NEW YORK (Reuters Health) – Octreotide, a long-acting somatostatin analogue, is an effective antitumor treatment for some patients with progressive malignant gastrinoma, according to a report in the January 15th issue of Cancer.
Octreotide has previously been shown to have antitumor effects against various neuroendocrine tumors, the authors explain, but little is known about its effect in gastrinoma patients.
Dr. Robert Jensen from National Institute of Diabetes and Digestive and Kidney Diseases in Bethesda, Maryland and colleagues studied the long-term effects of octreotide treatment in 15 patients with advanced progressive metastatic gastrinoma. Patients had been diagnosed with Zollinger-Ellison syndrome a mean of nearly 5 years after they developed symptoms, the authors report, and liver metastases developed a mean 10.1 years after symptoms arose.
Two patients were withdrawn from the study early (within 3 months of initiation of treatment) because of severe gastrointestinal side effects, the report indicates. Two additional patients with complicating medical conditions also experienced severe side effects that did not require treatment discontinuation.
Of the remaining 13 patients, 8 (53%) showed a tumor response to treatment, the researchers note, but none experienced complete remission with complete disappearance of liver metastases with treatment.
According to the results, 5 patients responded for at least one year, 4 for at least 2 years, and 1 for more than 4 years. Eight of the 15 patients were still alive at the time of last follow-up, and 6 were still receiving octreotide. Two of the 8 responders died during follow-up, compared with 5 of 7 nonresponders, the investigators say, a difference that approached statistical significance (p = 0.10).
Rapid tumor growth prior to octreotide had occurred in none of the responders but in 6 of the 7 nonresponders, the report indicates.
"These results," the authors conclude, "coupled with the low incidence of serious side effects, suggest that octreotide should replace chemotherapy as the primary treatment for patients with progressive metastatic gastrinoma, especially those patients with relatively slow-growing tumors prior to treatment with octreotide."
"Additional studies involving larger numbers of patients will be needed to determine a convincing effect on survival," the researchers add.
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