Role of somatostatin analogs in the management of neuroendocrine tumors.

Neuroendocrine tumors are rare neoplasms. During the last two decades, somato statin analogs, exerting their activity through both receptor binding and enzymatic inhibition mechanisms, have been a key option in the management of neuroen docrine tumors. The treatment of neuroendocrine tumors with high doses of so matostatin analogs determined high rates of tumor stabilization, but the dose-re sponse of somatostatin analogs on symptomatic relief and stabilization of tumor growth remains unpredictable. Several studies have indicated a higher efficacy of so matostatin analogs in well-differentiated, low-grade malignancy tumors that express a high density of somatostatin receptors. Synthesis of new, more effective molecules, with different pharmacokinetic profiles, receptor affinity and binding stability, will ease the clinician’s tasks and improve patient expectancies in terms of survival and quality of life. Further studies are needed to clarify mechanisms underlying the bet ter antiproliferative effect of higher doses of somatostatin analogs and to determine the optimum dose to saturate specific receptor subtypes. Free full text available at www.tumorionline.it