Clinical and hormonal effects of a long-acting somatostatin analogue in pancreatic endocrine tumors and in carcinoid syndrome.
Nine patients with pancreatic apudomas (seven gastrinomas, one glucagonoma, one tumor secreting a substance P-like component) and nine with metastasized carcinoid tumors were treated with a somatostatin analogue (SMS 201-995), administered subcutaneously twice daily for 3 days. Treatment was pursued for 2 to 12 months in nine patients in whom SMS was clinically and/or biologically beneficial. In gastrinomas, SMS decreased plasma gastrin in all but one patient, inhibited the residual gastric acid secretion under H2-blockers and improved diarrhea; in the glucagonoma patient, glucagonemia decreased and skin lesions disappeared. In carcinoid syndrome, clinical efficacy was partial and inconstant; daily 5-hydroxyindole acetic acid (5-HIAA) output was slightly decreased. Plasma substance P levels decreased in six patients with initially high concentrations. No antitumoral activity or side effects have been so far evidenced. SMS 201-995 is a useful, well-tolerated agent in secreting pancreatic apudomas and to a lesser extent in carcinoid syndrome, where high-dosage regimens may be required.
D000328:Adult; D000368:Aged; D002276:Carcinoid Tumor / Q000188:drug therapy*; D005260:Female; D005750:Gastric Juice / Q000378:metabolism; D005755:Gastrins / Q000097:blood; D005935:Glucagonoma / Q000188:drug therapy; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D015282:Octreotide; D010190:Pancreatic Neoplasms / Q000188:drug therapy*; D013004:Somatostatin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D013373:Substance P / Q000378:metabolism; D015043:Zollinger-Ellison Syndrome / Q000188:drug therapy*
D005755:Gastrins; D013373:Substance P; D013004:Somatostatin; D015282:Octreotide