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Advances in Molecular Imaging and Radionuclide Therapy of Neuroendocrine Tumors.

Neuroendocrine neoplasms make up a heterogeneous group of tumors with inter-patient and intra-patient variabilities. Molecular imaging can help to identify and characterize neuroendocrine tumors (NETs). Furthermore, imaging and treatment with novel theranostics agents offers a new, tailored approach to managing NETs. Recent advances in the management of NETs aim to enhance the effectiveness of targeted treatment with either modifications of known substances or the development of new substances with better targeting features. There have been several attempts to increase the detectability of NET

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… In comparison, MRI had a sensitivity of 56% and [ 99m Tc]Tc-hydrazinonicotinamide (HYNIC)-octreotide only 20% [ 87 ]. Thus, more prospective studies and experiences in the clinic setting are needed to validate these data. 3.4. … Somatostatin receptor imaging with 123I-Tyr3-Octreotide. Z. Gastroenterol. 1990;28(Suppl. S2):20–21. 9. Krenning E.P., Bakker W.H., Breeman W.A., Koper J.W., Kooij P.P., Ausema L., Lameris J.S., Reubi J.C., Lamberts S.W. …

[Treatment of Bell's palsy: Report of 36 cases].

BACKGROUND: Immune checkpoint inhibitors, including antibodies against programmed death 1 (PD-1) and cytotoxic T-lymphocyte antigen 4 (CTLA-4), are being used with increasing frequency for the treatment of cancer. Immune-related adverse events (irAEs) including colitis, dermatitis, and pneumonitis are well described, but less frequent events are now emerging with larger numbers of patients treated. Herein we describe the incidence and spectrum of thrombocytopenia following immune checkpoint inhibitor therapy and two severe cases of idiopathic thrombocytopenic purpura (ITP). CASE PRESENTATIONS

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… Our virtual screening showed that bleomycin and octreotide exhibit reasonably strong binding to FN1 and bleomycin, desmopressin, phosphonoacetic acid, cobicistat and oxytocin exhibit reasonably strong binding to Serpin B5, respectively. … Bleomycin and octreotide exhibit reasonably strong binding to FN1. For Serpin B5, we screened virtually for drugs from the four databases at the N-acetyl-D-glucosamine (NAG) binding site (Site 1) and the protease binding site (Site 2) ( Figure 4C ). …

Paraneoplastic Endocrine Changes in Gastrointestinal Tumors: A Clinical and Mechanistic Review.

Paraneoplastic endocrine syndromes (PESs) are hormonal disturbances associated with malignancies that result from tumor-related production of hormone-like substances, immune-mediated mechanisms, or dysregulated signaling pathways. While they are well recognized in lung and neuroendocrine cancers, their relevance in gastrointestinal tumors remains less clearly defined. This narrative review synthesizes current knowledge on paraneoplastic endocrine manifestations in gastrointestinal malignancies, based on a structured search of the literature in major databases, including PubMed, Scopus, and Web

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… Importantly, diazoxide and standard octreotide are consistently ineffective in NICTH, as they target insulin secretion rather than IGF-2 production [ 4 ]. 3.4.7. Critical Analysis Well-supported by primary evidence: IGF-2:IGF-1 ratio > 10 is diagnostic in 87.6% of cases [ 4 ]. … Standard octreotide scintigraphy has been shown to have limited sensitivity in some ectopic GHRH series, and should no longer be considered adequate as a single localization tool [ 53 , 54 ]. …

Декодирование GPCR, сигнализирующее перепрограммирование рака: молекулярные механизмы и терапевтические последствия.

G белковые рецепторы (GPCR) представляют собой крупнейшую мембранную группу рецепторов в геноме человека и служат ключевыми регуляторами клеточного сигнала, гомеостаза и фармакологической реакции. Помимо их классической роли в посредничестве внеклеточной стимуляции по зависящим от G-протеина и независимым путям, которые играют ключевую роль при помощи GPCR сигнальных путей, включая CAMP-PKA/EPAC, IP3/PLC, PI3K/Akt/mTOR и ERK/MAPK cascades, в вождении онкогенного распространения, апоптоза и метастаза. Кроме того, ГПХР замешаны в опухоли с помощью различных молекулярных механизмов, в рамках кото

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… In addition, somatostatin receptor-targeted therapies (e.g., lanreotide and octreotide) and radioligand therapies such as the FDA-approved Lutathera (177Lu-DOTATATE) have proven effective in well-differentiated neuroendocrine tumors (NETs) that express somatostatin receptors (Pokuri et al. 2016 ; Hennrich … Early SPECT-based agents include [Tyr 3 ]Octreotide (TOC) labeled with I-123, and OctreoScan labeled with In-111, and modern PET-based agents like 68Ga-DOTA-TATE, DOTA-TOC, and DOTA-NOC are used in the diagnosis phase. …

Challenges in the management of bone metastases: focus on differentiated thyroid cancer and neuroendocrine tumors.

Bone metastases represent an uncommon but clinically significant complication in endocrine malignancies including differentiated thyroid cancer and neuroendocrine tumors. Although these malignancies typically follow an indolent course, the development of bone metastases is associated with a worse prognosis and increased risk of skeletal-related events. The optimal strategies for the prevention and management of bone metastases in these patients remain unclear and are largely extrapolated from studies in other solid tumors. This presents a unique clinical challenge as treatment decisions need t

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… MRI of the abdomen revealed hepatic masses, core needle biopsy confirmed a metastatic neuroendocrine tumor (NET), and she was started on everolimus and monthly octreotide and underwent transarterial embolization of the liver. … No bone lesions were noted on an octreotide scan nor on serial chest CT and abdominal MRI scans over the next year. …

Review Article: Immune Effector Cell-Mediated Enterocolitis Following CAR-T Cell Therapy-Clinical Features, Pathophysiology and Management.

BACKGROUND: Chimeric antigen receptor T-cell (CAR-T) therapy has revolutionised the treatment of hematologic malignancies, and its use is expanding rapidly into numerous other disease states including autoimmune diseases. However, CAR-T therapy is associated with a spectrum of immune-related toxicities. In addition to the already well characterized cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome, it has become apparent that rarely, CAR-T can cause gastrointestinal mucosal inflammation, termed immune effector cell-mediated enterocolitis (IEC-EC). AIMS: This

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… Other first‐line supportive measures to reduce diarrhoea include octreotide, opioids (such as loperamide and diphenoxylate‐atropine), and bile acid sequestrants, although these are frequently ineffective. … Indeed, in our cohort, a durable response was seen in 0% of patients treated with bile acid sequestrants or octreotide [ 26 ]. …

PET/MRI versus PET/CT in oncology: a prospective single-center study of 330 examinations focusing on implications for patient management and cost considerations.

PurposePET/MRI has recently been introduced into clinical practice. We prospectively investigated the clinical impact of PET/MRI compared with PET/CT, in a mixed population of cancer patients, and performed an economic evaluation of PET/MRI.MethodsCancer patients referred for routine staging or follow-up by PET/CT underwent consecutive PET/CT and PET/MRI, using single applications of [18F]FDG, [68Ga]Ga-DOTANOC, or [18F]FDOPA, depending on tumor histology. PET/MRI and PET/CT were rated separately, and lesions were assessed per anatomic region; based on regions, per-examination and per-patient a

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… PET radiotracers and dosage For patients with well-differentiated neuroendocrine tumors (NET G1–2), PET/CT was performed 45–60 min after intravenous administration of 160–180 MBq of [ 68 Ga]Ga-DOTANOC (conjugate of the somatostatin analogue 1-Nal3-octreotide and [ 68 Ga]-labeled 1,4,7,10-tetraazacyclododecane-N … Synthesis of [68Ga]Gallium Dota-(Tyr3)-Octreotide Acetate ([68Ga]-Dotatoc) pp. 321–334. 24. Niederle B, Pape UF, Costa F, et al. ENETS consensus guidelines update for neuroendocrine neoplasms of the jejunum and ileum. Neuroendocrinology. 2016;103:125–138. doi: 10.1159/000443170. 25. …

Antibody-Drug Conjugates and Peptide-Drug Conjugates: Current Understandings and Future Perspectives.

Antibody-drug conjugates (ADCs) and peptide-drug conjugates (PDCs) are modular targeted therapeutics in which molecular recognition is coupled with controlled payload delivery. Owing to their high specificity and precision, they have been regarded as a transformative paradigm for cancer therapy. In this review, current understandings and future perspectives of ADCs and PDCs are synthesized across rational design principles, historical evolution, clinical translation, and emerging formats, aiming to improve practical comprehension and application in oncology. Key determinants of performance: ta

Regulatory Effect and Mechanism of Erythroblastic Island Macrophages on Anemia in Patients with Newly Diagnosed Multiple Myeloma.

ObjectiveTo examine the clinical characteristics and anemia-related factors in patients with newly diagnosed multiple myeloma (NDMM), as well as the effect and mechanism of erythroblastic islands (EBIs) and EBI macrophages in NDMM patients with anemia.MethodsWe collected and analyzed clinical data to find anemia-related factors. Using flow cytometry, the numbers and ratios of erythroblasts and EBI macrophages were determined. RNA sequencing (RNA-seq) was used to determine the differences of EBI macrophages in NDMM patients with or without anemia.ResultsBased on the clinical characteristics of

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… The somatostatin analog octreotide inhibits growth of interleukin-6 (IL-6)-dependent and IL-6-independent human multiple myeloma cell lines. Blood . 1999;93:1724–1731. 31. Spets H, Georgii-Hemming P, Siljason J, Nilsson K, Jernberg-Wiklund H. …

Radionuclide-labelled nanoparticles for cancer combination therapy: a review.

Radionuclide therapy (RT) is widely used to advanced local cancers. However, its therapeutic efficacy is limited to the radiation resistance of cancer cells. Combination therapy aims to circumvent tumor resistance, and the combination of RT with photothermal therapy (PTT), photodynamic therapy (PDT), chemotherapy (CMT), and immunotherapy has shown promising treatment outcomes. Nanotechnology holds promise in advancing combination therapy by integrating multiple therapies on a nanostructure platform. This is due to the increased surface area, passive/active targeting capabilities, high payload

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… The pioneer of Peptide Receptor Radionuclide Therapy (PRRT) is 111 In diethylenetriaminepentaacetic acid-D-[Phe1]-Octreotide. 111 In emits Auger and conversion electrons, which have potential cytotoxic effects [ 8 ]. … Moreover, 90 Y-DOTA-Tyr3-Octreotide [ 38 ] and 177 Lu-DOTA0-Tyr3 Octreotate [ 39 ] are commonly used for PRRT. The physical characteristics of radionuclide include decay modes, emission properties and half-life, while their biological characteristics include stability and toxicity in vivo. …

Current Status of 68Ga-Pentixafor in Solid Tumours.

Chemokine receptor CXCR4 is overexpressed in neoplasms and its expression is related to tumour invasion, metastasis and aggressiveness. 68Ga-Pentixafor is used to non-invasively image the expression of CXCR4 in tumours and has been widely used in haematological malignancies. Recent evidence shows that therapies targeting CXCR4 can increase the chemosensitivity of the tumour as well as inhibit tumour metastasis and aggressiveness. 68Ga-Pentixafor has shown promise as an elegant radiotracer to aid in the selection of patients whose tumours demonstrate CXCR4 overexpression and who therefore may b

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… To this end, Werner et al. compared 68 Ga-Pentixafor, 68 Ga-DOTA-D-Phe-Tyr3-octreotide ( 68 Ga-DOTATOC) and 18 F-fluorodeoxyglucose ( 18 F-FDG) in 12 patients with gastroenteropancreatic NET [ 48 ]. 68 Ga-Pentixafor was the least sensitive of the three tracers and detected tumour lesions in only 50% … Abbreviations ACC | Adrenocortical carcinoma BBB | Blood–brain barrier CAFs | Cancer-associated fibroblasts CXCR4 | Chemokine receptor 4 DOTATOC | DOTA-D-Phe-Tyr3-octreotide FDG | Fluorodeoxyglucose GBM | Glioblastoma HCC | Hepatocellular carcinoma HNSCC | Head and neck squamous cell carcinoma IHC …

PET Molecular Imaging: A Holistic Review of Current Practice and Emerging Perspectives for Diagnosis, Therapeutic Evaluation and Prognosis in Clinical Oncology.

PET/CT molecular imaging has been imposed in clinical oncological practice over the past 20 years, driven by its two well-grounded foundations: quantification and radiolabeled molecular probe vectorization. From basic visual interpretation to more sophisticated full kinetic modeling, PET technology provides a unique opportunity to characterize various biological processes with different levels of analysis. In clinical practice, many efforts have been made during the last two decades to standardize image analyses at the international level, but advanced metrics are still under use in practice.

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… III NeuroEndocrine Tumors Therapy clinical trial (NETTER-1) validated the use of SSR-based radioligand therapy in well-differentiated metastatic NETs of the midgut [ 88 ]: 177 Lu-SSR showed a 79% reduction in risk of progression and an estimated PFS of 40 months compared to 8.4 months for high-dose octreotide … Somatostatin receptor scintigraphy with [111In-DTPA-d-Phe1]- and [123I-Tyr3]-octreotide: The Rotterdam experience with more than 1000 patients Eur. J. Nucl. Med. 1993 20 716 731 10.1007/BF00181765 8404961 81. Hofmann M. Maecke H. Börner A. Wetckesser E. Schöffski P. Oei M. Schumacher J. Henze M. …

Hereditary hemorrhagic telangiectasia: diagnosis and management from the hematologist's perspective.

Hereditary hemorrhagic telangiectasia (HHT), also known as Osler-Weber-Rendu syndrome, is an autosomal dominant disorder that causes abnormal blood vessel formation. The diagnosis of hereditary hemorrhagic telangiectasia is clinical, based on the Curaçao criteria. Genetic mutations that have been identified include ENG, ACVRL1/ALK1, and MADH4/SMAD4, among others. Patients with HHT may have telangiectasias and arteriovenous malformations in various organs and suffer from many complications including bleeding, anemia, iron deficiency, and high-output heart failure. Families with the same mutatio

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… Octreotide therapy has also been proposed in reducing transfusion needs 66 but is without much supporting data. Management of the anemia and iron deficiency that result from this blood loss is addressed below. … The efficacy of octreotide therapy in chronic bleeding due to vascular abnormalities of the gastrointestinal tract. Aliment Pharmacol Ther. 1999;13(11):1429–1436. 67. Livesey JA, Manning RA, Meek JH, et al. …

Multidisciplinary supportive care in systemic light chain amyloidosis.

The immunoglobulin light-chain amyloidosis is a multisystemic disease which manifests by damage to the vital organs by light chain-derived amyloid fibril. Traditionally, the treatment has been directed to the underlying plasma cell clone with or without high dose chemotherapy followed by autologous stem cell transplantation using melphalan based conditioning. Now with the approval of highly tolerable anti-CD38 monoclonal antibody daratumumab based anti-plasma cell therapy in 2021, high rates of hematologic complete responses are possible even in patients who are otherwise deemed not a candidat

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… In patients who are refractory the aforementioned methods, bile acid binder or subcutaneous octreotide can be used [ 51 , 52 ]. A swallowing evaluation is recommended in dysphagic patients. In case aspiration is present, swallowing rehabilitation is suggested. … Octreotide for diarrhea in amyloidosis. Ann Intern Med. 1991;115:577. doi: 10.7326/0003-4819-115-7-577_1. 53. Rives S, Pera M, Rosiñol L, et al. …

Review of Hematology-Oncology Emergencies for Internal Medicine Residents.

The prevalence of cancer continues to grow globally every year. With therapeutic advances over the recent decades, the prevalence of individuals living with cancer continues to increase. Internal medicine residents can see patients admitted to the hospital for cancer-related emergencies. Early identification and appropriate management of these emergencies have been shown to improve mortality and morbidity. In this article, we aim to review the recent updates in the management of commonly encountered oncologic emergencies in the practice of internal medicine residents. This review will cover sp

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… Medical management of insulinoma includes diazoxide, octreotide, or lanreotide. Diazoxide decreases insulin secretion but can cause marked edema and hirsutism [ 20 ]. Diazoxide and somatostatin analogs do not play a role in non-islet cell tumors. …

Intravenous Ketamine for Cancer Pain Management, Including Flares During the COVID-19 Pandemic: A Retrospective Study.

OBJECTIVES: Cancer-related neuropathic pain (CNP) affects an increasing proportion of cancer patients, given improved survival, but it remains difficult to treat. There are no studies on an extended intravenous ketamine protocol and its synergies with common neuropathy treatments to treat CNP. This study aims to 1) evaluate the safety and effectiveness of an intravenous ketamine protocol to treat refractory CNP and 2) uncover synergies between ketamine and common neuropathy treatments. METHODS: This is a single-center, retrospective review of 57 patients and 192 infusions, with prospective fo

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… 69.2) | 23 (92.0) | 12 (92.3) | 5 (83.3) | 49 (86.0) Location of tumor compression, n (%) | | | | | Cranial nerve | 3 (23.1) | – | – | – | – Nerve roots | 8 (61.5) | – | – | – | – Plexus | 2 (15.4) | – | – | – | – CIPN: causative regimen, n (%) | | | | | Oxaliplatin | – | 1 (4.0) | – | – | – Octreotide …

Characteristics of clinical trials in rare vs. common diseases: A register-based Latvian study.

BackgroundConducting clinical studies in small populations may be very challenging; therefore quality of clinical evidence may differ between rare and non-rare disease therapies.ObjectiveThis register-based study aims to evaluate the characteristics of clinical trials in rare diseases conducted in Latvia and compare them with clinical trials in more common conditions.MethodsThe EU Clinical Trials Register (clinicaltrialsregister.eu) was used to identify interventional clinical trials related to rare diseases (n = 51) and to compose a control group of clinical trials in non-rare diseases (n = 1

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… oxaliplatin, capecitabine) | PFS; AE | 41 | 65 | 85 | 231 Lanreotide (Somatuline) | Acromegaly | Phase IV, open label | | Injection intervals (6 or 8 weeks) based on IGF-1 levels | 24 | 20 | 110 | 150 Lanreotide (Somatuline) | Carcinoid syndrome | Phase IV, RCT, double blind | Placebo | Usage of s/c octreotide …

Cutaneous paraneoplastic syndromes in cats: a comparative clinical review.

PRACTICAL RELEVANCE: Cutaneous paraneoplastic syndromes (CPSs) in cats represent a diverse group of rare dermatological manifestations that occur as indirect consequences of underlying neoplasia. These syndromes are thought to arise due to tumour-associated systemic effects, including dysregulation of immune responses, metabolic disturbances and aberrant production of cytokines or growth factors. Recognising CPSs is clinically relevant, as they may serve as early indicators of occult neoplasia, guiding timely diagnosis and intervention. CLINICAL CHALLENGES: Diagnosing CPSs requires a high ind

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… glucagon-producing islet cell tumour, there is no report in cats of a treatment attempt of tumour-associated SND with amino acids. 81 High-protein diets supplemented with zinc, fatty acids and vitamins (especially B-complex and E) may support long-term skin health, and somatostatin analogues such as octreotide … Successful treatment of canine necrolytic migratory erythema (superficial necrolytic dermatitis) due to metastatic glucagonoma with octreotide. Vet Dermatol 2010; 21: 510–516. 84. Didona D, Fania L, Didona B. et al. …

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Progress and Future Directions with Peptide-Drug Conjugates for Targeted Cancer Therapy.

We review drug conjugates combining a tumor-selective moiety with a cytotoxic agent as cancer treatments. Currently, antibody-drug conjugates (ADCs) are the most common drug conjugates used clinically as cancer treatments. While providing both efficacy and favorable tolerability, ADCs have limitations due to their size and complexity. Peptides as tumor-targeting carriers in peptide-drug conjugates (PDCs) offer a number of benefits. Melphalan flufenamide (melflufen) is a highly lipophilic PDC that takes a novel approach by utilizing increased aminopeptidase activity to selectively increase the

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… The approval of 177 Lu-dotatate was based on the results of the Phase III NETTER-1 study, which showed that 177 Lu-dotatate given every 8 weeks (four doses overall) plus the best supportive care, including long-acting repeatable octreotide acetate (LAR), achieved statistically significant improvements …