title: Treatment of malignant endocrine pancreatic tumors with a combination of alpha-interferon and somatostatin analogs.
abstract: Somatostatin analogs and alpha-interferon induce good responses as single drugs in the treatment of endocrine pancreatic tumors. We examined the efficacy and tolerability of the combination of alpha-interferon and somatostatin analogs in 16 patients with metastatic endocrine pancreatic tumors. All patients except one had received prior treatment and were in a progressive state. Doses of alpha-interferon and somatostatin analogs were individually titrated. The alpha-interferon doses varied between 9 and 25 million units per week and were combined with 100-1500 microg of octreotide or 6000 microg of lanreotide daily. Radiological response was seen in 3 of 16 (19%) patients (median duration 23 mo). Biochemical response was seen in 10 of 16 (62.5%) patients (median duration 22 mo). All three patients previously progressing on both alpha-interferon and somatostatin analog as single drugs achieved a stabilization of the disease when treated with the combination (median duration 10 mo). Seven of eight (88%) patients previously progressing on alpha-interferon treatment benefited from the combination with biochemical partial response or stabilization. All six patients previously progressing during somatostatin analog treatment achieved biochemical partial response or stabilization. More than 80% of patients who progressed during previous treatment with either drug benefited from the combined treatment, which also was well tolerated. Thus, a combination of alpha-interferon and somatostatin analogs may be considered for patients previously progressing on treatment with alpha-interferon or somatostatin analogs. However, in this study, the value of sequential treatment has not been evaluated.
authors.affiliation: Department of Medical Sciences, University Hospital, Uppsala, Sweden. marie-louise.fjallskog@medsci.uu.se
authors.forename: M L
authors.initials: ML
authors.lastname: Fjällskog
authors.forename: A
authors.initials: A
authors.lastname: Sundin
authors.forename: J E
authors.initials: JE
authors.lastname: Westlin
authors.forename: K
authors.initials: K
authors.lastname: Oberg
authors.forename: E T
authors.initials: ET
authors.lastname: Janson
authors.forename: B
authors.initials: B
authors.lastname: Eriksson
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D005260:Female; D015408:Gastrinoma / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D005935:Glucagonoma / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000008:administration & dosage; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D010456:Peptides, Cyclic / Q000008:administration & dosage; D013004:Somatostatin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D014055:Tomography, Emission-Computed
chemical_list: D016898:Interferon-alpha; D010456:Peptides, Cyclic; C060347:lanreotide; D013004:Somatostatin; D015282:Octreotide