Carcinoid

Liver Cancer/TACE – pro

The prognosis for patients with unresectable hepatocellular carcinoma (HCC) tumors is extremely poor. Even in the case of small nodular lesions detected by US screening, patients receiving no treatment showed a mean 3-year survival rate of 12%. Transcatheter arterial chemoembolization (TACE), most frequently performed by intra-arterially injecting an infusion of antineoplastic agents mixed with iodized oil (Lipiodol), has been extensively used in

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Intrahepatic therapies ablative therapies – pro

Percutaneous ablation is a commonly used modality of treatment when resection is not possible for HCC. Other local modalities are radiofrequency ablation or chemo embolization. When direst intratumor injection is used, alcohol is most commonly used and it is FDA approved for this purpose. However, acetic acid is more potent in animal models. Only a few studies tested the various modlaities against one another. A systematic review of RCTs published

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SIRT for hepatic mets of colon cancer – pro

SIRT -- a therapy that consists of millions of microscopic, radioactive glass microspheres (20-30 microns diameter) -- is infused into the arteries that feed inoperable liver tumors or metastatic cancer to the liver, bathing the malignancy in high levels of extremely localized radiation. In some studies of highly selected patients the response rates and stabilization rates ranged between 20-40 percent. Selective internal radiation therapy (SIRT)

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Interferon for neuroendocrine (carcinoid) cancer – pro

Lay Sumamry: Interferon is an accepted treatment for carcinoid. Systemic treatment for NETs includes therapy with somatostatin analogs, interferon-alfa and cytotoxic agents. In addition, other agents can be useful, including loperamide for diarrhea or H1 or H2 blockers for histamine-secreting tumours. Interferon-alfa may be considered in selected cases to control clinical symptoms of hormone hyper-secretion. Symptomatic and biochemical responses

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Intermittent versus continued infusions of octreotide – pro

Some claim that LA Sandostatic absorbtion is only 68% and octreotide delivered by pump is more effective. This is not proven, to my knowledge. Early studies have made this claim. In octreotide LAR drug registration trial, levels were in sub-optimal range for complete receptor saturation. Approximately 40% of patients required the use of “rescue “ medication (subcutaneous aqueous octreotide at doses of 100-500 micrograms three times a day) several

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Afinitor for carcinoid – pro

Everolimus has been approved by the US Food and Drug Administration (FDA) as the first oral, daily therapy (5 mg and 10 mg tablets) to treat advanced kidney cancer after failure of treatment with sunitinib or sorafenib. New data demonstrate that treatment with Afinitor® (everolimus) in combination with Sandostatin® LAR® (octreotide acetate suspension for injection) and Afinitor monotherapy may have the potential to stabilize tumour growth in patients

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Debulking carcinoid – pro

Surgery is the only potentially curative treatment for patients with carcinoid tumors. Patients with localized disease even with lymph node metastases can be resected for potential cure. It is no known how to best optimally follow competely resected non-metastatic tumors. these patients. NCCN says: "Conaiser abdominopelvic CT or MRI 3-12 months post resection: Otherswise followup is clinical and:"consider markers". Patients with distant metastatic

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Somatuline Depot (lanreotide acetate) for carciniod syndrome – pro

Somatuline Depot (lanreotide acetate) is an injectable, sustained-release formulation of lanreotide, an octapeptide somatostatin analog that inhibits Insulin-like growth factor-1 (IGF-1) and growth hormone (GH). Somatuline is specifically indicated for the long-term treatment of acromegalic patients who have had an inadequate response to surgery and/or radiotherapy, or for whom surgery and/or radiotherapy is not an option. However, in Europe it is

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Goblet cell carcinoid – pro

Goblet cell carcinoid (GCC) also known as crypt cell consists of a neuroendocrine component and a conventional carcinoma. Since it was identified in 1969 there has been greater understanding of this disease but issues remain regarding its histogenesis (the formation and differentiation of tissues), nomenclature, and management, particularly amongst pathologists and surgeons. There are no recommendations or evidence based guidelines for this rare

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IN-111 octreotide to scan and treat carcinoid – pro

The most important treatment modality for the carcinoid syndrome (flushing, diarrhea etc) due  to carcinoid secreted hormones)  is octreotide, a synthetic hormone similar in structure to the naturally-occurring hormone, somatostatin. First I discuss Octerotide scan. There are a number of case reports of this modlaity that suggest effectiveness. OctreoScan, using octreotide (Sandostatin) tagged with radiolabeled 111 Indium-pentetreotide is supported

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