The analysis of quantitative expression of somatostatin and dopamine receptors in gastro-entero-pancreatic tumours opens new therapeutic strategies

Objective: Somatostatin (sst) are present in the majority of gastro-entero-pancreatic (GEP) tumours. Effects of somatostatin receptor (sst) analogues are partial and of limited duration. Cell lines derived from GEP express dopaminergic receptors D-2. New chimeric analogues simultaneously recognising sst, and sst(5) or sst(2) and D-2 have additive effects in inhibition of GH and prolactin secretion in pituitary adenomas. Our aim was to quantify the expression of sst and D2 mRNA in human GEP tumours. Design and methods: mRNA expression of sst(1). sst(2), sst(3) and sst(5) as well as D-2, was analysed using real-time PCR (TaqMan probe) in a series of 3 5 patients with GEP tumours (pancreas (n = 19) and intestinal (n = 16)). Levels of expression were compared with a group of 13 somatotroph adenomas. Results: All GEP tumours express sst(1), sst(2) and D-2. Expression of sst(3) and sst(5) was observed in 89 and 76% of tumours respectively with highly variable levels. sst(2) mRNA expression was higher in nonfunctional tumours (P < 0.009) and sst5 was higher in pancreatic than in intestinal tumours (P < 0.02). Whereas sst(2) levels were similar between GEP and somatotroph tumours, levels of sst5 and D, were higher in the former (394.9 +/- 156.1X10(-2) vs 69.7 +/- 19.5X10(-2) copy/copy beta-Gus (P < 0.0036) and 519.6 +/- 121.2X10(-2) vs 50.0 +/- 21.6X10(-2) copy/copy beta-Gus (P < 0.0001) respectively). In small tumours (< 30mm), sst(2) density appeared as a crucial parameter in somatostatin receptor scintigraphy results, whereas in big tumours, a consistent bias in SRS results was introduced by the size. In pancreatic GEP, high-level sst(3) expression was found in tumours with more active angiogenesis (higher microvessel density and vascular endothelial growth factor expression (P < 0.03)). Conclusions: GEP tumours co-express sst(2) and D-2 in 100% of cases and sst(5) in 89% thus supporting the testing of bi-specific agonists (sst(2)/sst(5) or sst(2)/D-2) in these tumours.