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Published on: January 22, 2018
An evaluation of human recombinant alpha interferon in patients with metastatic gastrinoma
J R Pisegna1, G G Slimak, J L Doppman
1Digestive Diseases Branch, National Institute of Diabetes and Digestive and Kidney Disease, National Institutes of Health, Bethesda, Maryland.
Background:
Metastatic gastrinoma is becoming increasingly recognized in patients with Zollinger-Ellison Syndrome. The mean 5-year survival of these patients is < 20%. Chemotherapeutic regimens are of limited benefit. The aim of this study was to evaluate the use of interferon in these patients because a preliminary report suggested it might be effective.
Methods:
The efficacy and toxicity of interferon was assessed in 13 consecutive Zollinger-Ellison syndrome patients with liver metastases. Patients were treated with human recombinant alpha interferon (5 million IU, subcutaneously [SC]) daily and followed up at 3-month intervals with multiple imaging studies. At each follow-up, toxicity of therapy was assessed and fasting serum gastrin concentrations were obtained.
Results:
No patient showed a reduction in tumor size at any follow-up. One patient died after 2 months. At 6 months, six patients (46%) had stable tumor size in the liver, although new bone metastases developed in one patient. Three patients showed stable disease for up to 21 months. Changes in serum gastrin correlated with tumor response at 6 months. All patients developed some side effects of therapy. Thirty-one percent required dose reduction, and one patient (8%) had to have interferon therapy interrupted briefly.
Conclusions:
These results fail to define a therapeutic role for interferon in the treatment of metastatic gastrinoma.
Insights
Interferon therapy showed no significant benefit for patients with metastatic gastrinoma, a rare Zollinger-Ellison Syndrome complication. The study found no tumor reduction and noted significant side effects, failing to establish interferon as a viable treatment option.
Area of Science:
- Oncology
- Gastroenterology
- Endocrinology
Background:
- Metastatic gastrinoma, associated with Zollinger-Ellison Syndrome, has a poor prognosis with limited treatment options.
- Current chemotherapeutic regimens offer minimal benefit for patients with this condition.
- Preliminary reports suggested interferon might be effective, warranting further investigation.
Purpose of the Study:
- To evaluate the efficacy and toxicity of interferon in patients with metastatic gastrinoma.
- To determine if interferon can lead to tumor regression or stable disease in Zollinger-Ellison Syndrome patients with liver metastases.
Main Methods:
- A study involving 13 consecutive Zollinger-Ellison Syndrome patients with liver metastases.
- Treatment administered: human recombinant alpha interferon (5 million IU, subcutaneously daily).
- Regular follow-ups included imaging studies, toxicity assessments, and serum gastrin level measurements.
Main Results:
- No patient experienced a reduction in tumor size.
- 46% of patients had stable tumor size at 6 months, but one developed new bone metastases.
- All patients experienced side effects, with 31% requiring dose reduction and 8% brief treatment interruption.
Conclusions:
- Interferon therapy did not demonstrate efficacy in treating metastatic gastrinoma.
- The study failed to establish a therapeutic role for interferon in this patient population.
- Further research into effective treatments for metastatic gastrinoma is warranted.
