Casting a Wider NET: Pancreatic Exocrine Insufficiency Induced by Somatostatin Analogues among Patients with Neuroendocrine Tumours?
Somatostatin-analogues (SSAs) are a first-line treatment of unresectable neuroendocrine tumours (NETs). However, SSAs inhibit pancreatic secretions, which could lead to pancreatic exocrine insufficiency (PEI). PEI is known to be detrimental to patient quality of life and nutritional status. This stu...
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| Format: | Article |
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MDPI AG
2023-03-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/7/1933 |
| _version_ | 1797608293567299584 |
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| author | Lewis A. Hall Sarah Powell-Brett Oscar Thompson Daniel Smith Elizabeth Bradley Stacey Smith Suzanne Vickrage Joanne Kemp-Blake Keith J. Roberts Tahir Shah |
| author_facet | Lewis A. Hall Sarah Powell-Brett Oscar Thompson Daniel Smith Elizabeth Bradley Stacey Smith Suzanne Vickrage Joanne Kemp-Blake Keith J. Roberts Tahir Shah |
| author_sort | Lewis A. Hall |
| collection | DOAJ |
| description | Somatostatin-analogues (SSAs) are a first-line treatment of unresectable neuroendocrine tumours (NETs). However, SSAs inhibit pancreatic secretions, which could lead to pancreatic exocrine insufficiency (PEI). PEI is known to be detrimental to patient quality of life and nutritional status. This study aimed to evaluate the effect of SSAs on pancreatic exocrine function in patients with NETs, using the <sup>13</sup>C-mixed triglyceride breath test (<sup>13</sup>C-MTGT). Exocrine function was assessed using the <sup>13</sup>C-MTGT at baseline and after a third SSA injection (two months). A quotient of <sup>13</sup>CO<sub>2</sub>/<sup>12</sup>CO<sub>2</sub> was measured by mass spectrometry, and the cumulative percent dose recovered at 6 h (cPDR) is reported. The secondary endpoints investigated were change in weight, HbA1C, and vitamin D levels. Ten patients completed the study. Exocrine function reduced in all patients (n = 10) following SSA therapy (median reduction from baseline: −23.4% (range: −42.1–0.5%, <i>p</i> = 0.005)). vitamin D levels decreased in all but one patient (median decrease from baseline: −26.5%, (−44.7–10%; <i>p</i> = 0.038)), and median HbA1C levels increased by 8.0% (0–59.3%; <i>p</i> = 0.008). Change in weight was not significant (median decrease from baseline: −0.21% (−4.5–3.5%, <i>p</i> = 1.000)). SSA therapy has a consistent impact on exocrine function from early in the treatment course, but the long-term clinical effects of this remain to be defined. Further studies are required to determine the clinical relevance of this observation and optimise the management of PEI in this cohort. |
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| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-11T05:42:24Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
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| series | Cancers |
| spelling | doaj.art-f4e58c28e83c4b479cc9a822436eb0d52023-11-17T16:23:45ZengMDPI AGCancers2072-66942023-03-01157193310.3390/cancers15071933Casting a Wider NET: Pancreatic Exocrine Insufficiency Induced by Somatostatin Analogues among Patients with Neuroendocrine Tumours?Lewis A. Hall0Sarah Powell-Brett1Oscar Thompson2Daniel Smith3Elizabeth Bradley4Stacey Smith5Suzanne Vickrage6Joanne Kemp-Blake7Keith J. Roberts8Tahir Shah9College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UKCollege of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UKCollege of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UKCollege of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UKDepartment of Nutrition and Dietetics, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2TT, UKBirmingham Neuroendocrine Tumour Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2TT, UKBirmingham Neuroendocrine Tumour Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2TT, UKBirmingham Neuroendocrine Tumour Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2TT, UKCollege of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UKBirmingham Neuroendocrine Tumour Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2TT, UKSomatostatin-analogues (SSAs) are a first-line treatment of unresectable neuroendocrine tumours (NETs). However, SSAs inhibit pancreatic secretions, which could lead to pancreatic exocrine insufficiency (PEI). PEI is known to be detrimental to patient quality of life and nutritional status. This study aimed to evaluate the effect of SSAs on pancreatic exocrine function in patients with NETs, using the <sup>13</sup>C-mixed triglyceride breath test (<sup>13</sup>C-MTGT). Exocrine function was assessed using the <sup>13</sup>C-MTGT at baseline and after a third SSA injection (two months). A quotient of <sup>13</sup>CO<sub>2</sub>/<sup>12</sup>CO<sub>2</sub> was measured by mass spectrometry, and the cumulative percent dose recovered at 6 h (cPDR) is reported. The secondary endpoints investigated were change in weight, HbA1C, and vitamin D levels. Ten patients completed the study. Exocrine function reduced in all patients (n = 10) following SSA therapy (median reduction from baseline: −23.4% (range: −42.1–0.5%, <i>p</i> = 0.005)). vitamin D levels decreased in all but one patient (median decrease from baseline: −26.5%, (−44.7–10%; <i>p</i> = 0.038)), and median HbA1C levels increased by 8.0% (0–59.3%; <i>p</i> = 0.008). Change in weight was not significant (median decrease from baseline: −0.21% (−4.5–3.5%, <i>p</i> = 1.000)). SSA therapy has a consistent impact on exocrine function from early in the treatment course, but the long-term clinical effects of this remain to be defined. Further studies are required to determine the clinical relevance of this observation and optimise the management of PEI in this cohort.https://www.mdpi.com/2072-6694/15/7/1933pancreatic exocrine insufficiencyneuroendocrine tumoursomatostatin-analogues<sup>13</sup>C-MTG breath testfaecal-elastase-1 |
| spellingShingle | Lewis A. Hall Sarah Powell-Brett Oscar Thompson Daniel Smith Elizabeth Bradley Stacey Smith Suzanne Vickrage Joanne Kemp-Blake Keith J. Roberts Tahir Shah Casting a Wider NET: Pancreatic Exocrine Insufficiency Induced by Somatostatin Analogues among Patients with Neuroendocrine Tumours? Cancers pancreatic exocrine insufficiency neuroendocrine tumour somatostatin-analogues <sup>13</sup>C-MTG breath test faecal-elastase-1 |
| title | Casting a Wider NET: Pancreatic Exocrine Insufficiency Induced by Somatostatin Analogues among Patients with Neuroendocrine Tumours? |
| title_full | Casting a Wider NET: Pancreatic Exocrine Insufficiency Induced by Somatostatin Analogues among Patients with Neuroendocrine Tumours? |
| title_fullStr | Casting a Wider NET: Pancreatic Exocrine Insufficiency Induced by Somatostatin Analogues among Patients with Neuroendocrine Tumours? |
| title_full_unstemmed | Casting a Wider NET: Pancreatic Exocrine Insufficiency Induced by Somatostatin Analogues among Patients with Neuroendocrine Tumours? |
| title_short | Casting a Wider NET: Pancreatic Exocrine Insufficiency Induced by Somatostatin Analogues among Patients with Neuroendocrine Tumours? |
| title_sort | casting a wider net pancreatic exocrine insufficiency induced by somatostatin analogues among patients with neuroendocrine tumours |
| topic | pancreatic exocrine insufficiency neuroendocrine tumour somatostatin-analogues <sup>13</sup>C-MTG breath test faecal-elastase-1 |
| url | https://www.mdpi.com/2072-6694/15/7/1933 |
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