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Treatment with a long\u2010acting release formulation of octreotide, a somatostatin analog, can help to alleviate these symptoms. Although high doses of octreotide are often required for adequate symptom control, the relationship between octreotide dose escalation and symptom control in the <jats:styled-content style=\"fixed-case\">NET<\/jats:styled-content> context is not well quantified in the literature. A retrospective chart review was conducted of nonresectable metastatic <jats:styled-content style=\"fixed-case\">NET<\/jats:styled-content> patients who received a dose greater than 30\u00a0mg intramuscular octreotide long\u2010acting formulation (O\u2010<jats:styled-content style=\"fixed-case\">LAR<\/jats:styled-content>) at any time between January 2005 and December 2011 at the British Columbia Cancer Agency (<jats:styled-content style=\"fixed-case\">BCCA<\/jats:styled-content>). The association between dose escalation of O\u2010<jats:styled-content style=\"fixed-case\">LAR<\/jats:styled-content>, chromogranin A (<jats:styled-content style=\"fixed-case\">CGA<\/jats:styled-content>), 24\u2010h urine 5\u2010hydoxyindoacetate (5\u2010<jats:styled-content style=\"fixed-case\">HIAA<\/jats:styled-content>), symptom control, and radiological progression was explored. Dose escalation of O\u2010<jats:styled-content style=\"fixed-case\">LAR<\/jats:styled-content> was associated with improved symptom control in <jats:styled-content style=\"fixed-case\">NET<\/jats:styled-content> patients who were refractory to the standard dose levels. Reduction of serum CGA &amp; 5\u2010HIAA levels by at least 10% was observed in 31% and 23% respectively. Retrospective review of imaging did not document any reductions in tumor volume. Higher doses of O\u2010<jats:styled-content style=\"fixed-case\">LAR<\/jats:styled-content> are associated with improved symptom control in <jats:styled-content style=\"fixed-case\">NET<\/jats:styled-content> patients. The variability in tumor marker levels in response to O\u2010<jats:styled-content style=\"fixed-case\">LAR<\/jats:styled-content> dose escalation may indicate that tumor marker levels may not be an accurate assessment of therapeutic efficacy.<\/jats:p>","DOI":"10.1002\/cam4.435","type":"journal-article","created":{"date-parts":[[2015,2,27]],"date-time":"2015-02-27T03:00:29Z","timestamp":1425006029000},"page":"864-870","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Association of dose escalation of octreotide long\u2010acting release on clinical symptoms and tumor markers and response among patients with neuroendocrine tumors"],"prefix":"10.1002","volume":"4","author":[{"given":"Khalid","family":"Al\u2010Efraij","sequence":"first","affiliation":[{"name":"Division of Respirology University of British Columbia Vancouver British Columbia Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed A.","family":"Aljama","sequence":"additional","affiliation":[{"name":"Division of Hematology University of British Columbia Vancouver British Columbia Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hagen Fritz","family":"Kennecke","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology British Columbia Cancer Agency University of British Columbia Vancouver British Columbia Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,2,26]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.11105"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.15.4377"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2007.01185.x"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPA.0b013e31821f66b4"},{"key":"e_1_2_7_6_1","first-page":"3455","article-title":"Expression and localization of somatostatin receptor SSTR1, SSTR2, and SSTR3 messenger RNAs in primary human tumors using in situ hybridization","volume":"54","author":"Reubi J. 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