Endocrinology Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant'Andrea Hospital, ENETS Center of Excellence, Via di Grottarossa 1038, 00189, Rome, Italy.
J Endocrinol Invest. 2024 Jan;47(1):35-46. doi: 10.1007/s40618-023-02170-9. Epub 2023 Aug 15.
The specific indications of somatostatin analogs (SSAs) in patients with neuroendocrine tumor (NET) emerged over the time. The objective of this review is to summarize and discuss the most relevant data concerning long-acting SSAs in NET.
A narrative review was performed including publications focusing on therapy with the long-acting octreotide, lanreotide, and pasireotide in patients with NET.
Long-acting SSAs confirm to be a manageable and widely used tool in patients with NET. Both long-acting octreotide and lanreotide are safe as the short-acting formulations, while patient compliance and adherence is further improved. Together with some randomized phase-3 trials, many retrospective and prospective studies have been performed in the last 20 years revealing a variable but substantial impact on progression free survival, not only in gastroenteropancreatic but also in lung and unknown primary NETs. The most frequent tumor response to SSAs is stable disease, but an objective response can be observed, more frequently by using high-dose schedules and in MEN1-related pancreatic NETs. Low tumor burden, low tumor grade (G1 and low G2), good performance status and use as first-line therapy are the main predictive factors to SSAs in NET patients. Pasireotide has been evaluated in few studies. This compound remains a promising SSA and would deserve to be further evaluated as a potential additional indication in NET therapy.
Long-acting SSAs are an effective and safe initial therapy of patients with well differentiated NET, allowing tumor growth as well as symptoms control for long-time in selected patients.
生长抑素类似物（SSAs）在神经内分泌肿瘤（NET）患者中的具体适应证随着时间的推移逐渐显现。本综述的目的是总结和讨论关于长效 SSAs 在 NET 中的最相关数据。
进行了一项叙述性综述，纳入了关于长效奥曲肽、兰瑞肽和帕瑞肽在 NET 患者中的治疗的出版物。
长效 SSAs 被证实是 NET 患者一种可管理且广泛应用的治疗工具。长效奥曲肽和兰瑞肽与短效制剂一样安全，同时进一步提高了患者的依从性和顺应性。结合一些随机的 3 期临床试验，在过去的 20 年中进行了许多回顾性和前瞻性研究，发现它们对无进展生存期有不同程度的实质性影响，不仅在胃肠胰腺 NET 中，而且在肺和未知原发 NET 中也有影响。SSAs 最常见的肿瘤反应是疾病稳定，但可以观察到客观反应，在使用高剂量方案和 MEN1 相关胰腺 NET 中更为常见。肿瘤负荷低、肿瘤分级（G1 和低 G2）低、良好的体能状态和一线治疗是 NET 患者使用 SSAs 的主要预测因素。帕瑞肽在少数研究中得到了评估。这种化合物仍然是一种有前途的 SSA，值得进一步评估作为 NET 治疗的潜在附加适应证。
长效 SSAs 是分化良好的 NET 患者的有效且安全的初始治疗方法，允许选择的患者长时间控制肿瘤生长和症状。
