Lung Carcinoid With Cushing's Syndrome: Control of Serum Acth and Cortisol Levels Using SMS 201–995 (Sandostatin)

Hearn, P. R.; Reynolds, Claire; Johansen, Klaus; Woodhouse, Nicholas

doi:10.1111/j.1365-2265.1988.tb03654.x

Cited by 55 publications

(29 citation statements)

References 10 publications

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“…shown in our patient, is more suggestive of a gradual loss of control and may well, in the absence of concomi tant hypoglycaemia, be the earliest indicator of such a phenomenon. If loss of control is detected, then the dose of SMS 201-995 should be increased, as previous experi ence has shown in this condition [12,13], in acromegaly [18] and in ectopic ACTH-induced Cushing's syndrome [19] . Most patients will tolerate 100 pg t.i.d.…”

Section: Discussionmentioning

confidence: 99%

The Use of SMS 201-995 (Somatostatin Analogue) in Insulinomas

Hearn

Ahmed²,

Woodhouse³

1988

Horm Res

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A 76-year-old man, a known case of insulinoma, was well controlled for 11 days on 50 µg SMS 201-995 every 12 h; clinical recovery was immediate with normalization of blood sugars and C-peptide levels. The potential value of this new drug in the management of insulinomas is illustrated by this case and by 11 additional case reports which are reviewed. A rise in C-peptide levels during treatment without concomitant hypoglycaemia might be the first indication of a loss of control.

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Section: Discussionmentioning

confidence: 99%

The Use of SMS 201-995 (Somatostatin Analogue) in Insulinomas

Hearn

Ahmed²,

Woodhouse³

1988

Horm Res

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“…Octreotide 50 Ìg s.c. stat produced a 50% reduction of ACTH in 1 patient whilst the other was maintained in a clinical and biochemical remission for 10 weeks with octreotide 100 Ìg s.c. t.i.d. [145]. Subsequent reports indicate that, in the majority of cases, octreotide is an effective agent in the management of bronchial carcinoidrelated ectopic hormone syndromes providing palliation not only in Cushing's syndrome but also for ectopic GHRH-related acromegaly [111,113,146,147].…”

Section: Management Of Bronchial Carcinoidmentioning

confidence: 99%

Somatostatin, Its Receptors and Analogs, in Lung Cancer

et al. 2001

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Despite developments in diagnosis and treatment, lung cancer is the commonest cause of cancer death in Europe and North America. Due to increasing cigarette consumption, the incidence of the disease and resultant mortality is rising dramatically in women. Novel approaches to the management of lung cancer are urgently required. Somatostatin is a tetradecapeptide first identified in the pituitary and subsequently throughout the body particularly in neuroendocrine cells of the pancreas and gastrointestinal tract and the nervous system. The peptide has numerous functions including inhibition of hormone release, immunomodulation and neurotransmission and is an endogenous inhibitor of cell proliferation and angiogenesis. Somatostatin and its analogs, including octreotide (SMS 201–995), somatuline (BIM 23014) and vapreotide (RC-160), act by binding to specific somatostatin receptors (SSTR) of which there are 5 principal subtypes, SSTR-1–5. Although elevated plasma somatostatin levels may be detected in 14–15% of patients, tumor cell expression appears rare. SSTR may be expressed by lung tumors, particularly small cell lung cancer and bronchial carcinoid disease. [¹¹¹In]pentetreotide scintigraphy may have a role to play in the localization and staging of lung cancers both before and following treatment, and in detecting relapsed disease. The potential role of radiolabelled somatostatin analogs as radiotherapeutic agents in the management of lung cancer is currently being explored. Somatostatin analog therapy results in significant growth inhibition of both SSTR-positive and SSTR-negative lung tumors in vivo. Recent work indicates that these agents may enhance the efficacy of chemotherapeutic agents in the treatment of solid tumors including lung cancer.

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“…Another therapeutic alternative was the use of octreotide, as ectopic ACTH-producing tumors can express receptors for somatostatin and thus, respond to the administration of this polypeptide (35). Although performed in only three cases, the acute test with 50 mg of octreotide s.c. to evaluate the ACTH response had a good predictive value for a long-term clinical response to octreotide (36).…”

Section: Treatmentmentioning

confidence: 99%

Ectopic ACTH syndrome: our experience with 25 cases

Fragoso²,

et al. 2006

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Objective: Ectopic ACTH syndrome (EAS) occurs in about 5-10% of all patients with ACTH-dependent hypercortisolism with most of them caused by intrathoracic neoplasms. It may be associated with overt malignancies or with occult and indolent tumors. We assessed the accuracy of dynamic tests, inferior petrosal sinus sampling (IPSS) using desmopressin, and imaging in the work-up diagnosis of EAS. Design and subjects: Tumor markers, imaging, and outcome data from 25 patients (13F/12M) aged 18-72 years. High dexamethasone suppression test (HDDST), desmopressin test, GHRP-6 test, corticotropin-releasing hormone (CRH) test, IPSS, computed tomography (CT), magnetic resonance imaging (MRI), and 111 In-pentetreotide scintigraphy were revised. Results: In 5 out of 20 patients HDDST was positive. In 13 patients who underwent desmopressin test, ACTH-and cortisol-positive responses were seen in six and five patients respectively. GHRP-6 test was positive in two out of three cases. Two patients underwent CRH test with negative response. In the seven patients submitted to IPSS using desmopressin in six of them, none had ACTH gradients. CT was positive in 15 out of 21 patients and MRI in 8 out of 17 cases.111 In-pentetreotide scintigraphy was positive in three out of five patients. Fourteen patients had intrathoracic tumors, five had pheochromocytomas, three had pancreatic tumors, one had a glomic tumor, and had three occult tumors. Six out of 11 patients with metastasis died and 3 others without metastasis died. Conclusions: IPSS with desmopressin was helpful for differential diagnosis. Patients initially harboring occult carcinoids may also exhibit severe hypercortisolism and those harboring tymic carcinoids had poor prognoses when compared with bronchial carcinoids and pheocromocytomas.European Journal of Endocrinology 155 725-733

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Lung Carcinoid With Cushing's Syndrome: Control of Serum Acth and Cortisol Levels Using SMS 201–995 (Sandostatin)

Cited by 55 publications

References 10 publications

The Use of SMS 201-995 (Somatostatin Analogue) in Insulinomas

The Use of SMS 201-995 (Somatostatin Analogue) in Insulinomas

Somatostatin, Its Receptors and Analogs, in Lung Cancer

Ectopic ACTH syndrome: our experience with 25 cases

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