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Suppression of primary and secondary peptides with somatostatin analog in the therapy of functional endocrine tumors.
- Source :
-
Surgery, gynecology & obstetrics [Surg Gynecol Obstet] 1988 Dec; Vol. 167 (6), pp. 453-62. - Publication Year :
- 1988
-
Abstract
- Sandostatin (SMS 201-995 (SMS)), a potent, long acting analog of native somatostatin was used in five patients with functional endocrine tumors (gastrinoma, two patients; insulinoma, one patient; glucagonoma, one, and adult onset nesidioblastosis, one). Primary and secondary peptide levels were obtained during provocation with a test meal, a calcium infusion, a secretin bolus and either a glucagon or tolbutamide bolus. During provocation test, the levels of the primary peptides insulin and C-peptide (nesidioblastosis and insulinoma), gastrin (gastrinoma), glucagon (glucagonoma) and the secondary peptides calcitonin, gastrointestinal peptide, gastrin releasing peptide, motilin, neurotensin, pancreatic polypeptide, somatostatin, substance-P and vasoactive intestinal peptide were obtained at predetermined intervals and quantitated by radioimmunoassay. SMS therapy was begun and peptide levels were again obtained during provocation. SMS suppressed basal primary peptide levels in all patients by more than 50 per cent. In 23 of 26 provocative tests, SMS effectively decreased circulating peptide levels by more than 50 per cent. Thirteen instances of elevated basal secondary peptides were discovered, and SMS universally suppressed these levels by a mean of 54 per cent. Of the 44 provocative tests performed, elevated secondary peptide levels were present in 41. SMS was effective in 31 of these 41 tests. The mean suppression of these provoked secondary peptide levels was 70 per cent. SMS effectively suppresses both basal and provoked peptides and, thus, provides relief of the clinical symptoms induced by pathologic elevations of primary and secondary peptides.
- Subjects :
- Adenoma, Islet Cell blood
Adenoma, Islet Cell drug therapy
Adenoma, Islet Cell metabolism
Adult
Aged
Aged, 80 and over
Drug Evaluation
Female
Gastrinoma blood
Gastrinoma drug therapy
Gastrinoma metabolism
Glucagonoma blood
Glucagonoma drug therapy
Glucagonoma metabolism
Glucagonoma secondary
Humans
Insulinoma blood
Insulinoma drug therapy
Insulinoma metabolism
Male
Middle Aged
Neoplasm Proteins blood
Neoplasm Recurrence, Local blood
Neoplasm Recurrence, Local drug therapy
Neoplasm Recurrence, Local metabolism
Palliative Care
Pancreatic Function Tests methods
Pancreatic Neoplasms blood
Pancreatic Neoplasms drug therapy
Peptides blood
Time Factors
Zollinger-Ellison Syndrome blood
Zollinger-Ellison Syndrome drug therapy
Zollinger-Ellison Syndrome metabolism
Neoplasm Proteins metabolism
Octreotide pharmacology
Pancreatic Neoplasms metabolism
Peptides metabolism
Subjects
Details
- Language :
- English
- ISSN :
- 0039-6087
- Volume :
- 167
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Surgery, gynecology & obstetrics
- Publication Type :
- Academic Journal
- Accession number :
- 2460958