Glucagonoma medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2], Mohammed Abdelwahed M.D[3]
Overview
The predominant medical therapy for primary glucagonoma is somatostatin analogs (octreotide). Metastatic tumors need hepatic artery embolization, radiofrequency ablation, and molecular therapy.
Management of Primary Tumor
- Somatostatin analogs (octreotide) are the treatment of choice to control symptoms.[1]
- Doxorubicin and streptozotocin have also been used successfully to selectively damage alpha cells of the pancreatic islets.
Drug regimen
Preferred regimen (1): Octreotide 400 micrograms/day
Metastasis Therapy
Hepatic artery embolization
- Hepatic arterial embolization is a palliative treatment in patients with symptomatic hepatic metastases who are not candidates for surgical resection.
- Embolization can be performed via the infusion through an angiography catheter into hepatic arteries.
Radiofrequency ablation
- Ablation can be performed percutaneously or laparoscopically in patients with symptomatic hepatic metastases who are not candidates for surgical resection.
- Ablation is applicable only to smaller lesions less than 3 cm.[2]
Molecular therapy
- Sunitinib is a radio-labeled somatostatin analog which has a role in the management of glucagonoma's that are not symptomatic or have rapidly progressive metastasis.
References
- ↑ Rosenbaum A, Flourie B, Chagnon S, Blery M, Modigliani R (1989). "Octreotide (SMS 201-995) in the treatment of metastatic glucagonoma: report of one case and review of the literature". Digestion. 42 (2): 116–20. PMID 2548911.
- ↑ Gupta S, Yao JC, Ahrar K, Wallace MJ, Morello FA, Madoff DC; et al. (2003). "Hepatic artery embolization and chemoembolization for treatment of patients with metastatic carcinoid tumors: the M.D. Anderson experience". Cancer J. 9 (4): 261–7. PMID 12967136.