Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0016382 (flushing)
 6,387 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thirty patients with symptoms of the carcinoid syndrome and other symptoms not controlled by pharmacological agents were analysed with respect to the value of various treatment measures used. Tumour devascularization was carried out in 11 patients, either by surgical ligation of the main hepatic artery (6) or by percutaneous arterial embolization (5). The latter was shown to be the safer technique, both with respect to initial morbidity/mortality and other side effects. Control of flushing and diarrhoea was achieved in 80% and the technique was also repeated on one occasion with success when symptoms recurred. The use of cytotoxic drugs alone, including 5-fluorouracil, cyclophosphamide and Adriamycin produced symptomatic relief in only 4 of the 22 patients treated. They should only be considered if devascularization by arterial embolization proves impossible or cannot be repeated when symptoms recur.
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PMID:Use of arterial devascularization and cytotoxic drugs in 30 patients with the carcinoid syndrome. 618 1

Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are rare, generally indolent neoplasms that can arise throughout the gastrointestinal system. Some GEP-NETs, known as functional, secrete hormones that can lead to a complex of symptoms. Classical carcinoid syndrome is associated with flushing, diarrhea, bronchospasm, and symptoms of valvular heart disease. GEP-NETs are classified according to the primary tumor site, functionality of the disease, and histology. Treatment is guided by the resectability of the tumor, the location and extent of metastases, and the presence of clinical symptoms. Typically, first-line treatment of patients with unresectable disease includes the use of somatostatin analogs, such as octreotide LAR depot or lanreotide depot/autogel, which was recently approved by the US Food and Drug Administration for treatment of GEP-NETs. Somatostatin analogs can improve the severe diarrhea/flushing episodes that may be associated with metastatic carcinoid tumors. For patients with pancreatic NETs, additional approved treatment options include the targeted agents everolimus and sunitinib, which have demonstrated antitumor activity. Chemotherapy may also have a selective role, particularly in pancreatic NETs. Localized approaches, including cytoreductive surgery, hepatic arterial embolization, and ablative therapies, may be used for palliative treatment in patients with liver metastases.
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PMID:New and Emerging Treatment Options for Gastroenteropancreatic Neuroendocrine Tumors. 2643 Sep 56