Yau Hanford, Kinaan Mustafa, Quinn Suzanne L, Moraitis Andreas G
Division of Endocrinology, Diabetes, and Metabolism, University of California, San Francisco (Fresno Division), Fresno, CA, USA.
Division of Internal Medicine, University of Central Florida College of Medicine, Orlando, FL, USA.
Biologics. 2017 Dec 6;11:115-122. doi: 10.2147/BTT.S108818. eCollection 2017.
Over the past three decades, the incidence and prevalence of neuroendocrine tumors have gradually increased. Due to the slow-growing nature of these tumors, most cases are diagnosed at advanced stages. Prognosis and survival are associated with location of primary lesion, biochemical functional status, differentiation, initial staging, and response to therapy. Octreotide, the first synthetic somatostatin analog, was initially used for the management of gastrointestinal symptoms associated with functional carcinoid tumors. Its commercial development over time led to long-acting repeatable octreotide acetate, a long-acting version that provided greater administration convenience. Recent research demonstrates that octreotide's efficacy has evolved beyond symptomatic management to targeted therapy with antitumoral effects. This review examines the history and development of octreotide, provides a synopsis on the classification, grading, and staging of neuroendocrine tumors, and reviews the evidence of long-acting repeatable octreotide acetate as monotherapy and in combination with other treatment modalities in the management of non-pituitary neuroendocrine tumors with special attention to recent high-quality Phase III trials.
在过去三十年中，神经内分泌肿瘤的发病率和患病率逐渐上升。由于这些肿瘤生长缓慢，大多数病例在晚期才被诊断出来。预后和生存率与原发病变的位置、生化功能状态、分化程度、初始分期以及对治疗的反应有关。奥曲肽是第一种合成的生长抑素类似物，最初用于治疗与功能性类癌肿瘤相关的胃肠道症状。随着时间的推移，其商业开发产生了长效可重复注射用醋酸奥曲肽，这是一种长效剂型，给药更加方便。最近的研究表明，奥曲肽的疗效已从症状管理发展到具有抗肿瘤作用的靶向治疗。本文综述了奥曲肽的历史和发展，概述了神经内分泌肿瘤的分类、分级和分期，并回顾了长效可重复注射用醋酸奥曲肽作为单一疗法以及与其他治疗方式联合用于治疗非垂体神经内分泌肿瘤的证据，特别关注了近期高质量的III期试验。
