The Experts below are selected from a list of 189 Experts worldwide ranked by ideXlab platform
Juan W Valle - One of the best experts on this subject based on the ideXlab platform.
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telotristat ethyl a new option for the management of Carcinoid Syndrome
Expert Opinion on Pharmacotherapy, 2016Co-Authors: Angela Lamarca, Jorge Barriuso, Mairead G Mcnamara, Richard A Hubner, Juan W ValleAbstract:ABSTRACTIntroduction: Many patients with neuroendocrine tumour-related Carcinoid Syndrome treated with somatostatin analogues (SSA) won’t achieve adequate symptom relief with the SSA alone; new treatment options are required. Telotristat ethyl is a tryptophan hydroxylase inhibitor, developed for the treatment of Carcinoid Syndrome.Areas covered: This review summarises the evidence supporting the role of telotristat ethyl in the management of Carcinoid Syndrome. Rationale, pharmacodynamics, pharmacokinetics, metabolism, clinical experience, efficacy and toxicity profiles are covered.Expert opinion: The efficacy of telotristat ethyl in producing a statistically-significant and clinically-meaningful reduction in daily bowel movements has been confirmed in phase III clinical trials. Two pivotal trials, TELESTAR and TELECAST, explored the role of telotristat ethyl in the management of patients with Carcinoid Syndrome refractory to SSAs focusing on patients with ≥4 and <4 daily bowel movements, respectively. In...
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Telotristat ethyl: a new option for the management of Carcinoid Syndrome.
Expert Opinion on Pharmacotherapy, 2016Co-Authors: Angela Lamarca, Jorge Barriuso, Mairead G Mcnamara, Richard A Hubner, Juan W ValleAbstract:ABSTRACTIntroduction: Many patients with neuroendocrine tumour-related Carcinoid Syndrome treated with somatostatin analogues (SSA) won’t achieve adequate symptom relief with the SSA alone; new treatment options are required. Telotristat ethyl is a tryptophan hydroxylase inhibitor, developed for the treatment of Carcinoid Syndrome.Areas covered: This review summarises the evidence supporting the role of telotristat ethyl in the management of Carcinoid Syndrome. Rationale, pharmacodynamics, pharmacokinetics, metabolism, clinical experience, efficacy and toxicity profiles are covered.Expert opinion: The efficacy of telotristat ethyl in producing a statistically-significant and clinically-meaningful reduction in daily bowel movements has been confirmed in phase III clinical trials. Two pivotal trials, TELESTAR and TELECAST, explored the role of telotristat ethyl in the management of patients with Carcinoid Syndrome refractory to SSAs focusing on patients with ≥4 and
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patient reported outcomes with lanreotide autogel depot for Carcinoid Syndrome an international observational study
Digestive and Liver Disease, 2016Co-Authors: Philippe Ruszniewski, Juan W Valle, Catherine Lombardbohas, Daniel J Cuthbertson, Petros Perros, L Holubec, Gianfranco Delle Fave, D Smith, P Niccoli, Pascal MaisonobeAbstract:Abstract Background Lanreotide Autogel/Depot effectively controls symptoms in patients with Carcinoid Syndrome associated with neuroendocrine tumours. Data on patient-reported outcomes are sparse. Aim To evaluate the effect of lanreotide on patient-reported outcomes (PROs) with Carcinoid Syndrome. Methods This was an international, open-label, observational study of adults with neuroendocrine tumours and history of diarrhoea, receiving lanreotide for >3 months for relief of Carcinoid Syndrome symptoms. The primary PRO measure was satisfaction with diarrhoea control. Secondary PRO measures included severity, change in symptoms and impact on daily life of diarrhoea; and patient satisfaction with flushing control. Results Of 273 patients enrolled, 76% were ‘completely’ or ‘rather’ satisfied with diarrhoea control; 79% reported improvement in diarrhoea with lanreotide. The proportion of patients with ‘mild’, ‘minimal’, or ‘no diarrhoea’ increased from 33% before treatment to 75% during treatment; 75% were unconcerned about the impact of diarrhoea on daily life. Satisfaction with flushing control amongst patients with significant flushing at treatment initiation was 73%. Conclusions Lanreotide treatment was associated with improvements in symptoms as well as a range of PROs in patients with neuroendocrine tumours and Carcinoid Syndrome (ClinicalTrials.gov: NCT01234168 ).
Annamaria Colao - One of the best experts on this subject based on the ideXlab platform.
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Serotonin pathway in Carcinoid Syndrome: Clinical, diagnostic, prognostic and therapeutic implications
Reviews in Endocrine and Metabolic Disorders, 2020Co-Authors: Giuseppe Fanciulli, Rosaria M. Ruggeri, Erika Grossrubatscher, Fabio Lo Calzo, Antongiulio Faggiano, Andrea Isidori, Troy D. Wood, Annamaria ColaoAbstract:Carcinoid Syndrome represents the most common functional Syndrome that affects patients with neuroendocrine neoplasms. Its clinical presentation is really heterogeneous, ranging from mild and often misdiagnosed symptoms to severe manifestations, that significantly worsen the patient’s quality of life, such as difficult-to-control diarrhoea and fibrotic complications. Serotonin pathway alteration plays a central role in the pathophysiology of Carcinoid Syndrome, accounting for most clinical manifestations and providing diagnostic tools. Serotonin pathway is complex, resulting in production of biologically active molecules such as serotonin and melatonin, as well as of different intermediate molecules and final metabolites. These activities require site- and tissue-specific catalytic enzymes. Variable expression and activities of these enzymes result in different clinical pictures, according to primary site of origin of the tumour. At the same time, the biochemical diagnosis of Carcinoid Syndrome could be difficult even in case of typical symptoms. Therefore, the accuracy of the diagnostic methods of assessment should be improved, also attenuating the impact of confounding factors and maybe considering new serotonin precursors or metabolites as diagnostic markers. Finally, the prognostic role of serotonin markers has been only evaluated for its metabolite 5-hydroxyindole acetic acid but, due to heterogeneous and biased study designs, no definitive conclusions have been achieved. The most recent progress is represented by the new therapeutic agent telotristat, an inhibitor of the enzyme tryptophan hydroxylase, which blocks the conversion of tryptophan in 5-hydroxy-tryptophan. The present review investigates the clinical significance of serotonin pathway in Carcinoid Syndrome, considering its role in the pathogenesis, diagnosis, prognosis and therapy.
Shinshi Noda - One of the best experts on this subject based on the ideXlab platform.
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primary Carcinoid of the testis associated with Carcinoid Syndrome
International Journal of Urology, 2001Co-Authors: Tokumasa Hayashi, Shizuka Iida, Jun Taguchi, Jiro Miyajima, Mitsunori Matsuo, Katsuro Tomiyasu, Kei Matsuoka, Shinshi NodaAbstract:Abstract Testicular Carcinoid is a rare disease accounting for less than 1% of all testicular neoplasms. It rarely manifests symptoms of Carcinoid Syndrome. Recent reports have noted that only 1.1–3.1% of testicular Carcinoid tumors are complicated by Carcinoid Syndrome. In general, large tumor size and the presence of Carcinoid Syndrome are features associated with a malignant course. In the present case, pathological findings revealed pure Carcinoid of the testis without metastasis. Moreover, watery diarrhea due to Carcinoid Syndrome disappeared and the serum serotonin level normalized following orchiectomy. The patient was followed up for 12 months with whole body computed tomography scan and assessment of serotonin levels. To date, there is no evidence of tumor recurrence. These findings suggest that monitoring serum serotonin levels may be useful as a marker during follow up of this type of tumor.
Angela Lamarca - One of the best experts on this subject based on the ideXlab platform.
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telotristat ethyl a new option for the management of Carcinoid Syndrome
Expert Opinion on Pharmacotherapy, 2016Co-Authors: Angela Lamarca, Jorge Barriuso, Mairead G Mcnamara, Richard A Hubner, Juan W ValleAbstract:ABSTRACTIntroduction: Many patients with neuroendocrine tumour-related Carcinoid Syndrome treated with somatostatin analogues (SSA) won’t achieve adequate symptom relief with the SSA alone; new treatment options are required. Telotristat ethyl is a tryptophan hydroxylase inhibitor, developed for the treatment of Carcinoid Syndrome.Areas covered: This review summarises the evidence supporting the role of telotristat ethyl in the management of Carcinoid Syndrome. Rationale, pharmacodynamics, pharmacokinetics, metabolism, clinical experience, efficacy and toxicity profiles are covered.Expert opinion: The efficacy of telotristat ethyl in producing a statistically-significant and clinically-meaningful reduction in daily bowel movements has been confirmed in phase III clinical trials. Two pivotal trials, TELESTAR and TELECAST, explored the role of telotristat ethyl in the management of patients with Carcinoid Syndrome refractory to SSAs focusing on patients with ≥4 and <4 daily bowel movements, respectively. In...
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Telotristat ethyl: a new option for the management of Carcinoid Syndrome.
Expert Opinion on Pharmacotherapy, 2016Co-Authors: Angela Lamarca, Jorge Barriuso, Mairead G Mcnamara, Richard A Hubner, Juan W ValleAbstract:ABSTRACTIntroduction: Many patients with neuroendocrine tumour-related Carcinoid Syndrome treated with somatostatin analogues (SSA) won’t achieve adequate symptom relief with the SSA alone; new treatment options are required. Telotristat ethyl is a tryptophan hydroxylase inhibitor, developed for the treatment of Carcinoid Syndrome.Areas covered: This review summarises the evidence supporting the role of telotristat ethyl in the management of Carcinoid Syndrome. Rationale, pharmacodynamics, pharmacokinetics, metabolism, clinical experience, efficacy and toxicity profiles are covered.Expert opinion: The efficacy of telotristat ethyl in producing a statistically-significant and clinically-meaningful reduction in daily bowel movements has been confirmed in phase III clinical trials. Two pivotal trials, TELESTAR and TELECAST, explored the role of telotristat ethyl in the management of patients with Carcinoid Syndrome refractory to SSAs focusing on patients with ≥4 and
Ya Chen Tina Shih - One of the best experts on this subject based on the ideXlab platform.
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frequency of Carcinoid Syndrome at neuroendocrine tumour diagnosis a population based study
Lancet Oncology, 2017Co-Authors: Daniel M Halperin, Chan Shen, Arvind Dasari, Ying Xu, Shouhao Zhou, Ya Chen Tina ShihAbstract:Summary Background Neuroendocrine tumours (NETs) can secrete bioactive amines into the bloodstream, causing Carcinoid Syndrome, with symptoms including flushing and diarrhoea. However, Carcinoid Syndrome frequency in the NET population has never been rigorously assessed, nor has its relationship to presenting clinicopathological characteristics. This analysis assessed the proportion of patients with NETs and Carcinoid Syndrome in the USA and associated clinical factors. Methods We identified patients (≥65 years of age) from the Surveillance, Epidemiology, and End Results-Medicare database, excluding those with pancreatic tumours or small-cell or large-cell lung cancer, as well as those without complete data. We assessed the incidence of patients with at least two insurance claims of flushing, diarrhoea, or Carcinoid Syndrome during the 3 months before and after NET diagnosis. We compared demographic and clinical characteristics between patients with and without Carcinoid Syndrome using χ 2 tests. We used the Cochran-Armitage trend test to identify trends in Carcinoid Syndrome incidence and Cox regression to assess the relationship between Carcinoid Syndrome and survival. Findings Between April 1, 2000, and Dec 31, 2011, 9512 eligible patients were diagnosed with NETs, of whom 1786 (19%) had Carcinoid Syndrome. The number of patients with NETs and Carcinoid Syndrome increased from 50 (11%) of 465 patients in 2000 to 160 (19%) of 854 in 2011 (p Interpretation This population-based analysis reveals that Carcinoid Syndrome is significantly associated with tumour grade, stage, and primary tumour site, and leads to shorter survival compared with those patients without Carcinoid Syndrome. An improved understanding of the heterogeneity of presenting symptoms among patients with NETs might permit more tailored assessment and management than at present and enable future research into the effect of Carcinoid Syndrome control on patient survival. Funding Ipsen.