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Frontiers in Pharmacology 2022GLP-1 receptor agonists (GLP-1RA) have demonstrated cardiovascular benefits, but the relationship between GLP-1RA and tumors is controversial. Recently, clinical trials...
GLP-1 receptor agonists (GLP-1RA) have demonstrated cardiovascular benefits, but the relationship between GLP-1RA and tumors is controversial. Recently, clinical trials reported higher rates of malignancy with semaglutide than control group. As real-world evidence of GLP-1RA-associated tumor risk is very limited, we explored the association of GLP-1RA and all types of neoplasms by mining the FDA Adverse Event Reporting System (FAERS) database. The FAERS data from the first quarter (Q1) of 2004 to the second quarter (Q2) of 2020 in the AERSMine were extracted to conduct disproportionality analysis, which was used by the proportional reporting ratio (PRR) to assess the relationship between GLP-1RA and all types of neoplasms. Then, the details of disproportionate GLP-1RA-associated tumor cases from Q1 2004 to Q2 2021 in the FAERS Public Dashboard were collected to analyze demographic characteristics. A total of 8718 GLP-1RA-associated tumors were reported. Excluding cases with pre-existing tumors, other glucose-lowering drugs, and other GLP-1RA-related adverse events, diabetes cases with GLP-1RA as the main suspected drug were selected. GLP-1RA did not cause a disproportionate increase in all tumor cases (PRR 0.83) at the SOC level, and there was also no increase in most types of tumors associated with GLP-1RA at the HLGT/HLT levels. Significant signals were detected between GLP-1RA and certain tumors, including thyroid cancers [medullary thyroid cancer (PRR 27.43) and papillary thyroid cancer (PRR 8.68)], pancreatic neoplasms malignant (PRR 9.86), and islet cell neoplasms and APUDoma NEC (PRR 2.86). The combination of GLP-1RA with dipeptidyl-peptidase IV inhibitors (DPP4i) perhaps caused the increased reporting rate in some tumors. Our study provided new real-world evidence for oncology safety information of GLP-1RA. Given the wide use of GLP-1RA, clinicians should be well informed about important potential adverse events. Our pharmacovigilance analysis also prompted clinicians to raise concerns about potential tumor-related adverse effects when combining GLP-1RA with DPP4i.
PubMed: 36386208
DOI: 10.3389/fphar.2022.925377 -
Revista Espanola de Enfermedades... 2013
Topics: Apudoma; Female; Humans; Male; Pancreatic Neoplasms
PubMed: 24641468
DOI: 10.4321/s1130-01082013001000016 -
Problemy Endokrinologii Feb 2024Insulinoma is the most common hormonally active neuroendocrine tumor (NET) of the pancreas. In recent years, there has been a trend towards an increase in the incidence... (Review)
Review
RELEVANCE
Insulinoma is the most common hormonally active neuroendocrine tumor (NET) of the pancreas. In recent years, there has been a trend towards an increase in the incidence of NET especially insulinoma.
AIM
Summarizing and analyzing current data on various approaches to the treatment of insulinoma. Our review includes a comprehensive assessment of the advantages and disadvantages of currently available insulinoma treatment methods in comparison with past experience, as well as a review of promising methods that are not currently widely used.
MATERIALS AND METHODS
Analysis of literature from such databases as scientific electronic library elibrary.ru, Pubmed, Google Scholar, MedLine, Scopus and Web of Science.
RESULTS
The most common treatment for insulinoma is surgery. For patients with high operative risk, alternative methods such as alcohol ablation, radiofrequency ablation, and tumor embolization may be used. Medications include the use of somatostatin analogues, diazoxide. The literature describes the potential benefit of the use of beta-blockers, phenytoin, glucagon, however, in clinical trials, these drugs have not demonstrated a significant effect. For the treatment of malignant and metastatically advanced insulinoma, targeted therapy (primarily Everolimus), chemotherapy, as well as embolization (including chemoembolization, radioembolization), radiofrequency ablation (RFA), microwave ablation and cryoablation, ultrasound ablation (HIFU), laser ablation, brachytherapy, irreversible electroporation are used.
CONCLUSION
The study of new drugs is an important task for scientists, among medications the most promising are new generations of somatostatin analogues, targeted drugs and chemotherapy drugs. The rare frequency of insulinoma makes it difficult to conduct randomized controlled trials and prospective studies. That is why physicians and scientists need to maintain close contacts with each other and take into account the experience of treating each patient with such disease, which will help develop effective treatment algorithms in the future.
Topics: Humans; Insulinoma; Prospective Studies; Neuroendocrine Tumors; Apudoma; Pancreatic Neoplasms; Somatostatin
PubMed: 38433541
DOI: 10.14341/probl13281 -
Anaesthesia Oct 1977A variety of cells found in the pituitary and pineal glands, sympathetic nervous system and adrenal glands, the gut, pancreas, thyroid (C-cells), chemoreceptors (type... (Review)
Review
A variety of cells found in the pituitary and pineal glands, sympathetic nervous system and adrenal glands, the gut, pancreas, thyroid (C-cells), chemoreceptors (type I-Cells), lungs (P-cells), skin (melanocytes) and the urogenital tract have a common origin from the neural crest. These cells are programmed for neuro-endocrine function and, as a group, can be regarded as one of the physiological control systems. They secrete a variety of amine and peptide hormones and have common cytochemical characteristics from which the term APUD cell is derived. Tumours of these cells are referred to as 'apudomas' and may synthesise not only their own hormones but also those which are normally produced by other APUD cells. The relevant physiological properties of some of the peptides which have been described relatively recently are discussed and the principal clinical syndromes produced by the APUDomas are described.
Topics: APUD Cells; Adenoma, Islet Cell; Apudoma; Cushing Syndrome; Endocrine System Diseases; Gastrointestinal Neoplasms; Hormones; Humans; Malignant Carcinoid Syndrome; Neoplasms, Nerve Tissue; Pancreatic Neoplasms; Paraneoplastic Endocrine Syndromes; Pheochromocytoma; Pituitary Neoplasms; Thyroid Neoplasms; Vasopressins; Zollinger-Ellison Syndrome
PubMed: 23705
DOI: 10.1111/j.1365-2044.1977.tb10110.x -
Postgraduate Medical Journal Jul 1996The long-acting analogues of somatostatin have an established place in the medical treatment of patients with neuroendocrine tumours. They act through binding with... (Review)
Review
The long-acting analogues of somatostatin have an established place in the medical treatment of patients with neuroendocrine tumours. They act through binding with specific, high-affinity membrane receptors. Somatostatin analogue therapy is an effective and safe treatment for most growth hormone and thyrothropin-secreting pituitary adenomas. The potential therapeutic consequences of the presence of somatostatin receptors on clinically 'nonfunctioning' pituitary tumours are still uncertain. Somatostatin analogues are not useful in the treatment of patients with prolactinomas, or adrenocorticotropin (ACTH)-secreting adenomas. However, the somatostatin analogue octreotide suppressed pathological ACTH release in some patients with Nelson's syndrome and ACTH and cortisol secretion in several patients with Cushing's syndrome caused by ectopic ACTH secretion. Somatostatin analogues are effective in the sympatomatic treatment of most (metastatic) pancreatic islet cell tumours and most (metastatic) carcinoids. In some of these patients, they also induce tumour stabilisation or reduction. In some patients with (metastatic) medullary thyroid carcinomas, continuous treatment with very high doses of octreotide can be of temporary relief. The clinical effectiveness of somatostatin analogues in patients with small cell lung cancer is currently under investigation. Long-term therapy with somatostatin analogues of catecholamine-secreting (malignant) paragangliomas and phaeochromocytomas has not shown clinical benefits.
Topics: Antineoplastic Agents; Apudoma; Hormone Antagonists; Humans; Neuroendocrine Tumors; Octreotide; Peptides, Cyclic; Pituitary Neoplasms; Receptors, Somatostatin; Somatostatin
PubMed: 8935599
DOI: 10.1136/pgmj.72.849.403 -
Gut Jun 1975The case of a 44-year-old woman is reported. The diagnosis after the appropriate tests and laparotomy was ACTH-secreting 'apudoma' of the gallbladder. This is a rare...
The case of a 44-year-old woman is reported. The diagnosis after the appropriate tests and laparotomy was ACTH-secreting 'apudoma' of the gallbladder. This is a rare tumour and this case is believed to be the first reported of an ectopic hormone producing tumour from this side.
Topics: Adenocarcinoma; Adrenocorticotropic Hormone; Adult; Autopsy; Cushing Syndrome; Dexamethasone; Diagnosis, Differential; Female; Gallbladder Neoplasms; Hormones, Ectopic; Humans; Liver; Liver Neoplasms; Metyrapone; Neoplasm Metastasis; Paraneoplastic Endocrine Syndromes; Pituitary-Adrenal Function Tests
PubMed: 168130
DOI: 10.1136/gut.16.6.473 -
CA: a Cancer Journal For Clinicians 1986The cutaneous manifestations of internal cancer can develop either before or after the presence of an underlying tumor has been established. These signs may result... (Review)
Review
The cutaneous manifestations of internal cancer can develop either before or after the presence of an underlying tumor has been established. These signs may result either from the physical presence of tumor cells in the skin or from presumed metabolic effects of tumor cells located at visceral sites. Occasionally, skin involvement in cancer patients is biologically unrelated to the tumor but is instead part of a well-defined inherited syndrome featuring an increased incidence of internal cancer. Whatever the association, inspection of the skin remains an essential part of the complete physical examination.
Topics: Acanthosis Nigricans; Adrenocorticotropic Hormone; Apudoma; Carcinoid Tumor; Female; Gardner Syndrome; Histiocytosis, Langerhans-Cell; Hormones, Ectopic; Humans; Leukemia; Lymphoma; Male; Mycosis Fungoides; Neoplasms; Paget Disease, Extramammary; Paget's Disease, Mammary; Sarcoma, Kaposi; Skin Diseases; Skin Diseases, Infectious; Skin Neoplasms; Urticaria Pigmentosa
PubMed: 3011224
DOI: 10.3322/canjclin.36.3.130 -
International Journal of Radiation... 1987The development of the aralkylguanidine [131I]m-iodobenzylguanidine ([131I]MIBG) in the University of Michigan Nuclear Medicine Division has led to diagnostic and... (Review)
Review
The development of the aralkylguanidine [131I]m-iodobenzylguanidine ([131I]MIBG) in the University of Michigan Nuclear Medicine Division has led to diagnostic and therapeutic evaluations of all the neuroendocrine tumors. These tumors share the property of uptake, storage and release of [131I]MIBG uptake in chromaffin granules. This property has allowed the detection of pheochromocytomas, the detection of metastases in 46% of such patients, the treatment of malignant pheochromocytomas, the detection of neuroblastoma metastases, the treatment of neuroblastomas and the detection of a percent of apudomas. We have learned how to improve our results and this is discussed.
Topics: 3-Iodobenzylguanidine; Adrenal Gland Neoplasms; Humans; Iodine Radioisotopes; Iodobenzenes; Neuroblastoma; Pheochromocytoma; Radionuclide Imaging
PubMed: 3312118
DOI: 10.1016/0883-2897(87)90041-9 -
Annals of Surgery Apr 1997The purpose of this study was to assess the value and timing of orthotopic liver transplantation (OLT) in the treatment of metastatic neuroendocrine tumors (NET). (Review)
Review
OBJECTIVE
The purpose of this study was to assess the value and timing of orthotopic liver transplantation (OLT) in the treatment of metastatic neuroendocrine tumors (NET).
SUMMARY BACKGROUND DATA
Liver metastasis from NET seems less invasive than other secondary tumors. This observation suggests that OLT may be indicated when other therapies become ineffective. However, the potential benefit of this highly aggressive procedure is difficult to assess due to the scarcity and heterogeneity of NET.
METHODS
A retrospective multicentric study was carried out, including all cases of OLT for NET performed in France between 1989 and 1994. There were 15 cases of metastatic carcinoid tumor and 16 cases of islet cell carcinomas. Hormone-related symptoms were present in 16 cases (55%). Only 5 patients (16%) had no previous surgical or medical therapy before OLT. Median delay from diagnosis of liver metastasis and OLT was 19 months (range, 2 to 120).
RESULTS
The primary tumor was removed at the time of OLT in 11 cases, by upper abdominal exenteration in 7 cases and the Whipple resection in 3. Actuarial survival rate after OLT was 59% at 1 year, 47% at 3 years, and 36% at 5 years. Survival rates were significantly higher for metastatic carcinoid tumors (69% at 5 years) than for noncarcinoid apudomas (8% at 4 years), because of higher tumor- and non-tumor-related mortality rates for the latter.
CONCLUSION
OLT can achieve control of hormonal symptoms and prolong survival in selected patients with liver metastasis of carcinoid tumors. It does not seem indicated for other NET.
Topics: Adult; Female; France; Humans; Liver Neoplasms; Liver Transplantation; Male; Middle Aged; Neuroendocrine Tumors; Postoperative Complications; Retrospective Studies; Survival Rate; Time Factors
PubMed: 9114793
DOI: 10.1097/00000658-199704000-00003