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Society for Translational Oncology

Oral Ondansetron Offers Effective Antidiarrheal Activity for Carcinoid Syndrome Refractory to Somatostatin Analogues

Overview / Abstract:	Somatostatin analogs (SSAs) are standard for symptomatic patients with neuroendocrine tumors (NETs). However, most patients experience tachyphylaxis, and limited options exist for this so-called “refractory carcinoid syndrome.” Recently, 5-HT3 antagonist ondansetron has been associated with reduction of bowel movement in a small series. The aim of this analysis was to assess effectiveness of ondansetron for symptomatic treatment of carcinoid syndrome. Implications for Practice: Somatostatin analogs are standard treatment in patients with carcinoid syndrome and have an overall response rate of up to 50%. This symptomatic benefit, however, is lost in many patients because of the development of tachyphylaxis or tumor progression. Patients with this “refractory carcinoid syndrome” pose a therapeutic challenge and are sometimes faced with a detrimental effect on quality of life. In this article, the authors suggest the 5-HT3 receptor antagonist ondansetron as potential symptomatic therapy for patients with refractory diarrhea due to carcinoid syndrome. Although the number of patients in this retrospective series is limited, treatment was easily applicable, feasible, and safe and resulted in an ongoing symptomatic benefit in 85% of patients, including two long-term responders. Learning Objectives 1. Summarize the risks and benefits associated with ondansetron therapy in patients with refractory diarrhea due to carcinoid syndrome. 2. Describe the effectiveness of ondansetron treatment for patients with refractory diarrhea due to carcinoid syndrome, and discuss how this therapy can be incorporated into practice.
Expiration	Feb 15, 2021
Discipline(s)	Physician CME
Format	Online
Credits / Hours	1
Accreditation	Society for Translational Oncology
Presenters / Authors / Faculty	Barbara Kiesewetter Division of Oncology, Department of Internal Medicine I; Neuroendocrine Tumor Unit, Comprehensive Cancer Center Vienna, Medical University Vienna, Vienna, Austria The author disclosed no relevant financial interests. Heying Duan Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Comprehensive Cancer Center Vienna, Medical University Vienna, Vienna, Austria The author disclosed no relevant financial interests. Wolfgang Lamm Division of Oncology, Department of Internal Medicine I; Neuroendocrine Tumor Unit, Comprehensive Cancer Center Vienna, Medical University Vienna, Vienna, Austria The author disclosed no relevant financial interests. Alexander Haug Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Comprehensive Cancer Center Vienna, Medical University Vienna, Vienna, Austria The author disclosed no relevant financial interests. Philipp Riss Section of Endocrine Surgery, Division of General Surgery, Department of Surgery; Neuroendocrine Tumor Unit, Comprehensive Cancer Center Vienna, Medical University Vienna, Vienna, Austria The author disclosed no relevant financial interests. Andreas Selberherr Section of Endocrine Surgery, Division of General Surgery, Department of Surgery; Neuroendocrine Tumor Unit, Comprehensive Cancer Center Vienna, Medical University Vienna, Vienna, Austria The author disclosed no relevant financial interests. Christian Scheuba Section of Endocrine Surgery, Division of General Surgery, Department of Surgery; Neuroendocrine Tumor Unit, Comprehensive Cancer Center Vienna, Medical University Vienna, Vienna, Austria The author disclosed no relevant financial interests. Markus Raderer Division of Oncology, Department of Internal Medicine I; Neuroendocrine Tumor Unit, Comprehensive Cancer Center Vienna, Medical University Vienna, Vienna, Austria The author disclosed no relevant financial interests.
Activity Specialities / Related Topics	Hematology, Oncology / Cancer / Radiation Therapy
Sponsors / Supporters / Grant Providers	not applicable
Keywords / Search Terms	Society for Translational Oncology Carcinoid Syndrome Antidiarrheal Free CE CME

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