Does Sandostatin inhibit or reverse the growth of carcinoid tumors?
Here are a few medical references dealing with the issue of efficacy of octreotide in control of tumor growth and/or reduction. There are more, but these are the initial ones that come to mind plus the 2009 published study. Feel free to print this article and show it to any physician who doubts the efficacy of octreotide (in this case Sandostatin):
The reference published in 2009:
New Study First to Confirm Sandostatin LAR(R) Depot Controls Tumor Growth in Patients With Rare Gastrointestinal Tumors (Read full Text)
"In recent years, a growing body of evidence has suggested that Sandostatin LAR provides antitumor effects, but these are the first data to confirm this effect from a well-designed, prospective, placebo-controlled study," said David Epstein, President & CEO of Novartis Oncology.
EAST HANOVER, N.J., Jan. 13 /PRNewswire/ -- Sandostatin LAR(R) Depot (octreotide acetate suspension for injection) demonstrated antitumor benefit in patients with metastatic neuroendocrine tumors (NETs) of the midgut, according to interim data presented today at the 2009 Gastrointestinal Cancer Symposium of the American Society of Clinical Oncology.
- Data show significant 66% reduction in risk of disease progression versus placebo
- Sandostatin LAR more than doubled time without tumor growth for a median of 14 months compared to six months on placebo
- Results support Sandostatin LAR as first treatment after surgery in certain patients with newly diagnosed neuroendocrine tumors (NETs)
Placebo-Controlled, Double-Blind, Prospective, Randomized Study on the Effect of Octreotide LAR in the Control of Tumor Growth in Patients With Metastatic Neuroendocrine Midgut Tumors: A Report From the PROMID Study Group (Read Full Text)
Purpose: Somatostatin analogs are indicated for symptom control in patients with gastroenteropancreatic neuroendocrine tumors (NETs). The ability of somatostatin analogs to control the growth of well-differentiated metastatic NETs is a matter of debate. We performed a placebo-controlled, double-blind, phase IIIB study in patients with well-differentiated metastatic midgut NETs. The hypothesis was that octreotide LAR prolongs time to tumor progression and survival.
Patients and Methods: Treatment-naive patients were randomly assigned to either placebo or octreotide LAR 30 mg intramuscularly in monthly intervals until tumor progression or death. The primary efficacy end point was time to tumor progression. Secondary end points were survival time and tumor response. This report is based on 67 tumor progressions and 16 observed deaths in 85 patients at the time of the planned interim analysis.
Results: Median time to tumor progression in the octreotide LAR and placebo groups was 14.3 and 6 months, respectively (hazard ratio [HR] = 0.34; 95% CI, 0.20 to 0.59; P = .000072). After 6 months of treatment, stable disease was observed in 66.7% of patients in the octreotide LAR group and 37.2% of patients in the placebo group. Functionally active and inactive tumors responded similarly. The most favorable effect was observed in patients with low hepatic tumor load and resected primary tumor. Seven and nine deaths were observed in the octreotide LAR and placebo groups, respectively. The HR for overall survival was 0.81 (95% CI, 0.30 to 2.18)
Conclusion: Octreotide LAR significantly lengthens time to tumor progression compared with placebo in patients with functionally active and inactive metastatic midgut NETs. Because of the low number of observed deaths, survival analysis was not confirmatory.
Carcinoid tumor regression with high-dose octreotide acetate: a patient report.
Efficacy of octreotide in the regression of a metastatic carcinoid tumor despite negative imaging with In-111-pentetreotide (Octreoscan). http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Retrieve&list_uids=9626790&dopt=Abstract
Also in a very impressive and comprehensive review:
Carcinoid tumors and the carcinoid syndrome. Jensen, R.T., Norton, JA In: DeVita, VT Jr., Hellman, S, Rosenberg S eds. Cancer; Principles Practice of Oncology, 5th ed. Philadelphia, P Lippincott-Raven; 1997; 2:1704-1723.
It is stated on page 1718: octreotide may have a tumoriostatic effect, stabalizing the extent of metastatic disease and prolonging survival (with three references).
In Metastatic carcinoid tumors and the malignant carcinoid syndrome, Kvols, LK, Reubi, JC, the authors state: Even though objective tumor regression was unusual, previously progressive disease often became stable and this seems to have translated into favorable long-term survival.
Refer to: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Retrieve&list_uids=8323761&dopt=Abstract
And to quote from Somatostatin analogue octreotide and inhibition of tumor growth in metastatic endocrine gastroenteropancreatic tumors. Arnold, R, Trautmann, ME, Creutzfeldt, W, Benning R, Benning, M, Neuhaus, C, Jurgensen, R, Stein, K. Schafer, H, Bruns, C, Dennler, H.J. The results suggest that octreotide inhibits tumor growth in patients with metastases endocrine GEP tumors. The antiproliferative effect is, at least in some patients, long lasting.
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