Predictive factors of efficacy of the somatostatin analogue octreotide as first line therapy for advanced pancreatic endocrine carcinoma

G. Butturini, R. Bettini, E. Missiaglia, W. Mantovani, I. Dalai, P. Capelli, M. Ferdeghini, P. Pederzoli, A. Scarpa, M. Falconi

Research output: Contribution to journalArticle

Abstract

About 40% of nonfunctioning pancreatic endocrine carcinomas (NF-PEC) cannot be cured by surgery due to advanced stage disease. Somatostatin analogues have been proposed as first line therapy in these cases. We performed a prospective phase IV study to assess the efficacy of octreotide in advanced NF-PEC and identify factors predictive of response to therapy. Twenty-one consecutive patients with octreoscan-positive advanced-stage well-differentiated NF-PEC were treated with long-acting release octreotide 20 mg i.m. at diagnosis. The immunohistochemical expression of somatostatin receptor 2 (SSTR2) and the quantitative mRNA analysis of SSTR2 and SSTR5 were assessed in 12 tumours. The tumour proliferative fraction was assessed by immunohistochemistry for Ki-67. Eight patients (38%) had stable disease (SD) after a median follow-up of 49.5 months. Thirteen patients (62%) developed progression after a median of 18 months. Tumour progression correlated with a proliferative index ≥ 5% (P = 0.016), weight loss (P = 0.006) and absence of abdominal pain (P = 0.003) at diagnosis. Other clinical (age, gender and primary tumour resection) or pathological parameters (site, size and liver metastasis) lacked significant correlation with tumour progression. No difference in the amount of SSTR2 mRNA and protein or SSTR5 mRNA was found between tumours that were stable (n = 5) and seven tumours that progressed (n = 7). Treatment with long-acting release octreotide was associated with stabilization of disease and a good quality of life in 38% of patients. A Ki-67 index ≥ 5% and/or the presence of weight loss may justify more aggressive therapy without waiting for radiologically proven progression of disease.

Original languageEnglish
Pages (from-to)1213-1221
Number of pages9
JournalEndocrine-Related Cancer
Volume13
Issue number4
DOIs
Publication statusPublished - Dec 2006

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Octreotide
Somatostatin
Neoplasms
Messenger RNA
Therapeutics
Weight Loss
Pancreatic Carcinoma
Abdominal Pain
Disease Progression
Immunohistochemistry
Quality of Life
Neoplasm Metastasis
Liver
somatostatin receptor 2

ASJC Scopus subject areas

  • Endocrinology
  • Oncology
  • Cancer Research
  • Endocrinology, Diabetes and Metabolism

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Predictive factors of efficacy of the somatostatin analogue octreotide as first line therapy for advanced pancreatic endocrine carcinoma. / Butturini, G.; Bettini, R.; Missiaglia, E.; Mantovani, W.; Dalai, I.; Capelli, P.; Ferdeghini, M.; Pederzoli, P.; Scarpa, A.; Falconi, M.

In: Endocrine-Related Cancer, Vol. 13, No. 4, 12.2006, p. 1213-1221.

Research output: Contribution to journalArticle

Butturini, G, Bettini, R, Missiaglia, E, Mantovani, W, Dalai, I, Capelli, P, Ferdeghini, M, Pederzoli, P, Scarpa, A & Falconi, M 2006, 'Predictive factors of efficacy of the somatostatin analogue octreotide as first line therapy for advanced pancreatic endocrine carcinoma', Endocrine-Related Cancer, vol. 13, no. 4, pp. 1213-1221. https://doi.org/10.1677/erc.1.01200
Butturini, G. ; Bettini, R. ; Missiaglia, E. ; Mantovani, W. ; Dalai, I. ; Capelli, P. ; Ferdeghini, M. ; Pederzoli, P. ; Scarpa, A. ; Falconi, M. / Predictive factors of efficacy of the somatostatin analogue octreotide as first line therapy for advanced pancreatic endocrine carcinoma. In: Endocrine-Related Cancer. 2006 ; Vol. 13, No. 4. pp. 1213-1221.
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AU - Bettini, R.

AU - Missiaglia, E.

AU - Mantovani, W.

AU - Dalai, I.

AU - Capelli, P.

AU - Ferdeghini, M.

AU - Pederzoli, P.

AU - Scarpa, A.

AU - Falconi, M.

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