生长抑素类似物在GEP-NET治疗中的地位和作用.pptVIP

* Murcia May 2007 * * 奥曲肽LAR provides effective symptom relief via control of bioactive substances in patients with carcinoid syndrome.1 In patients with carcinoid syndrome，treatment with 奥曲肽LAR has led to a 42% reduction in the number of stools/day and an 84% reduction in the number of flushing episodes/day.2，3 Sandostatin LAR [Basic Prescribing Information]. Novartis Pharma AG; 2010. Rubin J，Ajani J，Schirmer W，et al. J Clin Oncol.1999;17：600-606. Anthony L，Freda PU. Curr Med Res Opin. 2009;25：2989-2999 * * * * * * The molecular basis of the mechanism of action of octreotide LAR is conceptually straightforward: binding to somatostatin receptors and thereby shutting down hormone secretion from cells of the diffuse neuroendocrine system. Effects of treatment with octreotide LAR can include cell cycle arrest, amplification of proapoptotic effects, inhibition of angiogenesis, and modulation of the immune system. To achieve these multiple effects, the pathways activated following octreotide LAR binding to somatostatin receptors are many and complex Octreotide LAR has direct antiproliferative effects mediated via sstrs; indirect antiproliferative effects such as inhibition of angiogenesis, inhibition of growth factor, and hormone synthesis; and immunomodulatory effects. A specific example of a possible indirect antiproliferative effect of octreotide LAR is the inhibition of IGF-1 secretion. Susini C, Buscail L. Ann Oncol 2006;17:1733-1742. * * 既往的对于奥曲肽抗肿瘤的研究，下一张片子将会分析这些研究的不足，以及提示为什么会有PROMID研究。 * * * * * 有效分群，签过知情同意书。参考PROMID原文 * * * 长效奥曲肽 30 mg较安慰剂显著延长至疾病进展时间（TTP，time to progression） * * * * * * * * * Several treatment guidelines are published and updated regularly to provide guidance to practitioners treating patients with NETs. Those available globally for NETs are the following: European Neuroendocrine Tumor Society (ENETS) Publishes Consensus Guidelines for the Diagnosis and Treatment of NETs1 United Kingdom Neuroendocrine Tumor Group (U