NEW YORK (Reuters Health) Nov 24 - Combining antineoplastic agents with a long-acting somatostatin analogue has benefits in patients with somatostatin-receptor-positive small cell lung cancer (SCLC), particularly those with limited disease, a study from Greece suggests.
As a neuroendocrine cancer, small cell lung tumors often posses high densities of somatostatin receptors. Long-acting somatostatin analogues combined with platinum analogues have demonstrated an anti-proliferative effect on growth of human SCLC xenographs.
"Many scientists have characterized somatostatin as the universal endocrine off switch," the authors note in a paper in Lung Cancer, published online October 22.
To investigate further, Dr. Kostantinos Zarogoulidis from Aristotle University Pulmonary Clinic in Thessaloniki and colleagues enrolled 130 previously untreated patients with SCLC in a phase 2/3 randomized clinical study. All of the patients were treated with paclitaxel plus carboplatin for up to six cycles.
By random allocation, 47 patients received no other therapy (Group A; control group); 43 patients received 30 mg lanreotide (Somatulin) by subcutaneous injection 48 hours after each chemotherapy cycle to stimulate somatostatin receptors for two weeks (Group B); and the remaining 40 patients received 60 mg sustained release lanreotide for four weeks (Group C).
Patients on subcutaneous lanreotide fared best. They had median survival of 476 days, which was significantly longer than that of Group A and Group C (300 and 347 days, respectively; p=0.029).
Patients with limited disease in Group B lived 565 days compared to 320 days and 347 days for their peers with limited disease in group A and C, respectively (p=0.012).
The median time to progression was also significantly longer in Group B relative to Group A and C (350 days vs. 224 days and 294 days; p=0.034). Patients with limited disease in Group B had a median time to progression of 371 days compared with 231 and 217 days for limited disease patients in groups A and C, respectively.
Hematological and non-hematological toxicities were "mild and well manageable" with hematopoietic growth factors, the investigators say.
The current study suggests that long-acting somatostatin analogues could be used as "an additive therapy" in combination with antineoplastic agents in patients positive for somatostatin receptors, they conclude.
However, the researchers say, "many unresolved questions still exist especially for the optimal duration of somatostatin administration."
The current study supports a 30 mg dose of lanreotide, especially in limited disease patients, given 48 hours after chemotherapy administration to stimulate receptors for no more than 2 weeks.
The researchers point out, however, that a reduction in the density of somatostatin receptors was observed in only 28 of 130 patients and was not correlated with extensiveness of disease therapy response or with survival, "thus leaving a gap in our understanding of the role of somatostatin receptors and their stimulation during chemotherapy."
SOURCE: http://bit.ly/us1x09
Lung Cancer 2011.
As a neuroendocrine cancer, small cell lung tumors often posses high densities of somatostatin receptors. Long-acting somatostatin analogues combined with platinum analogues have demonstrated an anti-proliferative effect on growth of human SCLC xenographs.
"Many scientists have characterized somatostatin as the universal endocrine off switch," the authors note in a paper in Lung Cancer, published online October 22.
To investigate further, Dr. Kostantinos Zarogoulidis from Aristotle University Pulmonary Clinic in Thessaloniki and colleagues enrolled 130 previously untreated patients with SCLC in a phase 2/3 randomized clinical study. All of the patients were treated with paclitaxel plus carboplatin for up to six cycles.
By random allocation, 47 patients received no other therapy (Group A; control group); 43 patients received 30 mg lanreotide (Somatulin) by subcutaneous injection 48 hours after each chemotherapy cycle to stimulate somatostatin receptors for two weeks (Group B); and the remaining 40 patients received 60 mg sustained release lanreotide for four weeks (Group C).
Patients on subcutaneous lanreotide fared best. They had median survival of 476 days, which was significantly longer than that of Group A and Group C (300 and 347 days, respectively; p=0.029).
Patients with limited disease in Group B lived 565 days compared to 320 days and 347 days for their peers with limited disease in group A and C, respectively (p=0.012).
The median time to progression was also significantly longer in Group B relative to Group A and C (350 days vs. 224 days and 294 days; p=0.034). Patients with limited disease in Group B had a median time to progression of 371 days compared with 231 and 217 days for limited disease patients in groups A and C, respectively.
Hematological and non-hematological toxicities were "mild and well manageable" with hematopoietic growth factors, the investigators say.
The current study suggests that long-acting somatostatin analogues could be used as "an additive therapy" in combination with antineoplastic agents in patients positive for somatostatin receptors, they conclude.
However, the researchers say, "many unresolved questions still exist especially for the optimal duration of somatostatin administration."
The current study supports a 30 mg dose of lanreotide, especially in limited disease patients, given 48 hours after chemotherapy administration to stimulate receptors for no more than 2 weeks.
The researchers point out, however, that a reduction in the density of somatostatin receptors was observed in only 28 of 130 patients and was not correlated with extensiveness of disease therapy response or with survival, "thus leaving a gap in our understanding of the role of somatostatin receptors and their stimulation during chemotherapy."
SOURCE: http://bit.ly/us1x09
Lung Cancer 2011.
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