Authors: Tropea, F.¹; Baldari, S.²; Restifo, G.²; Fiorillo, M.T.³; Surace, P.³; Herberg, A.²

Source: Clinical Drug Investigation, Volume 26, Number 12, 2006 , pp. 715-722(8)

Publisher: Adis International

Abstract:

Background: Chromogranin A (CgA) is well established as a serum marker for neuroendocrine tumours and has also been associated with some non-neuroendocrine tumours, suggesting a possible role for somatostatin analogues such as octreotide in the treatment of these tumours.

Objective: The aim of this study was to measure plasma CgA levels in patients with various non-neuroendocrine tumours in order to identify those patients who might benefit from octreotide therapy.

Methods: Plasma CgA levels were tested in 151 patients with metastatic non-neuroendocrine tumours. Patients with highly elevated levels were assessed by OctreoScan^® scintigraphy to determine their somatostatin receptor status, and those with positive results were offered treatment with the somatostatin analogue octreotide, 20mg every 4 weeks, and followed up every 3 months.

Results: CgA levels were elevated (>18 U/L) in 34/72 patients with breast cancer, 11/21 with lung cancer, 10/28 with gastrointestinal cancer, 7/12 with gynaecological cancer, 6/9 with genitourinary cancer, 5/5 with haematological cancer, and 3/4 with head and neck cancer. Eight patients with CgA levels >150 U/L underwent scintigraphy, five of whom (two colorectal, two prostate, one non-small cell lung cancer [NSCLC]) showed positive results and received treatment with octreotide. Follow-up for a mean 12-16 months showed improvements in biochemical parameters, cenesthesis and quality of life.

Conclusion: CgA levels were found to be elevated in approximately 50% of patients with non-neuroendocrine tumours. Further studies are required to determine the value of CgA as a marker for non-neuroendocrine tumours and the role of somatostatin analogues as a treatment for these tumour types.

Keywords: Antineoplastics; Biomarkers; Bladder cancer; Breast cancer; Colorectal cancer; Hodgkin's disease; Multiple myeloma; Nasopharyngeal cancer; Non Hodgkin's lymphoma; Non small cell lung cancer; Octreotide; Ovarian cancer; Prostate cancer; Renal cancer

Document Type: Research article

Affiliations: 1: 1 Department of Medical Oncology and Chemotherapy of Reggio Calabria, Reggio Calabria, Italy 2: 2 Nuclear Medicine Unit, Department of Radiology Sciences, University of Messina, Messina, Italy 3: 3 Clinical Laboratory Analysis Department, Cliniche Polo Sanitario Nord Reggio Calabria, Reggio Calabria, Italy

Publication date: 2006-01-01

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