Partial Remission of Carcinoid Tumor in Response to Cyproheptadine

Leitner, Stuart P.; Greenberg, Paul D.; Danieu, Linda; Michaelson, Richard A.

doi:10.7326/0003-4819-111-9-760

Cited by 4 publications

(2 citation statements)

References 6 publications

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“…The published results, however, often concern clinical experiences of very small numbers of patients, and sometimes the recommendations are made based on the outcome of one single case only (13)(14)(15). The therapeutic effect has often been poorly defined, and none of these agents can reliably and effectively palliate all symptoms of the syndrome.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Carcinoid Syndrome with Recombinant Interferon Alpha-2a

et al. 1993

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Section: Discussionmentioning

confidence: 99%

Treatment of Carcinoid Syndrome with Recombinant Interferon Alpha-2a

et al. 1993

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“…Regression of carcinoid tumors was seen in two of seven patients given cyproheptadine [ 36 ]. Others found symptomatic carcinoid improvements but no carcinoid regressions from cyproheptadine at maximum tolerable doses that ranged from 12 to 48 mg daily [ 37 , 38 ]. Of particular note, recent In Vitro studies demonstrated good cytotoxicity of cyproheptadine to GB cells with an IC50 of 95 microM [ 39 ].…”

Section: The Opals Medicinesmentioning

confidence: 99%

OPALS: A New Osimertinib Adjunctive Treatment of Lung Adenocarcinoma or Glioblastoma Using Five Repurposed Drugs

Kast¹,

Halatsch

Rosell

2021

Cells

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Background: Pharmacological targeting aberrant activation of epidermal growth factor receptor tyrosine kinase signaling is an established approach to treating lung adenocarcinoma. Osimertinib is a tyrosine kinase approved and effective in treating lung adenocarcinomas that have one of several common activating mutations in epidermal growth factor receptor. The emergence of resistance to osimertinib after a year or two is the rule. We developed a five-drug adjuvant regimen designed to increase osimertinib’s growth inhibition and thereby delay the development of resistance. Areas of Uncertainty: Although the assembled preclinical data is strong, preclinical data and the following clinical trial results can be discrepant. The safety of OPALS drugs when used individually is excellent. We have no data from humans on their tolerability when used as an ensemble. That there is no data from the individual drugs to suspect problematic interaction does not exclude the possibility. Data Sources: All relevant PubMed.org articles on the OPALS drugs and corresponding pathophysiology of lung adenocarcinoma and glioblastoma were reviewed. Therapeutic Opinion: The five drugs of OPALS are in wide use in general medicine for non-oncology indications. OPALS uses the anti-protozoal drug pyrimethamine, the antihistamine cyproheptadine, the antibiotic azithromycin, the antihistamine loratadine, and the potassium sparing diuretic spironolactone. We show how these inexpensive and generically available drugs intersect with and inhibit lung adenocarcinoma growth drive. We also review data showing that both OPALS adjuvant drugs and osimertinib have data showing they may be active in suppressing glioblastoma growth.

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A study of cyproheptadine in the treatment of metastatic carcinoid tumor and the malignant carcinoid syndrome

Moertel

Kvols

Rubin

1991

Cancer

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Sixteen patients with metastatic neuroendocrine tumors and the malignant carcinoid syndrome were treated with cyproheptadine (Periactin, Merck, Sharp & Dohme, West Point, PA) at maximum tolerable doses that ranged from 12 to 48 mg daily. Usual side effects were mild sedation and dry mouth, but three patients found it impossible to sustain treatment due to nausea and vomiting. Most patients had significant relief of diarrhea, frequently associated with weight gain. Relief of flushing was uncommon. The therapeutic benefit produced by cyproheptadine would appear to be a peripheral effect because 5‐hydroxyindoleacetic acid (5‐HIAA) excretion in these patients was not reduced. Although there have been case reports of objective tumor regression with cyproheptadine therapy, this was not observed in any of these 16 patients. Cyproheptadine would appear to be a useful therapeutic tool for the management of diarrhea associated with the malignant carcinoid syndrome. An appropriate initial total daily dose is 0.4 mg/kg divided in three fractions with prompt modification to produce minimal and tolerable side effects.

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Partial Remission of Carcinoid Tumor in Response to Cyproheptadine

Cited by 4 publications

References 6 publications

Treatment of Carcinoid Syndrome with Recombinant Interferon Alpha-2a

Treatment of Carcinoid Syndrome with Recombinant Interferon Alpha-2a

OPALS: A New Osimertinib Adjunctive Treatment of Lung Adenocarcinoma or Glioblastoma Using Five Repurposed Drugs

A study of cyproheptadine in the treatment of metastatic carcinoid tumor and the malignant carcinoid syndrome

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