WESTPORT, Aug 24 (Reuters Health) - Type II gastric carcinoid tumors regressed in three patients treated with a somatostatin analogue, according to a report in the August 24th issue of The New England Journal of Medicine.
The most recently introduced somatostatin analogue, octreotide, is known to control hypergastrinemia and enterochromaffin-like cell growth in patients with hypergastrinemic atrophic gastritis, the authors note, suggesting that such analogues might prove effective in treating gastric carcinoid tumors.
Dr. Lucio Gullo, of S. Orsola Hospital, Bologna, Italy, and colleagues treated three patients diagnosed with type II gastric carcinoid tumors (i.e., accompanied by multiple endocrine neoplasia type 1 and Zollinger-Ellison syndrome) using intramuscular lanreotide (two patients) or octreotide (one patient).
Patient 1, a 50-year-old man, had 30 gastric carcinoid tumors ranging from 3 to 10 mm in diameter and an initial serum gastrin level of 10,500 pg/mL, the report indicates. The tumors decreased in number by 6 months and disappeared after 12 months, by which time the patient's gastrin level was 840 pg/mL.
Patients 2 and 3 had 10 to 15 tumors 2 to 10 mm in diameter, the authors report, all of which disappeared completely after 1 year. Serum gastrin levels for patient 2 fell from 1560 pg/mL to 110 pg/mL with treatment. For patient 3, treatment reduced the gastrin levels from 1475 pg/mL to 80 pg/mL.
All three patients continue to receive treatments with somatostatin analogues while the researchers attempt to determine whether treatment can eventually be reduced or discontinued.
"Since hypergastrinemia is an important factor in the pathogenesis of gastric carcinoid tumors in patients with multiple endocrine neoplasia type 1 and the Zollinger-Ellison syndrome, it is likely that the disappearance of the tumors is related to the decrease in serum gastrin levels," the authors speculate.
"Our findings do not exclude the possibility that the somatostatin analogues have a direct effect on the proliferation of enterochromaffin-like cells," they add.