Therapeutic potential of octreotide in the treatment of liver metastases.
Octreotide is a synthetic analogue of somatostatin that has clear inhibitory effects on the growth of many animal and human cell lines, including colorectal cell lines both in vitro and in vivo. Colorectal cancer metastatic to the liver is clinically important, both in terms of the number of patients affected and the lack of any effective treatment for the majority of patients. Octreotide inhibits the growth of colorectal liver tumour in a number of experimental models and, in at least three tumour types, inhibits the growth of established micro-metastases. The precise mechanism of action is not known. However, the drug is likely to be most beneficial in the treatment of liver metastases when the tumour burden is relatively small. The available evidence, although experimental, suggests that octreotide may also have a beneficial effect on the development of liver metastases when used as an adjuvant to surgery in colorectal cancer and this area warrants urgent clinical investigation. The cytotoxics which are currently used as an adjuvant to surgery for colorectal cancer have unpleasant side effects which can be life-threatening. There will also be a proportion of patients who have undergone a truly curative resection of their tumour and will thus be treated unnecessarily. The potential benefits of octreotide in the adjuvant setting, although promising, remain speculative, but octreotide has an acceptably low incidence of side effects and can be administered safely for a prolonged period of time.
Davies
N
N
Department of Surgery, Musgrove Park Hospital, Somerset, England, UK.
Cooke
T G
TG
Jenkins
S A
SA
D000818:Animals; D018931:Antineoplastic Agents, Hormonal / Q000378:metabolism / Q000494:pharmacology* / Q000627:therapeutic use*; D002455:Cell Division / Q000187:drug effects; D002986:Clinical Trials as Topic; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply / Q000188:drug therapy* / Q000556:secondary*; D051379:Mice; D009367:Neoplasm Staging; D015282:Octreotide / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use*; D051381:Rats
D018931:Antineoplastic Agents, Hormonal; D015282:Octreotide