Context: A 56-yr-old woman presented with acromegaly, a pulmonary mass, and elevated levels of GHRH, GH, and IGF-I. Histological examination revealed a bronchial carcinoid with positive staining for GHRH. Somatostatin analogs (SAs) can play an important role in the treatment of neuroendocrine tumors, dependent on the somatostatin receptor subtype (sst) expression pattern. The sst pattern in bronchial carcinoids and effects of SAs have not been extensively investigated, particularly not for the recently developed universal SA SOM230 (Pasireotide) that has high affinity for sst1, 2, 3, and 5. Objective: Our objective was to investigate the in vivo response of a GHRH-producing bronchial carcinoid to octreotide (OCT), its sst-expression profile, and in vitro responses to different SAs, including SOM230. Methods: In vivo, 50 μg OCT was administered, and plasma GH and GHRH responses were determined. In vitro, the expression of ssts was analyzed by quantitative PCR. Furthermore, the effects of SOM230 and OCT on GHRH secretion were evaluated in primary cell cultures of the carcinoid tissue. Results: In vivo, OCT administration fully suppressed GH and GHRH levels. In vitro, sst 1 mRNA was most abundant, followed by sst2 and sst 5. Both SOM230 and OCT inhibited GHRH production dose dependently (SOM230 100 nM vs. control, P = 0.01; OCT 110 nM vs. control, P = 0.05). Conclusions: In this case of a GHRH-producing bronchial carcinoid, we demonstrated that SOM230 was a potent inhibitor of GHRH production in vitro and was at least equally potent compared with OCT. Therefore, SOM230 may be a potential therapeutic agent to control GHRH secretion in ectopic acromegaly.

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Keywords acromegaly, adult, article, bronchus carcinoid, cancer chemotherapy, case report, clinical feature, drug effect, drug inhibition, female, growth hormone, growth hormone blood level, growth hormone releasing factor, histopathology, hormone release, hormone synthesis, human, human tissue, laboratory test, lobectomy, octreotide, pasireotide, pentetreotide, physical examination, polymerase chain reaction, priority journal, protein expression, somatomedin C, somatostatin receptor, somatostatin receptor 2, somatostatin receptor 5
Persistent URL dx.doi.org/10.1210/jc.2008-1712, hdl.handle.net/1765/18494
Journal Journal of Clinical Endocrinology and Metabolism
Citation
van Hoek, M, Hofland, L.J, de Rijke, Y.B, van Nederveen, F.H, de Krijger, R.R, van Koetsveld, P.M, … Feelders, R.A. (2009). Effects of somatostatin analogs on a growth hormone-releasing hormone secreting bronchial carcinoid, in vivo and in vitro studies. Journal of Clinical Endocrinology and Metabolism, 94(2), 428–433. doi:10.1210/jc.2008-1712