The role of serotonin inhibition within the treatment of carcinoid syndrome.
carcinoids
neuroendocrine tumours
neuroendocrinology
somatostatin
Journal
Endocrine oncology (Bristol, England)
ISSN: 2634-4793
Titre abrégé: Endocr Oncol
Pays: England
ID NLM: 9918540584106676
Informations de publication
Date de publication:
01 Jan 2023
01 Jan 2023
Historique:
received:
20
03
2023
accepted:
20
04
2023
medline:
12
7
2023
pubmed:
12
7
2023
entrez:
12
7
2023
Statut:
epublish
Résumé
Carcinoid syndrome is the most frequent hormonal complication associated with neuroendocrine neoplasms. It was first reported in 1954, and the classical symptoms are diarrhoea, flushing and abdominal pain. It is caused by the secretion of several vasoactive substances, the most prominent being serotonin, which play a pathophysiological role in the clinical symptoms which characterise carcinoid syndrome. Therefore, the focus of carcinoid syndrome treatment is to reduce serotonin production and hence improve the patient's quality of life. There are a variety of management options for carcinoid syndrome including medical, surgical and loco-regional interventional radiological procedures. The most widely used are somatostatin analogues with three clinically approved drugs: lanreotide and octreotide (first-generation) and pasireotide (second-generation). Both everolimus and interferon used in combination with octreotide have shown significant reduction in urinary 5-hydroxyindoleacetic acid compared to octreotide alone. Telotristat ethyl has been increasingly utilised for patients with symptoms despite taking somatostatin analogues. It has also been shown to have a significant improvement in bowel movement frequency which was associated with a significant improvement in quality of life. Peptide receptor radionuclide therapy has proven symptomatic improvement in patients with uncontrolled symptoms. Chemotherapy is primarily reserved for patients with high proliferation tumours, with limited research on the efficacy in reducing symptoms. Surgical resection remains the optimal treatment due to being the only one that can achieve a cure. Liver-directed therapies are considered in patients where curative resection is not possible. There are therefore numerous different therapies. This paper describes the pathophysiology and therapy of carcinoid syndrome.
Identifiants
pubmed: 37434648
doi: 10.1530/EO-22-0077
pii: EO-22-0077
pmc: PMC10305560
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
e220077Informations de copyright
© the author(s).
Déclaration de conflit d'intérêts
The authors have no conflicting interests to declare.
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