Treatment of the malignant carcinoid syndrome. Evaluation of a long-acting somatostatin analogue.
We studied the effects of a long-acting analogue of somatostatin (SMS 201-995, Sandoz) in 25 patients with histologically proved metastatic carcinoid tumors and the carcinoid syndrome. This drug was self-administered by subcutaneous injection at a dose of 150 micrograms three times daily. Flushing and diarrhea associated with the syndrome were promptly relieved in 22 patients. All 25 patients had an elevated 24-hour urinary excretion of 5-hydroxyindoleacetic acid (5-HIAA) (mean, 265 mg per 24 hours; range, 14 to 1079), which served as an objective indicator of disease activity. Eighteen of the 25 patients (72 percent) had a decrease of 50 percent or more in their urinary 5-HIAA levels, as compared with the pretreatment values. The median duration of this biochemical response was more than 12 months (range, 1 to greater than 18). Since no serious toxicity was observed, we conclude that SMS 201-995 may be appropriate for use as early therapy in patients with symptoms due to the carcinoid syndrome who have not responded to simpler measures.
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D003967:Diarrhea / Q000188:drug therapy; D005260:Female; D005483:Flushing / Q000628:therapy; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000652:urine; D007279:Injections, Subcutaneous; D008297:Male; D008303:Malignant Carcinoid Syndrome / Q000188:drug therapy* / Q000652:urine; D008875:Middle Aged; D015282:Octreotide; D012646:Self Administration; D013004:Somatostatin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use
D000970:Antineoplastic Agents; D013004:Somatostatin; D006897:Hydroxyindoleacetic Acid; D015282:Octreotide