Effects of slow-release octreotide on urinary metanephrine excretion and plasma chromogranin A and catecholamine levels in patients with malignant or recurrent phaeochromocytoma.
OBJECTIVE
Somatostatin receptors are present on human phaeochromocytomas. Catecholamine concentrations may decrease following short-term administration of somatostatin agonists to patients with phaeochromocytomas. We carried out a prospective study on 10 patients with malignant or recurrent phaeochromocytomas to examine the clinical and hormonal effects of three monthly intramuscular injections of 20 mg slow-release octreotide.


METHODS
Patients underwent somatostatin receptor scintigraphy using 111In-pentetreotide before slow-release octreotide was administered. The patients' symptoms, blood pressure, blood glucose concentrations, glycosylated haemoglobin concentra-tions, plasma insulin and noradrenaline concentrations, and the levels of two putative markers of tumour burden, urinary metanephrine excretion and plasma chromogranin A concentration, were recorded before the first injection and 28 days after the third injection.


RESULTS
Slow-release octreotide did not significantly alter symptoms, blood pressure, blood glucose concentrations, plasma catecholamine and chromogranin A concentrations or metanephrine excretion. Median glycosylated haemoglobin concentrations increased from 5.3% to 6.0% (P = 0.03). Patients whose tumours took up 111In- pentetreotide did not differ from those whose tumours did not after slow-release octreotide treatment in terms of symptoms, blood pressure, blood glucose, plasma catecholamine and chromogranin A concentrations or metanephrine excretion.


CONCLUSIONS
Our data suggest that slow-release octreotide is of limited value for the long-term treatment of patients with malignant or recurrent benign phaeochromocytomas.
Lamarre-Cliche
Maxime
M
Clinical Investigation Center 9201, Assistance-Publique des Hôpitaux de Paris/INSERM, Paris, France.
Gimenez-Roqueplo
Anne-Paule
AP
Billaud
Eliane
E
Baudin
Eric
E
Luton
Jean-Pierre
JP
Plouin
Pierre-François
PF
D000310:Adrenal Gland Neoplasms / Q000097:blood / Q000188:drug therapy / Q000652:urine; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood / Q000652:urine; D001794:Blood Pressure; D002395:Catecholamines / Q000652:urine*; D053379:Chromogranin A; D002864:Chromogranins / Q000097:blood*; D003692:Delayed-Action Preparations; D005260:Female; D006339:Heart Rate; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008676:Metanephrine / Q000652:urine*; D008875:Middle Aged; D015282:Octreotide / Q000008:administration & dosage* / Q000627:therapeutic use; D010673:Pheochromocytoma / Q000097:blood / Q000188:drug therapy / Q000652:urine; D011446:Prospective Studies; D013004:Somatostatin / Q000031:analogs & derivatives* / Q000493:pharmacokinetics
D014408:Biomarkers, Tumor; C506150:CHGA protein, human; D002395:Catecholamines; D053379:Chromogranin A; D002864:Chromogranins; D003692:Delayed-Action Preparations; D008676:Metanephrine; D013004:Somatostatin; C081788:pentetreotide; D015282:Octreotide