Among the immunochemical markers currently used to characterize neuroendocrine (NE) tumors neurone specific enolase (NSE) was shown to be useful for evaluating chemosensitivity of the tumor and for monitoring the follow-up in patients with Small-Cell Lung Cancer (SCLC), a tumor expressing NE activation. Octreotide (OCT), a long-acting somatostatin analogue, showed promising results in the treatment of NE tumors. Accordingly, we have carried out a pilot study for the treatment of SCTC combining OCT 500 mcg thrice daily for 7 days followed by CEVE chemotherapy on the 8th day. After completing treatment OCT 200 mcg thrice a day was continued until recurrence. At present the 24 patients recruited show a good tolerance to the therapy; responses obtained on the 20 evaluable patients have been: 4 CR, 8 PR, 5 S, 3 P, totally similar to those obtained by conventional chemotherapy. The free-disease interval and long survival of patients submitted to continuous OCT therapy will be strictly monitored. Interesting was the observation that patients in whom basal NSE lowered more than 25% after the first cycle of OCT seemed the most benefitted candidates by synergic treatment. The interpretation of the decrease of NSE under OCT could be correlated to the presence of receptors for somatostatin in tumor tissue, as already shown by Lamberts in 1989. Evidently the presence of the receptors points out a higher differentiation of NE tissue, and then oscillations of the NSE value during the therapy with OCT higher than 25% can express a better prognosis of the tumor. We are planning to carry out a polycentric randomized trial comparing chemotherapy versus OCT plus chemotherapy.
|Number of pages||3|
|Publication status||Published - 1994|
- small-cell lung cancer
ASJC Scopus subject areas
- Internal Medicine