|
Advertisement |
|
|
||
 |
|
|||||
|
|||||
|
 |
||||||
|
||||||
|
||||||
|
Journal of Clinical Oncology, Vol 22, No 3 (February 1), 2004: pp. 573 © 2004 American Society of Clinical Oncology. DOI: 10.1200/JCO.2004.99.175
Is Lanreotide and/or Interferon Alfa an Adequate Therapy for Neuroendocrine Tumors?Technische Universität München, Munich, Germany To the Editor: Faiss et al [1] report on a prospective, randomized trial investigating the antiproliferative effect of lanreotide and interferon alfa in 80 patients with metastatic neuroendocrine tumors. This is one of the largest prospective series ever reported. The authors assumed a 300% increase in 1-year progression-free survival when combining lanreotide and interferon alfa compared to interferon alfa alone. However, the study was prematurely closed after 80 patients instead of the calculated 105 patients. Furthermore, the authors do not provide the basis for their assumptions of a 15% progression-free survival at 1 year for interferon and 25% for lanreotide, respectively. Interpretation of some of the data presented has to be considered inaccurate and uncommon. Subgroups of eight to 12 patients each comparing symptom control cannot be analyzed statistically, and we doubt the clinical accuracy and relevance of one versus two or two versus three episodes of flush and/or diarrhea per day. Eleven patients crossed over, achieving a "clear reduction in tumor growth"—response criteria should be well defined and applied. Finally, the authors’ point out their low disease stabilization (DS) rate compared with other reports, making four statements that are not supported by the literature. (1) The authors explain that the low DS rate is due to a large amount of foregut tumors. However, most other series do not specify the tumor localization and contain a high number of unknown primary sites [2,3]. Some series report on a comparable high number of foregut tumors, but obtain a higher DS-rate [4]. (2) Their study is not unique in having independent radiologic review [2-4]. (3) The authors claim that lanreotide is inferior to octreotide, although it has been demonstrated that both somatostatin analogs are equivalent [4,5]. (4) It is not clear why therapy-naïve patients should show a lower stable disease rate than patients who already received treatments. Unfortunately, the study presented shows some inconsistent results. In addition, although it is a large series of patients with this rare disease, the accrual could not be completed and thus did not reach statistical significance. Authors’ Disclosures of Potential Conflicts of Interest The authors indicated no potential conflicts of interest. REFERENCES
1. Faiss S, Pape UF, Böhmig M, et al: Prospective, randomized, mulitcenter trial on the antiproliferative effect of lanreotide, interferon alfa, and their combination for therapy of metastatic neuroendocrine gastroenteropathic tumors: The International Lanreotide and Interferon Alfa Study Group. J Clin Oncol 21: 2689-2696, 2003 2. Frank M, Klose KJ, Wied M, et al: Combination therapy with octreotide and alpha-interferon: Effect on tumor growth in metastatic endocrine gastroenteropathic tumors. Am J Gastroenterol 94: 1381-1387, 1999[Medline] 3. Ducreux M, Ruszniewksi P, Chayvialle JA, et al: The antitumoral effect of the long-acting somatostatin analog lanreotide in neuroendocrine tumors. Am J Gastroenterol 95: 3276-3281, 2000[CrossRef][Medline] 4. Aparicio T, Ducreux M, Baudin E, et al: Antitumor activity of somatostatin analogues in progressive metastatic neuroendocrine tumours. Eur J Cancer 37: 1014-1019, 2001 5. O’Toole D, Ducreux M, Bommelaer G, et al: Treatment of carcinoid syndrome: A prospective cross-over evaluation of lanreotide versus octreotide in terms of efficacy, patient acceptability, and tolerance. Cancer 88: 770-776, 2000[CrossRef][Medline]
Related Article
Related Correspondence
Related Reply
This article has been cited by other articles:
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|
|||||||||||
|
|||||||||||
|
|
Copyright © 2004 by the American Society of Clinical Oncology, Online ISSN: 1527-7755. Print ISSN: 0732-183X
|
