High somatostatin receptor expression and efficacy of somatostatin analogues in patients with metastatic Merkel cell carcinoma.

Autor: Akaike T; Division of Dermatology, Department of Medicine, University of Washington, Seattle, WA, USA., Qazi J; Division of Dermatology, Department of Medicine, University of Washington, Seattle, WA, USA., Anderson A; Division of Dermatology, Department of Medicine, University of Washington, Seattle, WA, USA., Behnia FS; Department of Radiology, University of Washington, Seattle, WA, USA., Shinohara MM; Division of Dermatology, Department of Medicine, University of Washington, Seattle, WA, USA., Akaike G; Department of Radiology, University of Washington, Seattle, WA, USA., Hippe DS; Department of Radiology, University of Washington, Seattle, WA, USA., Thomas H; Division of Dermatology, Department of Medicine, University of Washington, Seattle, WA, USA., Takagishi SR; Division of Dermatology, Department of Medicine, University of Washington, Seattle, WA, USA., Lachance K; Division of Dermatology, Department of Medicine, University of Washington, Seattle, WA, USA., Park SY; Division of Dermatology, Department of Medicine, University of Washington, Seattle, WA, USA., Tarabadkar ES; Division of Dermatology, Department of Medicine, University of Washington, Seattle, WA, USA., Iyer JG; Division of Dermatology, Department of Medicine, University of Washington, Seattle, WA, USA., Blom A; Division of Dermatology, Department of Medicine, University of Washington, Seattle, WA, USA., Parvathaneni U; Department of Radiation Oncology, University of Washington, Seattle, WA, USA., Vesselle H; Department of Radiology, University of Washington, Seattle, WA, USA., Nghiem P; Division of Dermatology, Department of Medicine, University of Washington, Seattle, WA, USA.; Fred Hutchinson Cancer Research Center, Seattle, WA, USA., Bhatia S; Fred Hutchinson Cancer Research Center, Seattle, WA, USA.; Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, WA, USA.
Jazyk: angličtina
Zdroj: The British journal of dermatology [Br J Dermatol] 2021 Feb; Vol. 184 (2), pp. 319-327. Date of Electronic Publication: 2020 Jun 16.
DOI: 10.1111/bjd.19150
Abstrakt: Background: Merkel cell carcinoma (MCC) is an aggressive, high-grade, cutaneous neuroendocrine tumour (NET). Agents blocking programmed death 1/programmed death ligand 1 have efficacy in metastatic MCC (mMCC), but half of patients do not derive durable benefit. Somatostatin analogues (SSAs) are commonly used to treat low- and moderate-grade NETs that express somatostatin receptors (SSTRs).
Objectives: To assess SSTR expression and the efficacy of SSAs in mMCC, a high-grade NET. Methods In this retrospective study of 40 patients with mMCC, SSTR expression was assessed radiologically by somatostatin receptor scintigraphy (SRS; n = 39) and/or immunohistochemically when feasible (n = 9). Nineteen patients (18 had SRS uptake in MCC tumours) were treated with SSA. Disease control was defined as progression-free survival (PFS) of ≥ 120 days after initiation of SSA.
Results: Thirty-three of 39 patients (85%) had some degree (low 52%, moderate 23%, high 10%) of SRS uptake. Of 19 patients treated with SSA, seven had a response-evaluable target lesion; three of these seven patients (43%) experienced disease control, with a median PFS of 237 days (range 152-358). Twelve of 19 patients did not have a response-evaluable lesion due to antecedent radiation; five of these 12 (42%) experienced disease control (median PFS of 429 days, range 143-1757). The degree of SSTR expression (determined by SRS and/or immunohistochemistry) did not correlate significantly with the efficacy endpoints.
Conclusions: In contrast to other high-grade NETs, mMCC tumours appear frequently to express SSTRs. SSAs can lead to clinically meaningful disease control with minimal side-effects. Targeting of SSTRs using SSA or other novel approaches should be explored further for mMCC.
(© 2020 British Association of Dermatologists.)
Databáze: MEDLINE
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