title: Pasireotide for malignant insulinoma.
abstract: Malignant insulinoma usually has a poor prognosis, as no efficient medical treatment is available. The somatostatin analogs octreotide and lanreotide have limited ability to control the hypoglycemic events. Pasireotide is a multi-receptor targeted somatostatin-analog with improved affinity for SSTR5. There is to date no reported treatment experience with this drug in such tumors.
  
  
  METHODS
  A 72-year-old patient with a G2 stage IV insulinoma, who underwent excision of the primary pancreatic tumor and multiple hepatic metastases, required further treatment for recurrent hypoglycemic events. The glycemic control achieved with pasireotide LAR was better compared with lanreotide and everolimus. However, none of these treatments showed tumor anti-proliferative effects.
  
  
  CONCLUSIONS
  Pasireotide monthly injections achieved improved glycemic control in a patient with malignant insulinoma and recurrent hypoglycemic events compared with other medical treatments.
authors.affiliation: Endocrine Institute, Rabin Medical Center, Petah Tiqva, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Amit
authors.initials: A
authors.lastname: Tirosh
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.|Institute of Oncology, Davidoff Center, Rabin Medical Center, Petah Tiqva, Israel.
authors.forename: Salomon M
authors.initials: SM
authors.lastname: Stemmer
authors.affiliation: Surgery, Rivka Ziv medical center, Sefad, Israel.
authors.forename: Evgeny
authors.initials: E
authors.lastname: Solomonov
authors.affiliation: Institute of Oncology, Davidoff Center, Rabin Medical Center, Petah Tiqva, Israel.
authors.forename: Eldad
authors.initials: E
authors.lastname: Elnekave
authors.affiliation: Institute of Neuropathology, University of Hamburg, Hamburg, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Saeger
authors.affiliation: Dan-Petah Tiqva district, Clalit Health Services, Petah Tiqva, Israel.
authors.forename: Yelena
authors.initials: Y
authors.lastname: Ravkin
authors.affiliation: Novartis Pharma Services, Petah Tiqva, Israel.
authors.forename: Kobi
authors.initials: K
authors.lastname: Nir
authors.affiliation: Internal Medicine F, Rabin Medical Center, Petah Tiqva, Israel.
authors.forename: Yeela
authors.initials: Y
authors.lastname: Talmor
authors.affiliation: Endocrine Institute, Rabin Medical Center, Petah Tiqva, Israel. ilanshi@clalit.org.il.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. ilanshi@clalit.org.il.
authors.forename: Ilan
authors.initials: I
authors.lastname: Shimon
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001706:Biopsy; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D006498:Hepatectomy; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D007150:Immunohistochemistry; D007340:Insulinoma / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000556:secondary; D008113:Liver Neoplasms / Q000145:classification / Q000150:complications / Q000188:drug therapy* / Q000556:secondary; D008297:Male; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D049268:Positron-Emission Tomography; D012008:Recurrence; D013004:Somatostatin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D001786:Blood Glucose; D013004:Somatostatin; C517782:pasireotide