High somatostatin receptor expression and efficacy of somatostatin analogues in patients with metastatic Merkel cell carcinoma.
High somatostatin receptor expression and efficacy of somatostatin analogues in patients with metastatic Merkel cell carcinoma.
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DOI：
10.1111/bjd.19150
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发表时间：
2021-03
期刊：
影响因子：
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通讯作者：
Bhatia S
中科院分区：
文献类型：
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作者：
Akaike T;Qazi J;Anderson A;Behnia FS;Shinohara MM;Akaike G;Hippe DS;Thomas H;Takagishi SR;Lachance K;Park SY;Tarabadkar ES;Iyer JG;Blom A;Parvathaneni U;Vesselle H;Nghiem P;Bhatia S
默克尔细胞癌(MCC)是一种侵袭性、高级别、皮肤神经内分泌肿瘤(NET)。阻断程序性死亡1/程序性死亡配体1的药物对转移性微囊癌(MMCC)有效，但一半的患者没有获得持久的好处。生长抑素类似物(SSA)通常用于治疗表达生长抑素受体(SSTR)的低级别和中等级别的Net。目的：评估SSTR在高级别MMCC中的表达及SSA的疗效。在这项对40例MMCC患者的回顾性研究中，应用生长抑素受体闪烁成像(SRS；n=39)和/或免疫组织化学方法(n=9)对SSTR的表达进行了放射学评估。19例患者(18例MCC肿瘤摄取SRS)接受了SSA治疗。疾病控制定义为≥治疗120天后的无进展生存(PFS)。39例患者中33例(85%)有不同程度的SRS摄取(低52%，中23%，高10%)。在接受SSA治疗的19名患者中，有7名患者有可评估反应的靶病变；这7名患者中有3名(43%)经历了疾病控制，中位PFS为237天(范围152-358)。19名患者中有12名由于先前的放射治疗没有可评估反应的损害；这12名患者中有5名(42%)经历了疾病控制(中位数PFS为429天，范围143-1757)。SSTR的表达程度(由SRS和/或免疫组织化学确定)与疗效终点没有显著相关性。与其他高级别Net不同，MMCC肿瘤似乎经常表达SSTR。SSAS可以导致临床上有意义的疾病控制，副作用最小。MMCC应进一步探讨使用SSA或其他新方法瞄准SSTR的问题。
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). To assess SSTR expression and the efficacy of SSAs in mMCC, a high-grade NET. 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. 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. 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.