Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:P61278 (somatostatin)
 22,083 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors report the case of a 48 years old man presenting a pancreatic islet cell carcinoma (gastrinoma) with liver, nodes and peritoneal metastases, associated with an elevated alpha-fetoprotein (AFP) concentration. Incomplete remission was first obtained with a chemotherapy using Streptozotocin combined with 5-Fluorouracil, in association with a Somatostatin analogue (SMS 201-995). But when relapses occur, another chemotherapy was not so effective. Serum gastrin and AFP levels had the same evolution and appear to have the same interest to follow the course of the disease.
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PMID:[Pancreatic endocrine tumor with metastases and increase of alpha-fetoprotein. A case report]. 128 58

The author gives an account of clinical syndromes which develop as a result of overproduction of gastrointestinal hormones. From the various diagnostic approaches, which are not always available or are expensive, the author summarizes the importance of thin-needle biopsy under sonographic control, the argentaffine technique (Grimelius) and histoenzymatic examination for neuron specific enolase. In addition to surgical treatment treatment with streptozotocine, 5-FU, dimethyl triazenoimidazole carboxamide and somatostatin is possible. The author draws attention to the possibility of using somatostatin not only in the treatment of apudomas but also of haemorrhage into the gastrointestinal tract and in the treatment of fistulae. Neuroendocrine factors probably play a significant role in the pathophysiology of irritable colon, Crohn's disease, achalasia and Hirschsprung's disease.
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PMID:[Gastrointestinal hormones--clinical significance]. 273 95

In the carcinoid syndrome, surgery is often curative when the disease is detected early and it may also provide palliation for some patients with metastatic disease. Often metastatic disease requires no treatment for months or years unless symptoms are serious or troublesome. Chemotherapy with either doxorubicin alone or streptozocin plus 5-FU achieves a response rate of about 23-33%. Hepatic artery occlusion followed by sequential chemotherapy has produced striking relief of symptoms, a higher percentage of regressions, and a longer duration of response. Somatostatin 201-995 is very effective in treating the syndrome and in preventing carcinoid crisis and has the advantage of producing virtually no significant side effects.
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PMID:The carcinoid syndrome: a treatable malignant disease. 307 20

The treatment of malignant neuroendocrine gut and pancreatic tumors provides a therapeutic challenge. Surgery as well as medical treatment rarely cure the patient at this stage. Symptoms related to secretory products from the tumor might be life-threatening or at least reduce the quality of life considerably. Interferons (IFNs) have demonstrated an antitumor effect in multiple tumor diseases and were introduced by our group in 1982 for the treatment of carcinoids. Today, more than 300 patients with various neuroendocrine tumors and who receive alpha-IFN have been reported in the literature. Treatment of midgut carcinoid tumors at doses of 3-9 MU 3-7 times per week subcutaneously has achieved biochemical responses in 44% of the patients with significant tumor reduction in 11%. Subjective improvement has been obtained in around 65% of the patients. A median survival from start of treatment in patients with carcinoid syndrome of 80+ months has to be compared with 8-12 months on chemotherapy (streptozotocin plus 5-FU). Treatment of endocrine pancreatic tumors with alpha-IFN at doses of 5-6 MU 3-5 times per week achieved biochemical responses in 51% of the patients and tumor responses in 12%. The median duration of response was 20 months (range 2-96). Combining alpha-IFN with the somatostatin analogue octreotide in patients with malignant tumors resistant to octreotide alone got biochemical responses in 77% with 18% complete biochemical remissions. No significant reduction of tumor size was noticed, but stabilization of the disease was obtained for a median of 15 months.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Interferons alone or in combination with chemotherapy or other biologicals in the treatment of neuroendocrine gut and pancreatic tumors. 769 40

The development of diabetic ketoacidosis is an unusual complication of a glucagon-secreting pancreatic islet cell neoplasm, with only four reported cases in the literature. In this article, the authors report on a 46-year-old woman with a glucagonoma cosecreting pancreatic polypeptide, somatostatin, and serotonin diagnosed 8 months before the onset of diabetic ketoacidosis. She was treated with hydration, insulin, and octreotide, with improvement in her clinical course and a decrease in the glucagon, pancreatic polypeptide, and chromogranin A plasma levels. With the addition of weekly 5-FU, she has maintained a partial radiographic response and has had no further episodes of diabetic ketoacidosis for a 4.5-year period. Diabetic ketoacidosis can develop in the presence of a glucagonoma, and the pathophysiology remains unknown.
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PMID:Case report: diabetic ketoacidosis in a patient with glucagonoma. 777 3

Progress in radioimmunology and immunohistochemistry and the use of intraoperative ultrasonography has considerably improved the diagnosis of endocrine tumors. These advances have changed the prognosis of these tumors since the outcome directly depends on early diagnosis. Surgery is the treatment of choice, in many cases even in the presence of hepatic metastasis. Medical treatment should be used when surgery is contraindicated and includes cytostatic agents (e.g. streptozotocin, 5-FU) or interferons and drugs preventing hormone release such as long-acting somatostatin analogs (SMS 201-995). Finally, symptomatic treatment alone should be confined to cases of unresectable tumors with diffuse metastasis.
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PMID:[Endocrine tumors of the pancreas. Status of the question]. 826 33

Neuroendocrine gut and pancreatic tumours have provided a diagnostic and therapeutic challenge over the years. These rather slowly growing neoplasms have been assigned a good prognosis but when liver metastases are present the prognosis is not better than that of most other malignant tumours. Despite the development of improved diagnostic procedures many patients are still referred at a stage of the disease too late for surgical cure, at which time medical treatment is warranted. The diagnosis is based on histopathological diagnosis including silver stainings (Grimelius, Masson) and immunohistochemistry for chromogranin A and synaptophysin. Analysis of chromogranin A in the plasma is an important adjunct in the screening for various types of neuroendocrine gut and pancreatic tumours. About 80%-100% of patients with verified neuroendocrine gastrointestinal tumours have elevated circulating levels of this glycoprotein. Depending on clinical symptoms the chromogranin A analysis is supplemented by other peptide hormone analyses as well as urinary 5-HIAA for patients with midgut carcinoid tumours. In the past the localization procedures were based on CT, MRI and ultrasound investigations but in recent years somatostatin receptor scintigraphy (octreoscan) and endoscopic ultrasonography have significantly improved the diagnostic potential. Almost 80% of neuroendocrine gastrointestinal tumours present somatostatin receptor subtype 2 binding 111Indium-labelled octreotide which can be used for staging of the disease, and which also indicates whether or not somatostatin analogues can be used in the treatment of these tumours. Surgery is still a cornerstone in the treatment of neuroendocrine gastrointestinal tumours, even if the patients are beyond cure. Debulking procedures and bypassing operations are important for improving clinical condition and facilitating impending medical treatment, and during the past decade a more aggressive surgical approach has emerged. The medical treatment is based on chemotherapy, and the use of somatostatin analogues and alpha-interferons. Chemotherapy, in particular the combination of streptozotocin with 5-FU or doxorubicin, is still first-line treatment for most endocrine pancreatic tumours, while somatostatin analogues and alpha-interferons are considered first-line for classical midgut carcinoids. Chemotherapy and biotherapy can be combined in many patients, and changes from one medical treatment to another during the course of the disease is mandatory for control of the disease. It is important to realise that most patients with malignant tumours are not cured by medical treatment but that the disease can be controlled for extended periods of time. In the future it will be possible to individualize treatments on the basis of new information about such features of tumour biology as proliferation capacity, expression of adhesion molecules, and growth factors and their receptors.
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PMID:Neuroendocrine gastrointestinal tumours. 883 99

Thirty-seven colorectal cancer patients with grade 1-4 diarrhea (NCICTC) caused by chemotherapy with 5-FU-containing regimens, received oral loperamide at the initial dose of 4 mg followed by 4 mg every 8 h (total dose 16 mg/24 h). Twenty-five patients (69%) were diarrhea-free and were considered to be treatment responders. Eight-four percent of the patients with grade 1 or 2 diarrhea achieved a response, but only 52% of those with grade 3-4 diarrhea. These data seem to suggest that high-dose loperamide is effective in patients with moderate diarrhea and can be regarded as the treatment of choice. The patients with more severe diarrhea did not respond so well, and should, perhaps, be given first-line treatment with more effective drugs, such as somatostatin analogues (e.g., octreotide).
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PMID:High-dose loperamide in the treatment of 5-fluorouracil-induced diarrhea in colorectal cancer patients. 1065 Sep 1

A 68 year old Ecuadorian man was investigated for polyuria, polydipsia and weight loss of 3 kg during the previous two months. Insulin dependent diabetes mellitus was diagnosed 10 year before admission and treated with appropriate diet and insulin (35 U/d). 18 months before was diagnosed in El Ecuador of "multiple liver nodes non-suggestive of malignancy". Physical examination showed a large multinodular petrous hepatomegaly. There was no evidence of skin lesions. Results of laboratory studies included a basal plasma glucose level that ranged between 275-367 mg/dl (N=60-100), glycosylated haemoglobin of 8.9% (N<5) and a serum albumin of 2.8 gr./dl (N=3.4-4.8). At admission non-other laboratory alterations were detected. Computed tomography showed a mass on the head of the pancreas with loco-regional lymph nodes and liver metastases. Tumor markers were normal. Fine-needle aspiration cytology of the liver masses revealed the presence of liver metastases of a non-differentiated malignant tumor. A 111In-DTPAOC scintigraphy revealed the presence of somatostatin receptors in the liver metastases, also detecting the presence of multiple bone metastases in the axial and appendicular skeleton. Plasma glucagon level was 678 pg/ml (N<250). A diagnosis of metastatic glucagonoma was established and therapy with streptozocin, 5-FU, insulin and synthetic somatostatin analogs was initiated. Three months after the therapy initiation the patient was symptom free. Some weeks after the patient suffered from left hip pain, and a control 111In-DTPA scintigraphy showed progression of his bone metastases. In conclusion, glucagonoma must be suspected in all diabetic patients with metastatic liver, even in absence of necrotic migratory erythema. In these circumstances, plasmatic glucagon level and somatostatin receptors scintigraphy will be a useful tool for establishing the final diagnosis.
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PMID:[Diabetes mellitus and pancreatic tumor]. 1471 49

Severe diarrhoea after chemotherapy is a dose-limiting toxicity of first-line chemotherapeutic agents approved for the treatment of colorectal cancer including 5-fluorouracil + leucovorin (5-FU/LV) and irinotecan (CPT-11). This report explores the potential of the long-acting version of the somatostatin analogue octreotide, for secondary prophylaxis in patients suffering from chemotherapy-induced diarrhoea (CID). A case series of three patients in a general community setting with colorectal cancer and severe refractory diarrhoea after fluoropyrimidine or irinotecan therapy resulting in suspension of chemotherapy, hospitalization, and/or refusal of further treatment. After the failure of initial aggressive antidiarrhoeal therapy with loperamide and/or diphenoxylate-atropine, patients were treated with octreotide LAR (30 mg q28d). The ability of octreotide LAR to resolve diarrhoea, prevent further episodes of grade 3 or 4 gastrointestinal toxicity and prevent costly hospitalizations. Octreotide LAR 30 mg q28d speed resolution of diarrhoea and was able prevent further episodes during subsequent cycles of chemotherapy. One patient who initially refused chemotherapy because of CID was able to complete his treatment. All patients reported improvement in quality of life following resolution of diarrhoea with octreotide LAR and no further hospitalizations because of CID were necessary.
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PMID:Octreotide LAR resolves severe chemotherapy-induced diarrhoea (CID) and allows continuation of full-dose therapy. 1530 7


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