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Low-dose octreotide treatment is not effective in patients with advanced pancreatic cancer
H Friess1, M Büchler, C Beglinger
1Department of General Surgery, University of Ulm, Germany.
Abstract:
Octreotide (SMS 201-995), a long-acting somatostatin analogue, has been shown to decelerate growth of human pancreatic cancer in vitro and in vivo. We analyzed the efficacy of octreotide treatment in 22 patients (14 men, 8 women) with histologically verified ductal pancreatic cancer. All patients had advanced tumor stages (stage III: 13 patients; stage IV: 9 patients). Octreotide was given by self-administered subcutaneous injection (3 x 100 micrograms/day). When there was evidence of tumor progression, the dose of octreotide was increased to 3 x 200 micrograms/day. A monthly follow-up, including clinical status, CT scan or ultrasonography, and tumor marker carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 19-9 determination was carried out. There were no severe side effects apart from slight burning sensation at the injection site. No partial or complete remission was seen. Eighteen patients showed tumor progression with a median survival time of 17 weeks (range 3-42 weeks). In three patients a "no change" evaluation with a median survival time of 46 weeks (range 40-68 weeks) was registered. In these three patients the serum tumor markers CA 19-9 and CEA did not show an increase to more than twice the baseline value during this time. One patient discontinued the octreotide treatment because of tumor progression. The results of the analysis indicate that low-dose octreotide treatment is not effective in patient suffering from advanced tumor stages of pancreatic cancer.
Insights
Low-dose octreotide treatment showed limited efficacy in advanced pancreatic cancer. While generally well-tolerated, it did not halt tumor progression or induce remission in most patients with ductal pancreatic cancer.
Area of Science:
- Oncology
- Pharmacology
Background:
- Octreotide, a somatostatin analogue, demonstrated potential in decelerating human pancreatic cancer growth in preclinical studies.
- Pancreatic cancer remains a significant health challenge, necessitating effective therapeutic strategies.
Purpose of the Study:
- To evaluate the efficacy of octreotide treatment in patients with advanced ductal pancreatic cancer.
- To assess the impact of octreotide on tumor progression, survival, and tumor markers in this patient cohort.
Main Methods:
- A study involving 22 patients with advanced (Stage III/IV) ductal pancreatic cancer receiving subcutaneous octreotide (100-200 micrograms/day).
- Monthly follow-ups included clinical assessment, imaging (CT/ultrasonography), and monitoring of tumor markers (CEA, CA 19-9).
Main Results:
- No partial or complete remission was observed in any patient.
- Eighteen patients experienced tumor progression, with a median survival of 17 weeks.
- Three patients had "no change" in disease status, with a median survival of 46 weeks, and stable tumor markers.
Conclusions:
- Low-dose octreotide treatment is not effective for patients with advanced-stage pancreatic cancer.
- Further research may be needed to explore alternative dosing or combination therapies for pancreatic cancer management.