of Munich, Munich, Germany
| | - Christine Spitzweg
- From the Departments of Nuclear Medicine and Internal Medicine 2 and Institute of Clinical Radiology, University of Munich, Munich, Germany
| | - Clemens C. Cyran
- From the Departments of Nuclear Medicine and Internal Medicine 2 and Institute of Clinical Radiology, University of Munich, Munich, Germany
| | - Harun Ilhan
- From the Departments of Nuclear Medicine and Internal Medicine 2 and Institute of Clinical Radiology, University of Munich, Munich, Germany
| | - Peter Bartenstein
- From the Departments of Nuclear Medicine and Internal Medicine 2 and Institute of Clinical Radiology, University of Munich, Munich, Germany
| | - Alexander R. Haug
- From the Departments of Nuclear Medicine and Internal Medicine 2 and Institute of Clinical Radiology, University of Munich, Munich, Germany
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Maxwell JE, Sherman SK, Menda Y, Wang D, O'Dorisio TM, Howe JR. Limitations of somatostatin scintigraphy in primary small bowel neuroendocrine tumors. J Surg Res 2014; 190:548-53. [PMID: 24950794 DOI: 10.1016/j.jss.2014.05.031] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 05/02/2014] [Accepted: 05/13/2014] [Indexed: 12/28/2022]
Abstract
BACKGROUND Somatostatin receptor scintigraphy (SRS; octreoscan) is used in neuroendocrine tumors to locate the primary tumor site and delineate the extent of disease. SRS has decreased sensitivity for small bowel neuroendocrine tumors (SBNETs). The reasons for SRS nonlocalization are not clear. We sought to determine factors that correlate with successful primary tumor localization by SRS in patients with resected SBNETs, and also identify factors that confound interpretation of SRS reports. METHODS Records of patients with resected SBNETs were reviewed for SRS results, tumor size, multifocality, N, and M status. Somatostatin receptor 2 (SSTR2) expression was analyzed in resected tumors by quantitative polymerase chain reaction. SRS reports were reviewed and categorized as localizing the primary tumor or not. A nuclear medicine physician independently reviewed available images. RESULTS Of 37 patients with preoperative SRS, the primary tumor was localized in 37%. Of all the factors tested, only small tumor size correlated significantly with SRS nonlocalization. Overexpression of SSTR2 was not significantly different between tumors that were or were not localized by SRS, regardless of tumor size. There were three instances where the SRS report did not agree with the nuclear medicine physician's interpretation as to whether SRS localized the primary tumor. In each case, uptake in mesenteric nodes was a confounding factor. CONCLUSIONS SBNETs <2 cm are most likely to be missed by SRS. SSTR2 expression did not correlate with SRS nonlocalization of the primary tumor. Uptake in mesenteric nodes may help indicate an SBNET primary but can also interfere with its visualization within the small bowel.
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Affiliation(s)
- Jessica E Maxwell
- Department of General Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Scott K Sherman
- Department of General Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Yusuf Menda
- Department of Radiology, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Donghong Wang
- Department of General Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Thomas M O'Dorisio
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - James R Howe
- Department of General Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa.
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Abstract
Pancreatic neuroendocrine tumors are a group of rare, heterogeneous neoplasms that have been increasing in incidence the past few decades largely because of the diagnosis of pancreatic incidentalomas on cross-sectional imaging. Although these tumors are classically associated with clinical syndromes that result from excess secretion of particular hormones, most pancreatic neuroendocrine tumors are nonfunctional tumors presenting with symptoms secondary to mass effect, metastatic disease, or as incidental findings. This article reviews the diagnostic algorithm, surgical management, and available systemic therapies for nonfunctional pancreatic neuroendocrine tumors.
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Affiliation(s)
- Jennifer H Kuo
- Division of GI/Endocrine Surgery, Columbia University, 161 Fort Washington Avenue, 8th Floor, New York, NY 10032, USA
| | - James A Lee
- COACH Education, Endocrine Surgery, Adrenal Center, New York Thyroid/Parathyroid Center, Simulation Center, Columbia University, 161 Fort Washington Avenue, 8th Floor, New York, NY 10032, USA.
| | - John A Chabot
- Division of GI/Endocrine Surgery, Columbia University, 161 Fort Washington Avenue, 8th Floor, New York, NY 10032, USA
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Sherman SK, Maxwell JE, Carr JC, Wang D, O'Dorisio MS, O'Dorisio TM, Howe JR. GIPR expression in gastric and duodenal neuroendocrine tumors. J Surg Res 2014; 190:587-93. [PMID: 24565507 DOI: 10.1016/j.jss.2014.01.044] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 01/16/2014] [Accepted: 01/24/2014] [Indexed: 01/14/2023]
Abstract
BACKGROUND Compounds targeting somatostatin-receptor-type-2 (SSTR2) are useful for small bowel neuroendocrine tumor (SBNET) and pancreatic neuroendocrine tumor (PNET) imaging and treatment. We recently characterized expression of 13 cell surface receptor genes in SBNETs and PNETs, identifying three drug targets (GIPR, OXTR, and OPRK1). This study set out to characterize expression of this gene panel in the less common neuroendocrine tumors of the stomach and duodenum (gastric and duodenal neuroendocrine tumors [GDNETs]). METHODS Primary tumors and adjacent normal tissue were collected at surgery, RNA was extracted, and expression of 13 target genes was determined by quantitative polymerase chain reaction. Expression was normalized to GAPDH and POLR2A internal control genes. Expression relative to normal tissue (ddCT) and absolute expression (dCT) were calculated. Wilcoxon tests compared median expression with false discovery rate correction for multiple comparisons. RESULTS Gene expression was similar in two gastric and seven duodenal tumors, and these were analyzed together. Like SBNETs (n = 63) and PNETs (n = 51), GDNETs showed significant overexpression compared with normal tissue of BRS3, GIPR, GRM1, GPR113, OPRK1, and SSTR2 (P < 0.05 for all). Of these, SSTR2 had the highest absolute expression in GDNETs (median dCT 4.0). Absolute expression of BRS3, GRM1, GPR113, and OPRK1 was significantly lower than SSTR2 in GDNETs (P < 0.05 for all), whereas expression of GIPR was similar to SSTR2 (median 4.3, P = 0.4). CONCLUSIONS As in SBNETs and PNETs, GIPR shows absolute expression close to SSTR2 but has greater overexpression relative to normal tissue (21.1 versus 3.5-fold overexpression). We conclude that GIPR could provide an improved signal-to-noise ratio for imaging versus SSTR2 and represents a promising novel therapeutic target in GDNETs.
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Affiliation(s)
- Scott K Sherman
- Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Jessica E Maxwell
- Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Jennifer C Carr
- Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Donghong Wang
- Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - M Sue O'Dorisio
- Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Thomas M O'Dorisio
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - James R Howe
- Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa.
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Sherman SK, Carr JC, Wang D, O'Dorisio MS, O'Dorisio TM, Howe JR. Gastric inhibitory polypeptide receptor (GIPR) is a promising target for imaging and therapy in neuroendocrine tumors. Surgery 2014; 154:1206-13; discussion 1214. [PMID: 24238043 DOI: 10.1016/j.surg.2013.04.052] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 04/25/2013] [Indexed: 01/18/2023]
Abstract
BACKGROUND Ligands binding the somatostatin receptor type 2 (SSTR2) are useful for imaging and treatment of neuroendocrine tumors (NETs), but not all tumors express high levels of these receptors. The aim of this study was to evaluate gene expression of new therapeutic targets in NETs relative to SSTR2. METHODS RNA was extracted from 103 primary small bowel and pancreatic NETs, matched normal tissue, and 123 metastases. Expression of 12 candidate genes was measured by quantitative polymerase chain reaction normalized to internal controls; candidate gene expression was compared with SSTR2. RESULTS Relative to normal tissue, primary NET expression of SSTR2, GPR98, BRS3, GIPR, GRM1, and OPRK1 were increased by 3, 8, 13, 13, 17, and 20-fold, respectively. Similar changes were found in metastases. Although most candidate genes showed lesser absolute expressions than SSTR2, absolute GIPR expression was closest to SSTR2 (mean dCT 3.6 vs. 2.7, P = .01). Absolute OPRK1 and OXTR expression varied greatly by primary tumor type and was close to SSTR2 in small bowel NETs but not pancreatic NETs. CONCLUSION Compared with the current treatment standard SSTR2, GIPR has only somewhat lesser absolute gene expression in tumor tissue but much lesser expression in normal tissue, making it a promising new target for NET imaging and therapy.
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Affiliation(s)
- Scott K Sherman
- Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, IA
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Walenkamp A, Crespo G, Fierro Maya F, Fossmark R, Igaz P, Rinke A, Tamagno G, Vitale G, Öberg K, Meyer T. Hallmarks of gastrointestinal neuroendocrine tumours: implications for treatment. Endocr Relat Cancer 2014; 21:R445-60. [PMID: 25296914 DOI: 10.1530/erc-14-0106] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
In the past few years, there have been advances in the treatment of neuroendocrine tumours (NETs) and improvements in our understanding of NET biology. However, the benefits to patients have been relatively modest and much remains yet to be done. The 'Hallmarks of Cancer', as defined by Hanahan and Weinberg, provide a conceptual framework for understanding the aberrations that underlie tumourigenesis and to help identify potential targets for therapy. In this study, our objective is to review the major molecular characteristics of NETs, based on the recently modified 'Hallmarks of Cancer', and highlight areas that require further research.
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Affiliation(s)
- Annemiek Walenkamp
- Department of Medical OncologyUniversity Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The NetherlandsDepartment of Medical OncologyHospital Universitario de Burgos, Avenida Islas Baleares 3, 09006 Burgos, SpainDepartment of Endocrine OncologyNational Cancer Institute, Bogotá, ColombiaDepartment of Cancer Research and Molecular MedicineNorwegian University of Science and Technology, 7491 Trondheim, Norway2nd Department of MedicineSemmelweis University, 46, Szentkiralyi Street, H-1088 Budapest, HungaryDepartment of GastroenterologyUniversity Hospital Marburg, Baldinger Strasse, Marburg D-35043, GermanyDepartment of General Internal MedicineSt Columcille's Hospital, Loughlinstown - Co., Dublin, IrelandDepartment of Clinical Sciences and Community Health (DISCCO)University of Milan, Milan, ItalyLaboratory of Endocrine and Metabolic ResearchIstituto Auxologico Italiano IRCCS, Via Zucchi 18, Cusano Milanino (MI) 20095, ItalyDepartment of Endocrine OncologyUniversity Hospital, Uppsala, SwedenUCL Cancer InstituteUCL, Huntley Street, London WC1E 6BT, UK
| | - Guillermo Crespo
- Department of Medical OncologyUniversity Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The NetherlandsDepartment of Medical OncologyHospital Universitario de Burgos, Avenida Islas Baleares 3, 09006 Burgos, SpainDepartment of Endocrine OncologyNational Cancer Institute, Bogotá, ColombiaDepartment of Cancer Research and Molecular MedicineNorwegian University of Science and Technology, 7491 Trondheim, Norway2nd Department of MedicineSemmelweis University, 46, Szentkiralyi Street, H-1088 Budapest, HungaryDepartment of GastroenterologyUniversity Hospital Marburg, Baldinger Strasse, Marburg D-35043, GermanyDepartment of General Internal MedicineSt Columcille's Hospital, Loughlinstown - Co., Dublin, IrelandDepartment of Clinical Sciences and Community Health (DISCCO)University of Milan, Milan, ItalyLaboratory of Endocrine and Metabolic ResearchIstituto Auxologico Italiano IRCCS, Via Zucchi 18, Cusano Milanino (MI) 20095, ItalyDepartment of Endocrine OncologyUniversity Hospital, Uppsala, SwedenUCL Cancer InstituteUCL, Huntley Street, London WC1E 6BT, UK
| | - Felipe Fierro Maya
- Department of Medical OncologyUniversity Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The NetherlandsDepartment of Medical OncologyHospital Universitario de Burgos, Avenida Islas Baleares 3, 09006 Burgos, SpainDepartment of Endocrine OncologyNational Cancer Institute, Bogotá, ColombiaDepartment of Cancer Research and Molecular MedicineNorwegian University of Science and Technology, 7491 Trondheim, Norway2nd Department of MedicineSemmelweis University, 46, Szentkiralyi Street, H-1088 Budapest, HungaryDepartment of GastroenterologyUniversity Hospital Marburg, Baldinger Strasse, Marburg D-35043, GermanyDepartment of General Internal MedicineSt Columcille's Hospital, Loughlinstown - Co., Dublin, IrelandDepartment of Clinical Sciences and Community Health (DISCCO)University of Milan, Milan, ItalyLaboratory of Endocrine and Metabolic ResearchIstituto Auxologico Italiano IRCCS, Via Zucchi 18, Cusano Milanino (MI) 20095, ItalyDepartment of Endocrine OncologyUniversity Hospital, Uppsala, SwedenUCL Cancer InstituteUCL, Huntley Street, London WC1E 6BT, UK
| | - Reidar Fossmark
- Department of Medical OncologyUniversity Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The NetherlandsDepartment of Medical OncologyHospital Universitario de Burgos, Avenida Islas Baleares 3, 09006 Burgos, SpainDepartment of Endocrine OncologyNational Cancer Institute, Bogotá, ColombiaDepartment of Cancer Research and Molecular MedicineNorwegian University of Science and Technology, 7491 Trondheim, Norway2nd Department of MedicineSemmelweis University, 46, Szentkiralyi Street, H-1088 Budapest, HungaryDepartment of GastroenterologyUniversity Hospital Marburg, Baldinger Strasse, Marburg D-35043, GermanyDepartment of General Internal MedicineSt Columcille's Hospital, Loughlinstown - Co., Dublin, IrelandDepartment of Clinical Sciences and Community Health (DISCCO)University of Milan, Milan, ItalyLaboratory of Endocrine and Metabolic ResearchIstituto Auxologico Italiano IRCCS, Via Zucchi 18, Cusano Milanino (MI) 20095, ItalyDepartment of Endocrine OncologyUniversity Hospital, Uppsala, SwedenUCL Cancer InstituteUCL, Huntley Street, London WC1E 6BT, UK
| | - Peter Igaz
- Department of Medical OncologyUniversity Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The NetherlandsDepartment of Medical OncologyHospital Universitario de Burgos, Avenida Islas Baleares 3, 09006 Burgos, SpainDepartment of Endocrine OncologyNational Cancer Institute, Bogotá, ColombiaDepartment of Cancer Research and Molecular MedicineNorwegian University of Science and Technology, 7491 Trondheim, Norway2nd Department of MedicineSemmelweis University, 46, Szentkiralyi Street, H-1088 Budapest, HungaryDepartment of GastroenterologyUniversity Hospital Marburg, Baldinger Strasse, Marburg D-35043, GermanyDepartment of General Internal MedicineSt Columcille's Hospital, Loughlinstown - Co., Dublin, IrelandDepartment of Clinical Sciences and Community Health (DISCCO)University of Milan, Milan, ItalyLaboratory of Endocrine and Metabolic ResearchIstituto Auxologico Italiano IRCCS, Via Zucchi 18, Cusano Milanino (MI) 20095, ItalyDepartment of Endocrine OncologyUniversity Hospital, Uppsala, SwedenUCL Cancer InstituteUCL, Huntley Street, London WC1E 6BT, UK
| | - Anja Rinke
- Department of Medical OncologyUniversity Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The NetherlandsDepartment of Medical OncologyHospital Universitario de Burgos, Avenida Islas Baleares 3, 09006 Burgos, SpainDepartment of Endocrine OncologyNational Cancer Institute, Bogotá, ColombiaDepartment of Cancer Research and Molecular MedicineNorwegian University of Science and Technology, 7491 Trondheim, Norway2nd Department of MedicineSemmelweis University, 46, Szentkiralyi Street, H-1088 Budapest, HungaryDepartment of GastroenterologyUniversity Hospital Marburg, Baldinger Strasse, Marburg D-35043, GermanyDepartment of General Internal MedicineSt Columcille's Hospital, Loughlinstown - Co., Dublin, IrelandDepartment of Clinical Sciences and Community Health (DISCCO)University of Milan, Milan, ItalyLaboratory of Endocrine and Metabolic ResearchIstituto Auxologico Italiano IRCCS, Via Zucchi 18, Cusano Milanino (MI) 20095, ItalyDepartment of Endocrine OncologyUniversity Hospital, Uppsala, SwedenUCL Cancer InstituteUCL, Huntley Street, London WC1E 6BT, UK
| | - Gianluca Tamagno
- Department of Medical OncologyUniversity Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The NetherlandsDepartment of Medical OncologyHospital Universitario de Burgos, Avenida Islas Baleares 3, 09006 Burgos, SpainDepartment of Endocrine OncologyNational Cancer Institute, Bogotá, ColombiaDepartment of Cancer Research and Molecular MedicineNorwegian University of Science and Technology, 7491 Trondheim, Norway2nd Department of MedicineSemmelweis University, 46, Szentkiralyi Street, H-1088 Budapest, HungaryDepartment of GastroenterologyUniversity Hospital Marburg, Baldinger Strasse, Marburg D-35043, GermanyDepartment of General Internal MedicineSt Columcille's Hospital, Loughlinstown - Co., Dublin, IrelandDepartment of Clinical Sciences and Community Health (DISCCO)University of Milan, Milan, ItalyLaboratory of Endocrine and Metabolic ResearchIstituto Auxologico Italiano IRCCS, Via Zucchi 18, Cusano Milanino (MI) 20095, ItalyDepartment of Endocrine OncologyUniversity Hospital, Uppsala, SwedenUCL Cancer InstituteUCL, Huntley Street, London WC1E 6BT, UK
| | - Giovanni Vitale
- Department of Medical OncologyUniversity Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The NetherlandsDepartment of Medical OncologyHospital Universitario de Burgos, Avenida Islas Baleares 3, 09006 Burgos, SpainDepartment of Endocrine OncologyNational Cancer Institute, Bogotá, ColombiaDepartment of Cancer Research and Molecular MedicineNorwegian University of Science and Technology, 7491 Trondheim, Norway2nd Department of MedicineSemmelweis University, 46, Szentkiralyi Street, H-1088 Budapest, HungaryDepartment of GastroenterologyUniversity Hospital Marburg, Baldinger Strasse, Marburg D-35043, GermanyDepartment of General Internal MedicineSt Columcille's Hospital, Loughlinstown - Co., Dublin, IrelandDepartment of Clinical Sciences and Community Health (DISCCO)University of Milan, Milan, ItalyLaboratory of Endocrine and Metabolic ResearchIstituto Auxologico Italiano IRCCS, Via Zucchi 18, Cusano Milanino (MI) 20095, ItalyDepartment of Endocrine OncologyUniversity Hospital, Uppsala, SwedenUCL Cancer InstituteUCL, Huntley Street, London WC1E 6BT, UK Department of Medical OncologyUniversity Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The NetherlandsDepartment of Medical OncologyHospital Universitario de Burgos, Avenida Islas Baleares 3, 09006 Burgos, SpainDepartment of Endocrine OncologyNational Cancer Institute, Bogotá, ColombiaDepartment of Cancer Research and Molecular MedicineNorwegian University of Science and Technology, 7491 Trondheim, Norway2nd Department of MedicineSemmelweis University, 46, Szentkiralyi Street, H-1088 Budapest, HungaryDepartment of GastroenterologyUniversity Hospital Marburg, Baldinger Strasse, Marburg D-35043, GermanyDepartment of General Internal MedicineSt Columcille's Hospital, Loughlinstown - Co., Dublin, IrelandDepartment of Clinical Sciences and Community Health (DISCCO)University of Milan, Milan, ItalyLaboratory of Endocrine and Metabolic ResearchIstituto Au
| | - Kjell Öberg
- Department of Medical OncologyUniversity Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The NetherlandsDepartment of Medical OncologyHospital Universitario de Burgos, Avenida Islas Baleares 3, 09006 Burgos, SpainDepartment of Endocrine OncologyNational Cancer Institute, Bogotá, ColombiaDepartment of Cancer Research and Molecular MedicineNorwegian University of Science and Technology, 7491 Trondheim, Norway2nd Department of MedicineSemmelweis University, 46, Szentkiralyi Street, H-1088 Budapest, HungaryDepartment of GastroenterologyUniversity Hospital Marburg, Baldinger Strasse, Marburg D-35043, GermanyDepartment of General Internal MedicineSt Columcille's Hospital, Loughlinstown - Co., Dublin, IrelandDepartment of Clinical Sciences and Community Health (DISCCO)University of Milan, Milan, ItalyLaboratory of Endocrine and Metabolic ResearchIstituto Auxologico Italiano IRCCS, Via Zucchi 18, Cusano Milanino (MI) 20095, ItalyDepartment of Endocrine OncologyUniversity Hospital, Uppsala, SwedenUCL Cancer InstituteUCL, Huntley Street, London WC1E 6BT, UK
| | - Tim Meyer
- Department of Medical OncologyUniversity Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The NetherlandsDepartment of Medical OncologyHospital Universitario de Burgos, Avenida Islas Baleares 3, 09006 Burgos, SpainDepartment of Endocrine OncologyNational Cancer Institute, Bogotá, ColombiaDepartment of Cancer Research and Molecular MedicineNorwegian University of Science and Technology, 7491 Trondheim, Norway2nd Department of MedicineSemmelweis University, 46, Szentkiralyi Street, H-1088 Budapest, HungaryDepartment of GastroenterologyUniversity Hospital Marburg, Baldinger Strasse, Marburg D-35043, GermanyDepartment of General Internal MedicineSt Columcille's Hospital, Loughlinstown - Co., Dublin, IrelandDepartment of Clinical Sciences and Community Health (DISCCO)University of Milan, Milan, ItalyLaboratory of Endocrine and Metabolic ResearchIstituto Auxologico Italiano IRCCS, Via Zucchi 18, Cusano Milanino (MI) 20095, ItalyDepartment of Endocrine OncologyUniversity Hospital, Uppsala, SwedenUCL Cancer InstituteUCL, Huntley Street, London WC1E 6BT, UK
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Baldelli R, Barnabei A, Rizza L, Isidori AM, Rota F, Di Giacinto P, Paoloni A, Torino F, Corsello SM, Lenzi A, Appetecchia M. Somatostatin analogs therapy in gastroenteropancreatic neuroendocrine tumors: current aspects and new perspectives. Front Endocrinol (Lausanne) 2014; 5:7. [PMID: 24570674 PMCID: PMC3916777 DOI: 10.3389/fendo.2014.00007] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Accepted: 01/13/2014] [Indexed: 12/14/2022] Open
Abstract
Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are rare tumors that present many clinical features secreting peptides and neuroamines that cause distinct clinical syndromes such as carcinoid syndrome. However most of them are clinically silent until late presentation with mass effects. Surgical resection is the first line treatment for a patient with a GEP-NET while in metastatic disease multiple therapeutic approaches are possible. GEP-NETs are able to express somatostatin receptors (SSTRs) bounded by somatostatin (SST) or its synthetic analogs, although the subtypes and number of SSTRs expressed are very variable. In particular, SST analogs are used frequently to control hormone-related symptoms while their anti-neoplastic activity seems to result prevalently in tumor stabilization. Patients who fail to respond or cease to respond to standard SST analogs treatment seem to have a response to higher doses of these drugs. For this reason, the use of higher doses of SST analogs will probably improve the clinical management of these patients.
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Affiliation(s)
- Roberto Baldelli
- Endocrinology Unit, Regina Elena National Cancer Institute, Rome, Italy
- *Correspondence: Roberto Baldelli, Endocrinology Unit, Regina Elena National Cancer Institute, via Elio Chianesi, 53, Rome, 00144 Italy e-mail:
| | - A. Barnabei
- Endocrinology Unit, Regina Elena National Cancer Institute, Rome, Italy
| | - L. Rizza
- Section of Endocrinology, Department of Experimental Medicine, “Sapienza” University of Rome, Rome, Italy
| | - A. M. Isidori
- Section of Endocrinology, Department of Experimental Medicine, “Sapienza” University of Rome, Rome, Italy
| | - F. Rota
- Endocrinology Unit, Regina Elena National Cancer Institute, Rome, Italy
| | - P. Di Giacinto
- Section of Reproductive Endocrinology, Department of Systems Medicine, Tor Vergata University of Rome, Fatebenefratelli Hospital, Rome, Italy
| | - A. Paoloni
- Endocrinology Unit, Regina Elena National Cancer Institute, Rome, Italy
| | - F. Torino
- Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - S. M. Corsello
- Department of Endocrinology, Catholic University of the Sacred Heart, Rome, Italy
| | - A. Lenzi
- Section of Endocrinology, Department of Experimental Medicine, “Sapienza” University of Rome, Rome, Italy
| | - M. Appetecchia
- Endocrinology Unit, Regina Elena National Cancer Institute, Rome, Italy
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41
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Carr JC, Sherman SK, Wang D, Dahdaleh FS, Bellizzi AM, O'Dorisio MS, O'Dorisio TM, Howe JR. Overexpression of membrane proteins in primary and metastatic gastrointestinal neuroendocrine tumors. Ann Surg Oncol 2013; 20 Suppl 3:S739-S746. [PMID: 24114056 DOI: 10.1245/s10434-013-3318-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Indexed: 01/02/2023]
Abstract
BACKGROUND Small bowel and pancreatic neuroendocrine tumors (SBNETs and PNETs) are rare tumors whose incidence is increasing. Drugs targeting the somatostatin receptor are beneficial in these tumors. To identify additional cell-surface targets, we recently found receptors and membrane proteins with gene expression significantly different from adjacent normal tissues in a small number of primary SBNETs and PNETs. We set out to validate these expression differences in a large group of primary neuroendocrine tumors and to determine whether they are present in corresponding liver and lymph node metastases. METHODS Primary SBNETs and PNETs, normal tissue, nodal, and liver metastases were collected and mRNA expression of six target genes was determined by quantitative PCR. Expression was normalized to GAPDH and POLR2A internal controls, and differences as compared to normal tissue were assessed by Welch's t test. RESULTS Gene expression was determined in 45 primary PNETs with 20 nodal and 17 liver metastases, and 51 SBNETs with 50 nodal and 29 liver metastases. Compared to normal tissue, the oxytocin receptor (OXTR) showed significant overexpression in both primary and metastatic SBNETs and PNETs. Significant overexpression was observed for MUC13 and MEP1B in PNET primary tumors, and for GPR113 in primary SBNETs and their metastases. SCTR and ADORA1 were significantly underexpressed in PNETs and their metastases. OXTR protein expression was confirmed by immunohistochemistry. CONCLUSIONS OXTR is significantly overexpressed relative to normal tissue in primary SBNETs and PNETs, and this overexpression is present in their liver and lymph node metastases, making OXTR a promising target for imaging and therapeutic interventions.
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Affiliation(s)
- Jennifer C Carr
- Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, IA
| | - Scott K Sherman
- Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, IA
| | - Donghong Wang
- Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, IA
| | - Fadi S Dahdaleh
- Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, IA
| | - Andrew M Bellizzi
- Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, IA
| | - M Sue O'Dorisio
- Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, IA
| | - Thomas M O'Dorisio
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA
| | - James R Howe
- Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, IA
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Abstract
This article reviews translational research in endocrine surgery, with a focus on disorders of the thyroid, parathyroids, adrenals, and endocrine pancreas. Discovery of genes responsible for heritable endocrine cancer syndromes has increased knowledge of the causes and mechanisms of endocrine cancer and has refined surgical treatment options. Knowledge of mutations in sporadic cancer has led to rapid progress in small-molecule kinase inhibitor strategies. These breakthroughs and their influence on current therapy are discussed to provide surgeons with an overview of the basic science research currently creating new clinical treatments and improving patient care.
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Affiliation(s)
- Scott K Sherman
- Department of Surgery, Carver College of Medicine, The University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA
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Toumpanakis C, Caplin ME. Update on the role of somatostatin analogs for the treatment of patients with gastroenteropancreatic neuroendocrine tumors. Semin Oncol 2013; 40:56-68. [PMID: 23391113 DOI: 10.1053/j.seminoncol.2012.11.006] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Somatostatin analogs (SA) are the standard of care for controlling symptoms of patients with functional gastro-entero-pancreatic neuroendocrine tumors (GEP-NETs). SA control symptoms in more than 70% of patients with carcinoid syndrome. Similar results are obtained in patients with functional, hormone-secreting, pancreatic NETs. The use of SA as antiproliferative agents has been established only recently. Retrospective studies have shown stabilization of tumor growth in >50% of patients with progressive disease. The results of a recent randomized phase III trial (PROMID) demonstrated that the median time to progression in patients with midgut carcinoid tumors treated with octreotide LAR (Long-Acting-Repeatable, Novartis, Basel, Switzerland) was more than twice as long compared to that of patients treated with placebo. The results of a phase III study of lanreotide versus placebo in nonfunctional NETs are not yet available. More studies are needed to determine whether combining SA with novel targeted treatments will result in enhanced antiproliferative activity compared to treatment with a SA alone. Studies are ongoing using pan-receptor agonists (eg, pasireotide) and chimeric dimers, which possess features of somatostatin and dopamine agonists (dopastatins) and are thought to enhance symptom control by binding multiple receptors (somatostatin and dopamine receptors). Somatostatin receptor antagonists are also currently being developed for clinical use. Peptide receptor radionuclide therapy (PRRT), consisting of yttrium-90 and lutetium-177 isotopes conjugated with SA appear to be efficacious in advanced NETs. Randomized studies are needed to definitively establish the safety and efficacy of this strategy compared to other available treatments, and to determine which radiolabeled isotopes or combinations are most effective.
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Affiliation(s)
- Christos Toumpanakis
- Neuroendocrine Tumour Unit, ENETS Centre of Excellence, Royal Free Hospital, London, UK
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44
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Peptide receptor targeting in cancer: the somatostatin paradigm. INTERNATIONAL JOURNAL OF PEPTIDES 2013; 2013:926295. [PMID: 23476673 PMCID: PMC3582104 DOI: 10.1155/2013/926295] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2012] [Revised: 12/10/2012] [Accepted: 12/28/2012] [Indexed: 02/06/2023]
Abstract
Peptide receptors involved in pathophysiological processes represent promising therapeutic targets. Neuropeptide somatostatin (SST) is produced by specialized cells in a large number of human organs and tissues. SST primarily acts as inhibitor of endocrine and exocrine secretion via the activation of five G-protein-coupled receptors, named sst1–5, while in central nervous system, SST acts as a neurotransmitter/neuromodulator, regulating locomotory and cognitive functions. Critical points of SST/SST receptor biology, such as signaling pathways of individual receptor subtypes, homo- and heterodimerization, trafficking, and cross-talk with growth factor receptors, have been extensively studied, although functions associated with several pathological conditions, including cancer, are still not completely unraveled. Importantly, SST exerts antiproliferative and antiangiogenic effects on cancer cells in vitro, and on experimental tumors in vivo. Moreover, SST agonists are clinically effective as antitumor agents for pituitary adenomas and gastro-pancreatic neuroendocrine tumors. However, SST receptors being expressed by tumor cells of various tumor histotypes, their pharmacological use is potentially extendible to other cancer types, although to date no significant results have been obtained. In this paper the most recent findings on the expression and functional roles of SST and SST receptors in tumor cells are discussed.
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46
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Pavel M. Translation of molecular pathways into clinical trials of neuroendocrine tumors. Neuroendocrinology 2013; 97:99-112. [PMID: 22508344 DOI: 10.1159/000336089] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Accepted: 12/08/2011] [Indexed: 12/20/2022]
Abstract
Current treatment options for neuroendocrine tumors (NET) include somatostatin analogs, interferon-α, peptide receptor-targeted therapy and cytotoxic chemotherapy. Most patients undergo sequential therapies since these drugs are active only in subpopulations of patients and for a limited period of time. There is a need for novel drugs that are capable of amelioration of symptomatology (syndromic control) and/or tumor growth control. A number of diverse signaling pathways are involved in the pathogenesis of NET and tumor growth, thus many potential targets are available for drug targeting. Targeted therapies therefore represent an appropriate developmental therapeutic strategy given the multiplicity of potential targets in NET. These include but are not limited to: inhibitory or activating G protein-coupled receptors, receptor tyrosine kinases, ligands, and intracellular targets such as the mammalian target of rapamycin (mTOR). Numerous drugs that utilize single or multiple targets are currently in clinical development. Recently, two target-directed agents, the multiple tyrosine kinase inhibitor sunitinib and the mTOR inhibitor everolimus, have been approved for the treatment of progressive pancreatic NET. This review provides a broad overview of established and potential molecular targets in NET, summarizes data from phase II and III clinical trials with targeted drugs and outlines future therapeutic directions.
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Affiliation(s)
- Marianne Pavel
- Department of Hepatology and Gastroenterology, Charité University Medicine, Berlin, Germany
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47
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Zitzmann K, Andersen S, Vlotides G, Spöttl G, Zhang S, Datta R, Culler M, Göke B, Auernhammer CJ. The novel somatostatin receptor 2/dopamine type 2 receptor chimeric compound BIM-23A758 decreases the viability of human GOT1 midgut carcinoid cells. Neuroendocrinology 2013; 98:128-36. [PMID: 23797089 DOI: 10.1159/000353784] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Accepted: 06/15/2013] [Indexed: 11/19/2022]
Abstract
The majority of neuroendocrine tumors (NETs) of the gastroenteropancreatic system coexpress somatostatin receptors (SSTRs) and dopamine type 2 receptors (D2R), thus providing a rationale for the use of novel SSTR2/D2R chimeric compounds in NET disease. Here we investigate the antitumor potential of the SSTR2/D2R chimeric compounds BIM-23A760 and BIM-23A758 in comparison to the selective SSTR2 agonist BIM-23023 and the selective D2R agonist BIM-53097 on human NET cell lines of heterogeneous origin. While having only minor effects on human pancreatic and bronchus carcinoid cells (BON1 and NCI-H727), BIM-23A758 induced significant antitumor effects in human midgut carcinoid cells (GOT1). These effects involved apoptosis induction as well as inhibition of mitogen-activated protein kinase and Akt signaling. Consistent with their antitumor response to BIM-23A758, GOT1 cells showed relatively high expression levels of SSTR2 and D2R mRNA. In particular, GOT1 cells highly express the short transcript variant of D2R. In contrast to BIM-23A758, the SSTR2/D2R chimeric compound BIM-23A760 as well as the individual SSTR2 and D2R agonistic compounds BIM-23023 and BIM-53097 induced no or only minor antitumor responses in the examined NET cell lines. Taken together, our findings suggest that the novel SSTR2/D2R chimeric compound BIM-23A758 might be a promising substance for the treatment of NETs highly expressing SSTR2 and D2R. In particular, a sufficient expression of the short transcript variant of DR2 might play a pivotal role for effective treatment.
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Affiliation(s)
- Kathrin Zitzmann
- Department of Internal Medicine II, University Hospital Campus Grosshadern, Ludwig Maximilians University, Munich, Germany
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Gabalec F, Beranek M, Netuka D, Masopust V, Nahlovsky J, Cesak T, Marek J, Cap J. Dopamine 2 receptor expression in various pathological types of clinically non-functioning pituitary adenomas. Pituitary 2012; 15:222-6. [PMID: 21597974 DOI: 10.1007/s11102-011-0316-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Clinically non-functioning pituitary adenomas account for about one-third of pituitary tumors. The majority of them are pathologically classified as gonadotropinomas or null-cell adenomas without hormonal expression. The rest represent silent corticotroph adenomas and plurihormonal tumors. Conservative therapy with dopamine agonists is effective in some cases only depending on the expression of dopamine 2 receptors (D2R). The aim of this study was to quantitatively estimate D2R expression in clinically non-functioning pituitary adenomas and correlate the results with adenoma type according to pathological classification. Out of the 87 adenomas investigated, 63 expressed gonadotropins, 7 were silent corticotroph adenomas, 7 were plurihormonal tumors, and only 6 did not express any pituitary hormone on immunohistochemical investigation. With the use of the reverse transcriptase PCR technique, D2R mRNA was expressed in all adenomas with very heterogeneous quantity. The expression was very low in corticotroph adenomas (relative median quantity after normalization to housekeeping gene 0.01) and lower in plurihormonal tumors (median 0.4) than in gonadotroph (median 1.3) and null-cell adenomas (median 1.9). The difference between corticotroph adenomas and plurihormonal tumors in comparison with other pathological types was statistically significant. The expression of D2R did not depend on the presence or absence of gonadotropins. We conclude that D2R expression is very low in corticotroph adenomas and significantly lower in plurihormonal tumors. The positivity of gonadotropins does not predict the D2R quantity.
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Affiliation(s)
- Filip Gabalec
- Second Department of Internal Medicine, Charles University Faculty of Medicine and Teaching Hospital in Hradec Králové, Sokolská 581, 50005, Hradec Králové, Czech Republic.
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49
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Abstract
Somatostatin (SS) and dopamine (DA) receptors have been highlighted as two critical regulators in the negative control of hormonal secretion in a wide group of human endocrine tumors. Both families of receptors belong to the superfamily of G protein-coupled receptors and share a number of structural and functional characteristics. Because of the generally reported high expression of somatostatin receptors (SSTRs) in neuroendocrine tumors (NET), somatostatin analogs (SSA) have a pronounced role in the medical therapy for this class of tumors, especially pituitary adenomas and well-differentiated gastroenteropancreatic NET (GEP NET). Moreover, NET express not only SSTR but also frequently dopamine receptors (DRs), and DA agonists targeting the D(2) receptor (D(2)) have been demonstrated to be effective in controlling hormone secretion and cell proliferation in in vivo and in vitro studies. The treatment with SSAs combined with DA agonists has already been demonstrated efficacious in a subgroup of patients with GH-secreting pituitary adenomas and few reported cases of carcinoids. The recent availability of new selective and universal SSA and DA agonists, as well as the chimeric SS/DA compounds, may shed new light on the potential role of SSTR and D(2) as combined targets for biotherapy in NET. This review provides an overview of the latest studies evaluating the expression of SSTR and DR in NET, focusing on their co-expression and the possible clinical implications of such co-expression. Moreover, the most recent insights in SSTR and D(2) pathophysiology and the future perspectives for treatment with SSA, DA agonists, and SS/DA chimeric compounds are discussed.
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Affiliation(s)
- Federico Gatto
- Division of Endocrinology, Department of Internal Medicine, Erasmus Medical Center, Room Ee530b, Dr. Molewaterplein 50, 3015 GE Rotterdam, The Netherlands
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50
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Khan MS, Caplin ME. Therapeutic management of patients with gastroenteropancreatic neuroendocrine tumours. Endocr Relat Cancer 2011; 18 Suppl 1:S53-74. [PMID: 22005115 DOI: 10.1530/erc-10-0271] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Patients with neuroendocrine tumours (NETs) are best managed in a specialist centre as part of a multidisciplinary team comprising gastroenterologists, oncologists, endocrinologists, gastrointestinal and hepatopancreaticobiliary surgeons, pathologists, nuclear medicine physicians and technicians, radiologists, specialist nurses, pharmacists, biochemists and dieticians. This should ideally be led by a clinician with experience and interest in NETs. Although the number of medical treatments and clinical trials has increased in the decade, there is still a lack of prospective randomised trials; thus, management is mainly based on limited often single-centre studies, although there are now formal guidelines based on consensus expert opinion. We have outlined the current optimal management of patients with NETs. We have reviewed therapeutic options including surgery, somatostatin analogues and other biotherapies and peptide receptor-targeted therapy. We have discussed the challenge in managing hepatic metastases including hepatic artery embolisation, ablation and orthotopic liver transplant. In addition, we have briefly reviewed the emerging therapies such as the mammalian target of rapamycin and angiogenic inhibitors and the newer somatostatin analogues.
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Affiliation(s)
- Mohid S Khan
- Neuroendocrine Tumour Unit, Centre for Gastroenterology, Royal Free Hospital, London NW3 2QG, UK
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