Resistance of metastatic pancreatic endocrine tumours after long-term treatment with the somatostatin analogue octreotide (SMS 201-995).
Ten patients with metastatic pancreatic endocrine tumours were treated with the long-acting somatostatin analogue octreotide (SMS 201-995). Three patients showed no response, clinically or biochemically, and treatment was therefore withdrawn. The seven remaining patients continued treatment for a median period of 28 months (range 13-54 months). Treatment was initially effective, symptoms improved and the concentrations of tumour-related hormones were reduced. Worsening of symptoms and rising levels of tumour-related hormone concentrations occurred a median of 5 months (range 1-6 months) after the start of therapy and were initially reversed by increasing the dose of octreotide over a median of 10 months (range 6-16 months). However, after a median of 13 months (range 5-34 months) at the maximum dosage, symptoms recurred and were no longer responsive to a further increase in dosage of octreotide or other therapeutic measures. All patients died within a period of 5 months once this resistant phase of their illness had been reached.
Wynick
D
D
Department of Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London, UK.
Anderson
J V
JV
Williams
S J
SJ
Bloom
S R
SR
D007516:Adenoma, Islet Cell / Q000188:drug therapy* / Q000556:secondary; D005755:Gastrins / Q000378:metabolism; D005934:Glucagon / Q000378:metabolism; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary; D015282:Octreotide / Q000008:administration & dosage / Q000627:therapeutic use*; D010190:Pancreatic Neoplasms / Q000188:drug therapy*; D013997:Time Factors; D014660:Vasoactive Intestinal Peptide / Q000378:metabolism
D005755:Gastrins; D014660:Vasoactive Intestinal Peptide; D005934:Glucagon; D015282:Octreotide