Prolonged Radiographic Stabilization of a Metastatic Octreotide Scan-Positive Poorly Differentiated Neuroendocrine Tumor Using Octreotide Acetate Therapy Alone

Steven Sorscher

Department of Oncology, Washington University School of Medicine, Saint Louis, USA.

DOI: 10.4236/jct.2013.47132                

Abstract

Pancreatic poorly differentiated neuroendocrine tumors (PDNETs) are a subtype of neuroendocrine Tumors (NETs) clinically distinguished by their much more rapid growth and immunohistochemically diagnosed by having a higher Ki-67 cancer cell staining percentage compared to their well or intermediately differentiated NET counterparts. While standard first line treatment for metastatic well or intermediately differentiated pancreatic NETs typically involves octreotide acetate therapy, here I report, to my knowledge, the first case of a patient with a pancreatic PDNET with radiographic stabilization of his disease with octreotide acetate use alone. Octreotide acetate was chosen after first establishing that, based on his octreotide scan, receptors might be targeted using the octreotide analog.

Keywords

PDNET; Octreotide Acetate; Pancreatic Cancer; mTOR Overexpression

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	M. H. Kulke, A. B. Benson, E. Bergsland III, J. D. Berlin, L. S. Blaszkowsky, M. A. Choti, et al., “Neuroendocrine Tumors,” Journal of National Comprehensive Cancer Network, Vol. 10, No. 6, 2012, pp. 724-764.
[2]	V. M. Maccaulay, I. E. Smith, M. J. Everard, J. D. Teale, J. C. Reubi and J. R. Millar, “Experimental and Clinical Studies with Somatostatin Analogue Octreotide in Small Cell Lung Cancer,” British Journal of Cancer, Vol. 64, No. 3, 1991, pp. 451-456. doi:10.1038/bjc.1991.330
[3]	A. Rinke, H. H. Muller, C. Schade-Brittinger, K. J. Klose, P. Barth, M. Wied, et al., “Placebo-Controlled, DoubleBlind, Prospective Randomized Study on the Effect of Octreotide LAR in the Control of Tumor Growth in Patients with Metastatic Neuroendocrine Miidgut Tumors; A Report from the PROMID Study Group,” Journal of Clinical Oncology, Vol. 27, No. 28, 2009, pp. 4656-4663. doi:10.1200/JCO.2009.22.8510
[4]	M. E. Pavel, J. D. Hainsworth, E. Baudin, M. Peeters, D. Horsch, R. E. Winkler, et al., “Everolimus Plus Octreotide Long-Acting Repeatable for the Treatment of Advanced Neuroendocrine Tumours Associated with Carcinoid Syndrome (RADIANT 2): A Randomised, PlaceboControlled, Phase 3 Study,” The Lancet, Vol. 378, No. 9808, 2011, pp. 2005-2012. doi:10.1016/S0140-6736(11)61742-X
[5]	G. Kloppel, A. Perren and P. U. Heitz, “The Gastroenteropancreatic Neuroendocrine Cell System and Its Tumors: The WHO Classification,” Annals of the New York Academy of Science, Vol. 1014, 2004, pp. 13-27. doi:10.1196/annals.1294.002
[6]	L. Tachhmanova, M. Pensabene, I. Capuano, I. Spagnoletti, P. Zetta, S. Del Vecchio, et al., “Poorly Differentiated Small Cell Neuroendocrine Carcinoma Localized in Three Different Endocrine Glands: Response to Chemotherapy and Octrotide LAR,” Journal of Endocrinological Investigation, Vol. 28, No. 4, 2005, pp. 371-378.
[7]	L. Catena, E. Bajetta, M. Milione, M. Ducceschi, M. Valente, F. Dominoni and V. Colonna, “Mammalian Target of Rapamycin Expression in Poorly Differentiated Endocrine Carcinoma: Clinical and Therapeutic Future Challenges,” Target Oncology, Vol. 6, No. 2, 2011, pp. 65-68. doi:10.1196/annals.1294.002