Somatostatin analogs in the treatment of medullary thyroid carcinoma
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The medical therapy for advanced or metastatic medullary thyroid carcinoma has not been fully established. Somatostatin analogs have been used with variable success in the therapy of a few patients with medullary thyroid carcinoma. In the present study, we evaluated the effects of somatostatin analog therapy on calcitonin (ct) and carcinoembryonic antigen in patients with advanced medullary thyroid carcinoma. Five patients (2 men and 3 women, aged 35-57 yr) with post-operative recurrent medullary thyroid carcinoma received somatostatin analog therapy for 12 weeks. All had been previously treated with total thyroidectomy and lymphadenectomy. Four of them showed positive uptake in 111In-pentetreotide scanning. One patient was treated with sc octreotide (100 μg/8 h), 3 patients received im slow release lanreotide (30 mg/14 days), and a further one received im octreotide LAR (30 mg/28 days). Serum samples for ct and carcinoembryonic antigen were obtained at 0, 1, 2, 4, 8 and 12 weeks of therapy. Therapy was well-tolerated in general, with minimal side-effects. One patient died after the first month of therapy because of advanced disease. Another patient showed normalization of his ct and carcinoembryonic antigen concentrations at the second week of therapy, maintaining elevated values thereafter. No clinically relevant changes in serum concentrations of ct and carcinoembryonic antigen were observed in the rest of the patients. One patient with positive 111In-pentetreotide scan, showed no uptake after somatostatin analog therapy. No significant decrease in the size of metastases was evident in the remaining patients. In conclusion, therapy with different formulations of octreotide and lanreotide does not seem to modify serum concentrations of ct and carcinoembryonic antigen in patients with recurrent medullary thyroid carcinoma.
Key wordsOctreotide lanreotide medullary thyroid carcinoma
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- 1.Ball D.W., Baylin S.B., de Bustros A.C. Medullary thyroid carcinoma. In: Braverman L.E. & Utiger R.D. (Eds.), Werner and Ingbar’s The Thyroid, 7th ed. Lippincott-Raven, Philadelphia, 1996, p. 946–960.Google Scholar
- 5.Modigliani E., Guliana J.M., Maroni M., et al. Effets de l’administration sous cutanée de la sandostatine (SMS 201.995) en sous cutané dans 18 cas de cancer médullaire du corps thyroïde. Ann. Endocrinol. (Paris) 1989, 50: 483–488.Google Scholar
- 6.Guliana J.M., Guillausseau P.J., Caron J., Siame-Mourot C., Calmettes C., Modigliani E. Effects of the short-term subcutaneous administration of SMS 201-995 on calcitonin plasma levels in patients suffering from medullary thyroid carcinoma. Horm. Metab. Res. 1989, 21: 584–586.PubMedCrossRefGoogle Scholar
- 8.Libroia A., Di Sacco G., Verga U., Piolini M., Muratori F. Effect of the chronic administration of Sandostatin in two patients affected by medullary thyroid carcinoma responders to the acute test (abstract). J. Endocrinol. Invest. 1990, 13: 222.Google Scholar
- 13.Berkelhammer C.H., Rosenberg I.H., Fedorak R.N., O’Dorisio T.M. Inefficacy of somatostatin analogue SMS 201-995 in reducing severe diarrhoea in a patient with medullary thyroid carcinoma (abstract 246). Can. J. Physiol. Pharmacol. 1986, 64: 67.Google Scholar
- 15.Jerkins T.W., Sacks H.S., O’Dorisio T.M., Tuttle S., Solomon S.S. Medullary carcinoma of the thyroid, pancreatic nesidioblastosis and microadenosis, and pancreatic polypeptide hypersecretion: A new association and clinical and hormonal responses to long-acting somatostatin analog SMS 201–995. J. Clin. Endocrinol. Metab. 1987, 64: 1313–1319.PubMedCrossRefGoogle Scholar
- 18.Somlo G., Akman S.A., Doroshow J.H., et al. Treatment of neuroendocrine tumors with a somatostatin analogue (Sandostatin™) (abstract 378). Proc. Am. Soc. Clin. Oncol. 1990, 9: 97.Google Scholar
- 20.Fugazzola L., Pacini F., Elisei R. Chronic somatostatin therapy is not effective in medullary thyroid cancer (abstract). J. Endocrinol. Invest. 1991, 14: 22.Google Scholar
- 24.Frank-Raue K., Ziegler R., Raue F. The use of octreotide in the treatment of medullary thyroid carcinoma. Horm. Metab. Res. 1993, Suppl. (27): 44–47.Google Scholar
- 25.Frank-Raue K., Raue F., Ziegler R. Therapy of metastatic medullary thyroid gland carcinoma with the somatostatin analog octreotide. Med. Klin. 1995, 90: 63–66.Google Scholar
- 27.Sanabria C., Aguirre M., Domínguez-Gadea L. Utilidad del análogo de somatostatina octreotida en el tratamiento y seguimiento gammagráfico de un carcinoma medular de tiroides (abstract). Endocrinología 1995, 42: 28.Google Scholar