Advertisement

Investigational New Drugs

, Volume 19, Issue 4, pp 341–343 | Cite as

Therapeutic Response to Octreotide in Patients with Refractory CPT-11 Induced Diarrhea

  • Barbara Pro
  • Richard Lozano
  • Jaffer A. Ajani
Article

Abstract

Purpose. Severe diarrhea can represent adose-limiting toxicity with the use ofCPT-11. Conventional therapy isineffective in some patients and is alsolimited by patient compliance. We reportour observation on the effectiveness ofoctreotide acetate in the treatment ofCPT-11-induced diarrhea refractory toopioids. Patients and methods. We describe 4 patientswith metastaticgastrointestinal tumors who developedsevere diarrhea following treatment withCPT-11 (65–125 mg/m2/weekly for 4weeks every 6 weeks). Diarrhea wasrefractory to treatment with loperamide anddiphenoxylate and was treated withoctreotide acetate. Results. Complete resolution ofdiarrhea was observed within 2–4 days of octreotideacetate treatment. Three patientsresponded to SC octreotide given every 8hours and the 4th patient tooctreotide given by continuous SC infusion.Conclusions. Our preliminary observation suggestsvalue of octreotide in the control of CPT-11induced refractory diarrhea. Prospectivestudies are warranted.

octreotide acetate somatostatin analogue CPT-11 diarrhea 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

REFERENCES

  1. 1.
    Leichman CG, Fleming TR, Muggia FM, Tangen CM, Ardalan B, Doroshow JH, Meyers FJ, Holcombe RF, Weiss GR, Mangalik A: Phase II study of fluorouracil and its modulation in advanced colorectal cancer: A Southwest Oncology Group study.J Clin Oncol13:1303–1311,1995Google Scholar
  2. 2.
    Petrelli N, Herrera L, Rustum Y, Burke P, Creaven P, Stulc J, Emrick LJ, Mittelman A: A prospective randomized trial of 5-fluorouracil versus 5-fluorouracil and high-dose leucovorin versus 5-fluorouracil and methotrexate in previously untreated patients with advanced colorectal carcinoma.J Clin Oncol5:1559–1565,1987Google Scholar
  3. 3.
    Conti JA, Kemeny NE, Saltz LB, Huang Y, Tong WP, Chou TC, Sun M, Pulliam S, Gonzalez C: Irinotecan is an active agent in untreated patients with metastatic colorectal cancer.J Clin Oncol14:709–715,1996Google Scholar
  4. 4.
    Saliba F, Hagipantelli R, Misset JL, Bastian G, Vassal G, Bonnay M, Herait P, Cote C, Mahjoubi M, Mignard D, Cvitkovic E: Pathophysiology and therapy of irinotecan-induced-delayedonset diarrhea in patients with advanced colorectal cancer: A prospective assessment.J Clin Oncol16:2745–2751,1998Google Scholar
  5. 5.
    Wadler S, Haynes H, Wiernik PH: Phase I trial of the somatostatin analog octreotide acetate in the treatment of fluoropyrimidine-induced diarrhea.J Clin Oncol13:222–226, 1995Google Scholar
  6. 6.
    Gebbia V, Carreca I, Testa A, Valenza R, Curto G, Cannata G, Borsellino N, Latteri MA, Cipolla C, Florena M: Subcutaneous octreotide versus oral loperamide in the treatment of diarrhea following chemotherapy.Anticancer Drugs4:443–445,1993Google Scholar
  7. 7.
    Cascinu S, Fedeli A, Fedeli SL, Catalano G:Control of chemotherapy-induced diarrhea with octreotide.Oncology51: 70–73,1994Google Scholar
  8. 8.
    Cascinu S, Fedeli A, Fedeli SL, Catalano G: Octreotide versus loperamide in the treatment of fluorouracil-induced diarrhea: a randomized trial.J Clin Oncol11:148–151,1993Google Scholar
  9. 9.
    Petrelli NJ, Rodriguez-Bigas M, Rustum Y, Herrera L, Creaven P: Bowel rest, intravenous hydration, and continuous highdose infusion of octreotide acetate for the treatment of chemotherapy-induced diarrhea in patients with colorectal carcinoma. Cancer72: 1543–1546,1993Google Scholar

Copyright information

© Kluwer Academic Publishers 2001

Authors and Affiliations

  • Barbara Pro
    • 1
  • Richard Lozano
    • 1
  • Jaffer A. Ajani
    • 1
  1. 1.Departments of Medical Oncology, Pharmacy, and Gastrointestinal Medical OncologyThe University of TexasHoustonU.S.A.

Personalised recommendations