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Minerva Chirurgica 2016 April;71(2):91-7


language: English

Long-acting octreotide as secondary prevention of chemotherapy-induced diarrhea: proof of concept

Bert VAN DEN HEUVEL 1, Marc PEETERS 1, Alain HENDLISZ 2, Marc VAN DEN EYNDE 3, Godelieve MACHIELS 2, Isabel DERO 4, Karen GEBOES 5, Marc DE MAN 5, Koen HENDRICKX 6, Thierry DELAUNOIT 7, Els MONSAERT 8, Erik VANDERSTRAETEN 8, Jean L. VAN LAETHEM 9, Willem LYBAERT 10, Stephane HOLBRECHTS 11, Christian ROLFO 1

1 Department of Medical Oncology, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium; 2 Department of Digestive Oncology, Jules Bordet Institute, Brussels, Belgium; 3 Department of Gastroenterology, Catholic University of Louvain, Brussels, Belgium; 4 Department of Gastroenterology, Sint Augustinus Hospital, GZA Hospital Group, Wilrijk, Belgium; 5 Department of Gastroenterology, Ghent University Hospital, Ghent, Belgium; 6 Onze-Lieve-Vrouw Hospital, Aalst, Belgium; 7 Department of Gastroenterology, Jolimont Hospital, Haine-Saint-Paul, Belgium; 8 Department of Gastroenterology, Maria Middelares Hospital, Ghent, Belgium; 9 Department of Gastroenterology, Erasme Hospital, Brussels, Belgium; 10 Department of Medical Oncology, Nikolaas Hospital, Sint-Niklaas, Belgium; 11 Department of Gastroenterology, Ambroise Paré University Hospital, Mons, Belgium


BACKGROUND: The aim of this study is to investigate the role of octreotide long-acting release (LAR) in secondary prevention in patients with chemotherapy-induced diarrhea.
METHODS: In this study, patients experiencing CID ≥ grade 2 received 30 mg long-acting octreotide as a monthly injection and the next chemotherapy dose was administrated with a 25% dose decrease. If no CID ≥ grade 2 occurred, subsequent chemotherapy doses were increased to the initial 100% values. The primary endpoint of the study was the diarrhea control rate (< grade 2) for patients receiving the optimal dose of chemotherapy for a minimum of 2 cycles.
RESULTS: Twenty-nine patients were included. Ten patients experienced no improvement or ended the study very early after the first injection of octreotide LAR. Nineteen patients had a reduction in the grade of diarrhea after the first administration of octreotide LAR and a reduced chemotherapy dose. Seven of them (24%) did not reach the end of the study because of disease progression (6) or lost to follow-up (1). Ultimately, 12 patients (41%) continued the study till the end. In ten of these twelve patients, there was a significant and persisting reduction of diarrhea while receiving full-dose chemotherapy.
CONCLUSIONS: This study suggests that monthly injections with long-acting octreotide might be used as a secondary prevention of chemotherapy-induced diarrhea. Its usefulness and optimal dosage in secondary prevention in combination with antidiarrheal agents needs further research.

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