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  • Title: High-dose octreotide acetate for management of gastroenteropancreatic neuroendocrine tumors.
    Author: Chadha MK, Lombardo J, Mashtare T, Wilding GE, Litwin A, Raczyk C, Gibbs JF, Kuvshinoff B, Javle MM, Iyer RV.
    Journal: Anticancer Res; 2009 Oct; 29(10):4127-30. PubMed ID: 19846960.
    Abstract:
    BACKGROUND: Long-acting sandostatin (S-LAR; octreotide acetate) is well tolerated and effective for symptom control and possibly disease control in gastroenteropancreatic neuroendocrine tumors (GEP-NETs). We undertook a retrospective analysis to study the efficacy and tolerability of higher doses (more than 20-30 mg/month) of S-LAR in GEP-NETs. PATIENTS AND METHODS: With IRB approval, charts of all patients with GEP-NET who received S-LAR between June 2002 to September 2007 at Roswell Park Cancer Institute were reviewed and their data analyzed. RESULTS: Fifty-four patients with GEP-NET received S-LAR; thirty required dose escalation. Patients received a median of 5 doses of S-LAR at conventional dose followed by up-titration of the dose for symptom control (20) and radiological progression (17). Median high dose of S-LAR was 40 mg (range: 40-90 mg) with a median of 8.5 high doses received. No treatment related toxicities were seen. The estimated 1-year survival for patients on conventional dose alone was 0.77 (95% CI of 0.50 to 0.91) and those on high-dose was 0.88 (95% CI of 0.68 to 0.96) (p=0.4777) while median time to any other intervention was 2.9 months versus 17.7 months (p=0.12). CONCLUSION: Dose escalation of S-LAR is well tolerated and may provide longer disease control.
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