Somatostatin receptor ligand therapy-a potential therapy for neurocytoma

Dongyun Zhang, Sarah S.R. Kim, Daniel F. Kelly, Sylvia L. Asa, Masoud Movassaghi, Sergey Mareninov, William H. Yong, Timothy F. Cloughesy, Fausto J. Rodriguez, Paul McKeever, Jiang Qian, Jian Yi Li, Qinwen Mao, Kathy L. Newell, Richard M. Green, Cynthia T. Welsh, Zhenggang Xiong, Anthony P. Heaney

Research output: Contribution to journalArticle

Abstract

Context: Neurocytoma (NC) is a rare, low-grade tumor of the central nervous system, with a 10-year survival rate of 90% and local control rate of 74%. However, 25% of NCs will be atypical, with an elevated Ki-67 labeling index >2%, and will exhibit a more aggressive course, with a high propensity for local recurrence and/or craniospinal dissemination. Although no standard treatment regimen exists for these atypical cases, adjuvant stereotactic or conventional radiotherapy and/or chemotherapy have been typically offered but have yielded inconsistent results. Case Description: We have described the case of a patient with a vasopressin-secreting atypical NC of the sellar and cavernous sinus region. After subtotal resection via endoscopic transsphenoidal surgery, the residual tumor showed increased fluorodeoxyglucose uptake and high somatostatin receptor (SSTR) expression on a 68Ga-DOTA-TATE positron emission tomography/CT scan. Somatostatin receptor ligand (SRL) therapy with lanreotide (120 mg every 28 days) was initiated. Four years later, the residual tumor was stable with decreased fluorodeoxyglucose tumor uptake. Immunocytochemical SSTR2 and SSTR5 expression >80% was further confirmed in a series of NC tissues. Conclusions: To the best of our knowledge, we have described the first use of SRL therapy for an atypical NC. Our results support consideration of adjuvant SRL therapy for NC refractory to surgical removal. Our findings further raise the possibility of SSTR-directed peptide receptor radionuclide therapy as NC therapy.

Original languageEnglish (US)
Pages (from-to)2395-2402
Number of pages8
JournalJournal of Clinical Endocrinology and Metabolism
Volume104
Issue number6
DOIs
StatePublished - Jun 1 2019

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

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    Zhang, D., Kim, S. S. R., Kelly, D. F., Asa, S. L., Movassaghi, M., Mareninov, S., Yong, W. H., Cloughesy, T. F., Rodriguez, F. J., McKeever, P., Qian, J., Li, J. Y., Mao, Q., Newell, K. L., Green, R. M., Welsh, C. T., Xiong, Z., & Heaney, A. P. (2019). Somatostatin receptor ligand therapy-a potential therapy for neurocytoma. Journal of Clinical Endocrinology and Metabolism, 104(6), 2395-2402. https://doi.org/10.1210/jc.2018-02419