Department of Hematology and Medical Oncology, Morales Meseguer University Hospital, Calle Marqués de los Vélez, s/n, CP 30008, Murcia, Spain.
Department of Medical Oncology, Central Asturias University Hospital, Oviedo, Spain.
Curr Oncol Rep. 2017 Sep 18;19(11):72. doi: 10.1007/s11912-017-0633-2.
Somatostatin analogues, aiming to control tumor secretion or growth, constitute the most attractive therapeutic option for patients with well-differentiated gastroenteropancreatic neuroendocrine tumors (GEP-NETs). The objective of this article is to provide a comprehensive review of the current state-of-the-art knowledge gaps and potential opportunities for future development and optimization of this therapeutic modality.
A contextualized systematic review with a narrative component was conducted using PubMed, The Cochrane Library, EMBASE, and Google Scholar. Titles were screened, and non-English, duplicate, or irrelevant entries were excluded. Selection criteria for articles included the following: publication in English between 1995 and 2016, patients with GEP-NETs, analysis of efficacy, safety, practical management considerations, predictive factors, and/or strategies for overcoming resistance, concerning somatostatin analogs.
Ninety-seven studies out of 2771 screened publications met the inclusion criteria (16 randomized clinical trials, 27 phase II trials, 3 phase I trials, 3 subgroup analyses of clinical trials, 1 open-label extension of a randomized trial, 1 phase IV trial, 32 observational studies, and 14 basic research articles). The nature and scope of literature was diverse with most articles dedicated to drug efficacy or indications of use (n = 49), pharmacological issues (n = 8), assessment or predictors of response (n = 4), practical management (n = 11), combination therapy or other means to overcome resistance (n = 19), receptors and signaling pathways (n = 3), and subgroup analyses (n = 3).
In this appraisal, we have found some practical aspects that can help to the optimization of somatostatin analog (SSA) therapy in patients with well-differentiated GEP-NETs. We have also identified areas of uncertainty in an effort to guide clinical research in the coming years.
生长抑素类似物旨在控制肿瘤的分泌或生长，是治疗分化良好的胃肠胰神经内分泌肿瘤（GEP-NET）患者的最具吸引力的治疗选择。本文的目的是全面回顾当前的最新知识空白，并为未来发展和优化这种治疗方式提供潜在机会。
使用 PubMed、The Cochrane Library、EMBASE 和 Google Scholar 进行了上下文系统综述，其中包括叙述性内容。筛选标题，并排除非英语、重复或不相关的条目。纳入文章的选择标准包括：1995 年至 2016 年间以英文发表、患有 GEP-NET 的患者、分析疗效、安全性、实际管理注意事项、预测因素和/或克服耐药性的策略，这些研究与生长抑素类似物有关。
从 2771 篇筛选出的文献中，有 97 篇符合纳入标准（16 项随机临床试验、27 项 2 期临床试验、3 项 1 期临床试验、3 项临床试验的亚组分析、1 项随机试验的开放标签扩展、1 项 4 期临床试验、32 项观察性研究和 14 项基础研究文章）。文献的性质和范围多种多样，大多数文章专注于药物疗效或用途（n=49）、药理学问题（n=8）、反应评估或预测因素（n=4）、实际管理（n=11）、联合治疗或其他克服耐药性的方法（n=19）、受体和信号通路（n=3）和亚组分析（n=3）。
在本次评估中，我们发现了一些有助于优化分化良好的胃肠胰神经内分泌肿瘤患者生长抑素类似物（SSA）治疗的实际方面。我们还确定了一些不确定的领域，以便在未来几年指导临床研究。
