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Treatment of metastatic breast cancer with somatostatin analogues--a meta-analysis
J T Dolan1, D M Miltenburg, T S Granchi
1Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas 77030, USA.
Background:
Somatostatin analogues appear to have antiproliferative effects in breast cancer by inhibiting various hormones. Several small phase 1 and 2 clinical trails have evaluated the efficacy of somatostatin analogues, but the results are varied. The purpose of this study was to use the technique of meta-analysis to determine the effect of somatostatin analogues on tumor response, toxicity, and serum hormone levels in women with metastatic breast cancer.
Methods:
All published and unpublished trials were reviewed. Meta-analysis was preformed by best linear unbiased estimate regression with observations weighted inversely to their variance. Significance was considered at P < .05.
Results:
Fourteen studies (N = 210) were included. Positive tumor response was reported in 87 patients (41.4%). Mean duration of response was 3.9 months. Response was best when somatostatin analogues were given as first-line therapy (69.5% versus 28.5%, P < .006) and in patients with < or =2 metastases (45.0% versus 5.6%, P = .3). Mild side effects occurred in 47 of 185 patients (25.4%). Therapy was associated with a decrease in serum insulin-like growth factor (IGF-1) and an increase in growth hormone.
Conclusions:
In patients with metastatic breast cancer, treatment with somatostatin analogues was associated with a tumor response of over 40% with few side effects. Best results were achieved when somatostatin analogues were given as first-line therapy.
Insights
Somatostatin analogues show over 40% tumor response in metastatic breast cancer patients with few side effects. Optimal results are seen with first-line therapy.
Area of Science:
- Oncology
- Endocrinology
- Pharmacology
Background:
- Somatostatin analogues exhibit antiproliferative effects in breast cancer by modulating hormone levels.
- Clinical trials on somatostatin analogues for breast cancer have yielded varied efficacy results.
- Hormonal inhibition by somatostatin analogues is a key mechanism in breast cancer treatment.
Purpose of the Study:
- To determine the efficacy of somatostatin analogues in metastatic breast cancer.
- To evaluate the impact of somatostatin analogues on tumor response and toxicity.
- To assess changes in serum hormone levels associated with somatostatin analogue therapy.
Main Methods:
- A meta-analysis of published and unpublished clinical trials.
- Best linear unbiased estimate regression for meta-analysis.
- Statistical significance assessed at P < .05.
Main Results:
- Fourteen studies (N=210) were analyzed, showing a 41.4% positive tumor response rate.
- First-line therapy yielded significantly better response rates (69.5%) compared to later lines (28.5%, P < .006).
- Mild side effects were observed in 25.4% of patients; decreased IGF-1 and increased growth hormone levels were noted.
Conclusions:
- Somatostatin analogues demonstrate a notable tumor response (>40%) with acceptable toxicity in metastatic breast cancer.
- First-line administration of somatostatin analogues is associated with superior treatment outcomes.
- The therapy impacts key hormonal markers, including insulin-like growth factor 1 and growth hormone.
