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Advances with Somatostatin Analogs in Neuroendocrine Tumors; The Promise of Radionuclides in Neuroendocrine Tumors

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Management of Neuroendocrine Tumors of the Pancreas and Digestive Tract

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Abstract

Somatostatin (SST) analogs form the cornerstone of medical therapy of well-differentiated neuroendocrine tumors (NETs). These tumors are commonly characterized by high SST receptor expression levels, mainly of subtype 2 (SSTR2), which is the basis for SST use in imaging and therapeutic strategies in digestive NETs. Since the 1980s, SST analogs (octreotide and lanreotide) have been widely prescribed to relieve symptoms resulting from hormonal hypersecretion in functioning tumors, such as carcinoid syndrome. In the last few years, two phase III studies have demonstrated that in addition to their antisecretory effects, SST analogs also exert antiproliferative effects in selected patients. Moreover, underlying molecular mechanisms of action have been elucidated, paving the way for strategies to overcome acquired resistance, such as dose optimization, combination with other targeted agents, and dual-targeting chimeric molecules. Conjugation of SST analogs with radionuclides has also been used for peptide-receptor-targeted radiotherapy (PRRT) in advanced NETs, with promising results. This chapter summarizes key preclinical and clinical data on the antisecretory and antitumor effects of SST analogs and provides an overview of recent advances with these agents and SST-based PRRT.

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Authors and Affiliations

  1. Department of Medical Oncology (INSERM U728—Paris 7 Diderot University), Beaujon University Hospital, Assistance Publique—Hôpitaux de Paris, 100 boulevard du Général Leclerc, 92110, Clichy, France

    Eric Raymond

  2. Department of Gastroenterology and Pancreatology, Beaujon University Hospital (Assistance Publique Hôpitaux de Paris—PRES SPC: Paris 7 Diderot), Clichy, France

    Cindy Neuzillet, Olivia Hentic & Philippe Ruszniewski

  3. Department of Medical Oncology (INSERM U728—Paris 7 Diderot University), Beaujon University Hospital (Assistance Publique Hopitaux de Paris—PRES SPC: Paris 7 Diderot), Clichy, France

    Cindy Neuzillet

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  1. Medical Oncology, Bichat-Beaujon University Hospitals, Clichy cedex, France

    Eric Raymond

  2. Bichat-Beaujon University Hospitals Medical Oncology, Clichy cedex, France

    Sandrine Faivre

  3. Pancreatology, Bichat-Beaujon University Hospitals Gastroenterology and, Clichy cedex, France

    Philippe Ruszniewski

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Neuzillet, C., Hentic, O., Raymond, E., Ruszniewski, P. (2014). Advances with Somatostatin Analogs in Neuroendocrine Tumors; The Promise of Radionuclides in Neuroendocrine Tumors. In: Raymond, E., Faivre, S., Ruszniewski, P. (eds) Management of Neuroendocrine Tumors of the Pancreas and Digestive Tract. Springer, Paris. https://doi.org/10.1007/978-2-8178-0430-9_4

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