Sandostatin and the Hammersmith experience

Ten patients with various metastatic pancreatic tumours have received Sandostatin (octreotide) for up to 5 years, initially 50 micrograms t.i.d. subcutaneously but increased over 6-12 months to 500 micrograms t.i.d. Three patients showed no biochemical or clinical response to Sandostatin. In the remaining patients, treatment was extremely effective: tumour secretions fell by nearly 60% and clinical symptoms improved or resolved in all. At 5-6 months, all patients showed worsening symptoms and rising hormonal concentrations. Although relapses were initially responsive to Sandostatin (at 500 micrograms t.i.d.), patients eventually became unresponsive to all therapies, and all died within 6 months of the development of this resistive phase. Side effects were minimal and long-term therapy was well tolerated. Steatorrhoea and the development of gallstones were not observed.