Response and relapse rates after treatment with long-acting somatostatin analogs in multifocal or recurrent type-1 gastric carcinoids: A systematic review and meta-analysis

United European Gastroenterol J. 2020 Mar;8(2):140-147. doi: 10.1177/2050640619890465. Epub 2019 Nov 22.


Background: Type-1 gastric neuroendocrine tumors represent a recurring disease and long-acting somatostatin analogs can inhibit both gastrin release and endocrine cell proliferation. The efficacy and timing of this treatment are still unclear. We performed a systematic review of the literature to clarify the role of somatostatin analog treatment in type-1 gastric neuroendocrine tumors.

Methods: A computerized literature search was performed using relevant keywords to identify all the pertinent articles published in the last 15 years.

Results: Eight studies were included in this systematic review on somatostatin analogs in type-1 gastric neuroendocrine tumors. A complete response rate ranged from 25-100%. When only the six prospective studies were considered, no significant heterogeneity was observed, and the pooled cumulative complete response rate was 84.5% (confidence interval 73.8-92.8). Three studies evaluated the type-1 gastric neuroendocrine tumor recurrence, with a cumulative relapse rate of 30.2% (confidence interval 13.1-50.6) after 34 months.

Conclusion: Somatostatin analogs, namely lanreotide and octreotide, have an excellent response rate, with a good safety profile in selected type-1 gastric neuroendocrine tumors, which cannot be safely managed by endoscopic follow-up or resection due to multiple or frequently recurring disease. After therapy discontinuation, the cumulative relapse rate observed after a median 34-month follow-up was relatively high (30.2%).

Keywords: Gastric neuroendocrine tumors; gastric carcinoids; lanreotide; octreotide; somatostatin analogs.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Carcinoid Tumor / drug therapy*
  • Carcinoid Tumor / mortality
  • Carcinoid Tumor / pathology
  • Disease-Free Survival
  • Drug Administration Schedule
  • Follow-Up Studies
  • Humans
  • Intestinal Neoplasms / drug therapy*
  • Intestinal Neoplasms / mortality
  • Intestinal Neoplasms / pathology
  • Neoplasm Recurrence, Local / epidemiology*
  • Neoplasm Recurrence, Local / prevention & control
  • Neuroendocrine Tumors / drug therapy*
  • Neuroendocrine Tumors / mortality
  • Neuroendocrine Tumors / pathology
  • Octreotide / administration & dosage*
  • Octreotide / adverse effects
  • Pancreatic Neoplasms / drug therapy*
  • Pancreatic Neoplasms / mortality
  • Pancreatic Neoplasms / pathology
  • Peptides, Cyclic / administration & dosage*
  • Peptides, Cyclic / adverse effects
  • Prospective Studies
  • Somatostatin / administration & dosage
  • Somatostatin / adverse effects
  • Somatostatin / analogs & derivatives*
  • Stomach / drug effects
  • Stomach / pathology
  • Stomach Neoplasms / drug therapy*
  • Stomach Neoplasms / mortality
  • Stomach Neoplasms / pathology


  • Peptides, Cyclic
  • lanreotide
  • Somatostatin
  • Octreotide

Supplementary concepts

  • Gastro-enteropancreatic neuroendocrine tumor