Morse Michael A, Liu Eric, Joish Vijay N, Huynh Lynn, Cheng Mu, Duh Mei Sheng, Seth Kiernan, Lapuerta Pablo, Metz David C
Duke Cancer Institute, School of Medicine, Duke University, Durham, NC, USA.
The Neuroendocrine Institute at Rocky Mountain Cancer Centers, Denver, CO, USA.
Cancer Manag Res. 2020 Jul 30;12:6607-6614. doi: 10.2147/CMAR.S261257. eCollection 2020.
Neuroendocrine tumors (NETs) associated with carcinoid syndrome (CS) overproduce serotonin, mediated by tryptophan hydroxylase-1 (TPH1). The TPH inhibitor telotristat ethyl (TE) reduces peripheral serotonin and relieves CS symptoms. We conducted a real-world clinical practice study to explore the effects of TE on tumor growth in patients with NETs and CS.
Single-arm, pre/post chart review study of patients with advanced NETs who received TE for ≥6 months and had ≥2 radiological scans within 12 months before and ≥1 scan after TE initiation. Linear regression and longitudinal analyses assessed changes in tumor size controlling for background NET treatment.
Two hundred patients were enrolled, most (61%) had well-differentiated gastrointestinal NETs (61%) and received TE for an average of 12 months (SD, 7.3). Mean reduction in tumor size after TE initiation was 0.59 cm (p=0.006). Longitudinal analysis showed an 8.5% reduction in tumor size (p=0.045) from pre- to post-TE periods. Documented NET treatment prior to initiating TE and time between scans were not significant predictors of changes in tumor size. Results were consistent in a subgroup of patients with the same documented NET treatment before and after initiating TE.
TE may have antitumor effects consistent with serotonin overproduction in tumor growth.
与类癌综合征(CS)相关的神经内分泌肿瘤(NETs)会过度产生血清素,这由色氨酸羟化酶-1(TPH1)介导。TPH抑制剂乙基替洛曲星(TE)可降低外周血清素水平并缓解CS症状。我们开展了一项真实世界临床实践研究,以探究TE对NETs和CS患者肿瘤生长的影响。
对晚期NETs患者进行单臂、治疗前后图表回顾研究,这些患者接受TE治疗≥6个月,在TE开始前12个月内有≥2次放射学扫描,且在TE开始后有≥1次扫描。线性回归和纵向分析评估了在控制NET背景治疗的情况下肿瘤大小的变化。
共纳入200例患者,大多数(61%)患有高分化胃肠道NETs,平均接受TE治疗12个月(标准差7.3)。TE开始后肿瘤大小平均缩小0.59 cm(p = 0.006)。纵向分析显示,从TE治疗前到治疗后,肿瘤大小减少了8.5%(p = 0.045)。开始TE治疗前记录的NET治疗情况以及扫描间隔时间并非肿瘤大小变化的显著预测因素。在开始TE治疗前后有相同记录的NET治疗的患者亚组中,结果一致。
TE可能具有与肿瘤生长中血清素过度产生相一致的抗肿瘤作用。