Treatment of metastatic islet cell carcinoma with a somatostatin analogue (SMS 201-995).
We used an octapeptide analogue of somatostatin, SMS 201-995, in dosages ranging from 150 to 450 micrograms/d administered subcutaneously in three daily doses for 1 to 16 months, to treat 22 patients with advanced malignant islet cell carcinomas. Of the 22 patients, there were 9 with gastrinomas; 3 with glucagonomas; 4 with insulinomas; 1 with ectopic production of parathyroid hormone; and 3 with mixed syndromes. The only biochemical marker in 1 patient was pancreatic polypeptide, and 1 patient had no demonstrable peptide production from the tumor. In 14 patients, dramatic decreases in the levels of circulating peptides (insulin, vasoactive intestinal polypeptide, gastrin, and glucagon) have been accompanied by major alleviations of symptoms. Steatorrhea appears to be the most significant toxicity. This analogue of somatostatin may be appropriate for use as early therapy in patients who have symptoms from syndromes related to islet cell carcinomas but in whom there is no immediate threat from tumor progression.
D007516:Adenoma, Islet Cell / Q000188:drug therapy* / Q000378:metabolism / Q000556:secondary; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002446:Celiac Disease / Q000139:chemically induced; D005260:Female; D005935:Glucagonoma / Q000188:drug therapy; D006801:Humans; D007340:Insulinoma / Q000188:drug therapy; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary; D008297:Male; D008875:Middle Aged; D015282:Octreotide; D010190:Pancreatic Neoplasms / Q000188:drug therapy*; D010281:Parathyroid Hormone / Q000378:metabolism; D013004:Somatostatin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D015043:Zollinger-Ellison Syndrome / Q000188:drug therapy
D000970:Antineoplastic Agents; D010281:Parathyroid Hormone; D013004:Somatostatin; D015282:Octreotide