Control of irinotecan-induced diarrhea by octreotide after loperamide failure.
Diarrhea is a well-recognized side effect of chemotherapy, which affects the quality of life and when refractory is potentially life threatening. Irinotecan (CPT-11) is associated with an elevated incidence of chemotherapy-induced diarrhea and subsequent morbidity. Standard antidiarrheal treatment is based on high-dose loperamide, but this agent is associated with a significant failure rate. Octreotide is active against chemotherapy-induced diarrhea caused by fluoropyrimidines and irinotecan, with a distinct mechanism of action. We administered octreotide in a phase I trial in 37 patients who received irinotecan and experienced loperamide-refractory diarrhea, 23 of whom experienced grade III-IV diarrhea and were treated with loperamide. The 13 patients in whom to loperamide failed to control diarrhea received octreotide, with a high response rate (92%). We conclude that octreotide is effective against loperamide-refractory diarrhea resulting from irinotecan-based chemotherapy.
Barbounis
V
V
2nd Department of Medical Oncology, St Saves Hospital, Athens, Greece.
Koumakis
G
G
Vassilomanolakis
M
M
Demiri
M
M
Efremidis
A P
AP
D000328:Adult; D000368:Aged; D000930:Antidiarrheals / Q000627:therapeutic use*; D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects*; D002166:Camptothecin / Q000009:adverse effects* / Q000031:analogs & derivatives*; D003967:Diarrhea / Q000139:chemically induced* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D000077146:Irinotecan; D008139:Loperamide / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use*; D011446:Prospective Studies; D017211:Treatment Failure
D000930:Antidiarrheals; D000972:Antineoplastic Agents, Phytogenic; D008139:Loperamide; D000077146:Irinotecan; D015282:Octreotide; D002166:Camptothecin