Clinical evaluation of SMS 201-995. Long-term treatment in gut neuroendocrine tumours, efficacy of oral administration, and possible use in non-tumoural inappropriate TSH hypersecretion.

Abstract

Long-acting somatostatin analogues such as SMS 201-995 (Sandoz) are being evaluated in a wide range of clinical indications, including gut neuroendocrine tumours and acrogemaly. Long-term continuous SMS 201-995 treatment has achieved useful symptomatic improvement in diarrhoea in 4 patients with metastatic VIPomas who had relapsed following previous treatment. Clinical improvement has outlasted suppression of VIP secretion (suggesting an additional direct antisecretory action of SMS 201-995) and has occurred despite expansion of hepatic metastases. In 6 patients with tumours secreting gastrin and/or glucagon, secretion of these peptides was acutely inhibited by SMS 201-995. However, endocrine and clinical responses to chronic treatment have been less consistent. SMS 201-995 is active orally at doses of 4-8 mg and when given thrice-daily to 6 patients with active acromegaly, suppressed mean 24-h growth hormone levels by 51-88%. Despite significantly reduced plasma insulin concentrations, glucose tolerance did not deteriorate. SMS 201-995 was also effective in suppressing thyroid-stimulating hormone (TSH) and thyroid hormone secretion in a patient with mild thyrotoxicosis due to non-tumoural inappropriate TSH hypersecretion. In all cases SMS 201-995 treatment has been well tolerated and has few side-effects.

• Authors: G Williams, J V Anderson, S J Williams, S R Bloom
• Journal: Acta endocrinologica. Supplementum (Acta Endocrinol Suppl (Copenh)) Vol. 286 Pg. 26-36 ( 1987) ISSN: 0300-9750 [Print] Denmark
• PMID: 2892335 (Publication Type: Case Reports, Journal Article)

Chemical References

• Vasoactive Intestinal Peptide
• Somatostatin
• Streptozocin
• Thyrotropin
• Growth Hormone
• Octreotide

Topics

• Acromegaly (blood, drug therapy)
• Adenoma (metabolism)
• Adult
• Aged
• Diarrhea (drug therapy)
• Female
• Gastrointestinal Neoplasms (drug therapy)
• Glucagonoma (blood, drug therapy)
• Growth Hormone (blood)
• Humans
• Hyperthyroidism (drug therapy, etiology)
• Liver Neoplasms (drug therapy, pathology, secondary)
• Male
• Middle Aged
• Neoplasms, Glandular and Epithelial (drug therapy)
• Octreotide
• Pancreatic Neoplasms (blood, drug therapy, pathology)
• Pituitary Neoplasms (metabolism)
• Somatostatin (adverse effects, analogs & derivatives, therapeutic use)
• Streptozocin (therapeutic use)
• Thyrotropin (metabolism)
• Vasoactive Intestinal Peptide (blood)
• Vipoma (blood, drug therapy, pathology)
• Zollinger-Ellison Syndrome (blood, drug therapy)