Phase I trial of the somatostatin analog octreotide acetate in the treatment of fluoropyrimidine-induced diarrhea

S. Wadler, Hilda Haynes-Lewis, P. H. Wiernik

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

Purpose: Diarrhea is one of the dose-limiting toxicities for administration of fluorouracil (5FU) in patients with gastrointestinal malignancies and can result in severe morbidities or mortality. The somatostatin analog octreotide acetate has been used in the treatment of 5FU- induced diarrhea with promising results. A phase I trial was initiated to determine the maximum-tolerated dose of octreotide acetate that could be administered in this setting. Patients and Methods: Patients were required to have National Cancer Institute Common Toxicity Criteria ≥ grade 2 diarrhea or watery diarrhea secondary to treatment with 5FU or a modulated 5FU regimen. At least three patients were treated at each dose level; after satisfactory completion of this dose level (zero of three or one of six patients with ≤ grade 2 toxicity), additional patients were added at the next dose level. Doses of octreotide acetate studied were 50 to 2,500 μg subcutaneously three times daily for 5 days. Results: A total of 35 patients received 49 courses of therapy. The only significant toxicities occurred at 2,500 μg. At this dose level, one patient developed an allergic reaction with flushing, nausea, and dizziness after each of the first two injections. A second patient developed asymptomatic hypoglycemia with a serum glucose level of 26 mg/dL. The maximum-tolerated dose was 2,000 μg. The efficacy of the treatment correlated significantly (P = .01) with the dose of octreotide administered, and more patients completed the course of therapy at the higher doses. Conclusion: Octreotide acetate can be safely administered treatment of fluoropyrimidine-induced diarrhea in patients with gastrointestinal malignancies. The dose-limiting toxicities were allergic (nausea, rash, and light-headedness) and endocrine (hypoglycemia). There was a significant correlation between complete response to therapy and octreotide dose.

Original languageEnglish (US)
Pages (from-to)222-226
Number of pages5
JournalJournal of Clinical Oncology
Volume13
Issue number1
StatePublished - Jan 1 1995

Fingerprint

Octreotide
Diarrhea
Fluorouracil
Therapeutics
Maximum Tolerated Dose
Dizziness
Hypoglycemia
Nausea
somatostatin-22
National Cancer Institute (U.S.)
Exanthema
Somatostatin
Neoplasms
Hypersensitivity
Morbidity

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Phase I trial of the somatostatin analog octreotide acetate in the treatment of fluoropyrimidine-induced diarrhea. / Wadler, S.; Haynes-Lewis, Hilda; Wiernik, P. H.

In: Journal of Clinical Oncology, Vol. 13, No. 1, 01.01.1995, p. 222-226.

Research output: Contribution to journalArticle

@article{e99a584d123a4bb5b18f003f30381165,
title = "Phase I trial of the somatostatin analog octreotide acetate in the treatment of fluoropyrimidine-induced diarrhea",
abstract = "Purpose: Diarrhea is one of the dose-limiting toxicities for administration of fluorouracil (5FU) in patients with gastrointestinal malignancies and can result in severe morbidities or mortality. The somatostatin analog octreotide acetate has been used in the treatment of 5FU- induced diarrhea with promising results. A phase I trial was initiated to determine the maximum-tolerated dose of octreotide acetate that could be administered in this setting. Patients and Methods: Patients were required to have National Cancer Institute Common Toxicity Criteria ≥ grade 2 diarrhea or watery diarrhea secondary to treatment with 5FU or a modulated 5FU regimen. At least three patients were treated at each dose level; after satisfactory completion of this dose level (zero of three or one of six patients with ≤ grade 2 toxicity), additional patients were added at the next dose level. Doses of octreotide acetate studied were 50 to 2,500 μg subcutaneously three times daily for 5 days. Results: A total of 35 patients received 49 courses of therapy. The only significant toxicities occurred at 2,500 μg. At this dose level, one patient developed an allergic reaction with flushing, nausea, and dizziness after each of the first two injections. A second patient developed asymptomatic hypoglycemia with a serum glucose level of 26 mg/dL. The maximum-tolerated dose was 2,000 μg. The efficacy of the treatment correlated significantly (P = .01) with the dose of octreotide administered, and more patients completed the course of therapy at the higher doses. Conclusion: Octreotide acetate can be safely administered treatment of fluoropyrimidine-induced diarrhea in patients with gastrointestinal malignancies. The dose-limiting toxicities were allergic (nausea, rash, and light-headedness) and endocrine (hypoglycemia). There was a significant correlation between complete response to therapy and octreotide dose.",
author = "S. Wadler and Hilda Haynes-Lewis and Wiernik, {P. H.}",
year = "1995",
month = "1",
day = "1",
language = "English (US)",
volume = "13",
pages = "222--226",
journal = "Journal of Clinical Oncology",
issn = "0732-183X",
publisher = "American Society of Clinical Oncology",
number = "1",

}

TY - JOUR

T1 - Phase I trial of the somatostatin analog octreotide acetate in the treatment of fluoropyrimidine-induced diarrhea

AU - Wadler, S.

AU - Haynes-Lewis, Hilda

AU - Wiernik, P. H.

PY - 1995/1/1

Y1 - 1995/1/1

N2 - Purpose: Diarrhea is one of the dose-limiting toxicities for administration of fluorouracil (5FU) in patients with gastrointestinal malignancies and can result in severe morbidities or mortality. The somatostatin analog octreotide acetate has been used in the treatment of 5FU- induced diarrhea with promising results. A phase I trial was initiated to determine the maximum-tolerated dose of octreotide acetate that could be administered in this setting. Patients and Methods: Patients were required to have National Cancer Institute Common Toxicity Criteria ≥ grade 2 diarrhea or watery diarrhea secondary to treatment with 5FU or a modulated 5FU regimen. At least three patients were treated at each dose level; after satisfactory completion of this dose level (zero of three or one of six patients with ≤ grade 2 toxicity), additional patients were added at the next dose level. Doses of octreotide acetate studied were 50 to 2,500 μg subcutaneously three times daily for 5 days. Results: A total of 35 patients received 49 courses of therapy. The only significant toxicities occurred at 2,500 μg. At this dose level, one patient developed an allergic reaction with flushing, nausea, and dizziness after each of the first two injections. A second patient developed asymptomatic hypoglycemia with a serum glucose level of 26 mg/dL. The maximum-tolerated dose was 2,000 μg. The efficacy of the treatment correlated significantly (P = .01) with the dose of octreotide administered, and more patients completed the course of therapy at the higher doses. Conclusion: Octreotide acetate can be safely administered treatment of fluoropyrimidine-induced diarrhea in patients with gastrointestinal malignancies. The dose-limiting toxicities were allergic (nausea, rash, and light-headedness) and endocrine (hypoglycemia). There was a significant correlation between complete response to therapy and octreotide dose.

AB - Purpose: Diarrhea is one of the dose-limiting toxicities for administration of fluorouracil (5FU) in patients with gastrointestinal malignancies and can result in severe morbidities or mortality. The somatostatin analog octreotide acetate has been used in the treatment of 5FU- induced diarrhea with promising results. A phase I trial was initiated to determine the maximum-tolerated dose of octreotide acetate that could be administered in this setting. Patients and Methods: Patients were required to have National Cancer Institute Common Toxicity Criteria ≥ grade 2 diarrhea or watery diarrhea secondary to treatment with 5FU or a modulated 5FU regimen. At least three patients were treated at each dose level; after satisfactory completion of this dose level (zero of three or one of six patients with ≤ grade 2 toxicity), additional patients were added at the next dose level. Doses of octreotide acetate studied were 50 to 2,500 μg subcutaneously three times daily for 5 days. Results: A total of 35 patients received 49 courses of therapy. The only significant toxicities occurred at 2,500 μg. At this dose level, one patient developed an allergic reaction with flushing, nausea, and dizziness after each of the first two injections. A second patient developed asymptomatic hypoglycemia with a serum glucose level of 26 mg/dL. The maximum-tolerated dose was 2,000 μg. The efficacy of the treatment correlated significantly (P = .01) with the dose of octreotide administered, and more patients completed the course of therapy at the higher doses. Conclusion: Octreotide acetate can be safely administered treatment of fluoropyrimidine-induced diarrhea in patients with gastrointestinal malignancies. The dose-limiting toxicities were allergic (nausea, rash, and light-headedness) and endocrine (hypoglycemia). There was a significant correlation between complete response to therapy and octreotide dose.

UR - http://www.scopus.com/inward/record.url?scp=0028815907&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028815907&partnerID=8YFLogxK

M3 - Article

C2 - 7799023

AN - SCOPUS:0028815907

VL - 13

SP - 222

EP - 226

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

SN - 0732-183X

IS - 1

ER -