Tailored intermittent therapy of carcinoid.

BACKGROUND/AIMS: There is no established standard care of carcinoids as all experts agree. Endogenous somatostatin diurnal rhythm is influenced by administration of lanreotid. The purpose of this study is to evaluate efficacy of lanreotid on the clinical course in a group of patients with metastatic carcinoid.

METHODOLOGY

In 43 patients with carcinoid tumors somatostatin serum level, 5-HIAA (5-hydroxyindolacetic acid), NSE (neuron-specific enolase), and chromogranin A were examined. Fifteen patients received 30mg of somatulin (Lanreotid) in two-week intervals.

RESULTS

Therapy with somatostatin analogue improved symptoms in 70-80% of patients with metastases and carcinoid syndrome. 5-HIAA significantly decreased after lanreotid therapy. NSE values are undulating. With progression of the disease they rise. Chromogranin is higher in patients with advanced metastatic disease. Mesor of the diurnal excretion of somatostatin is higher (32 pg/mL) in patients with metastatic disease than in patients without (20 pg/mL). After lanreotid administration mesor decreased (16 pg/mL) in the group of patients with metastases.

CONCLUSIONS

Intermittent lanreotid therapy is efficient. A rise--(ascend) of endogenous SMS level could be one of the markers of increased activity of carcinoid cells and an indication for the next application of lanreotid therapy. Mean survival of patients with metastatic carcinoid in our study was 46.3 months.