Amit Tirosh1,2, Salomon M Stemmer2,3, Evgeny Solomonov4, Eldad Elnekave3, Wolfgang Saeger5, Yelena Ravkin6, Kobi Nir7, Yeela Talmor8, Ilan Shimon9,10. 1. Endocrine Institute, Rabin Medical Center, Petah Tiqva, Israel. 2. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 3. Institute of Oncology, Davidoff Center, Rabin Medical Center, Petah Tiqva, Israel. 4. Surgery, Rivka Ziv medical center, Sefad, Israel. 5. Institute of Neuropathology, University of Hamburg, Hamburg, Germany. 6. Dan-Petah Tiqva district, Clalit Health Services, Petah Tiqva, Israel. 7. Novartis Pharma Services, Petah Tiqva, Israel. 8. Internal Medicine F, Rabin Medical Center, Petah Tiqva, Israel. 9. Endocrine Institute, Rabin Medical Center, Petah Tiqva, Israel. ilanshi@clalit.org.il. 10. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. ilanshi@clalit.org.il.
Abstract
UNLABELLED: Malignant insulinoma usually has a poor prognosis, as no efficient medical treatment is available. The somatostatin analogs octreotide and lanreotide have limited ability to control the hypoglycemic events. Pasireotide is a multi-receptor targeted somatostatin-analog with improved affinity for SSTR5. There is to date no reported treatment experience with this drug in such tumors. CASE DESCRIPTION: A 72-year-old patient with a G2 stage IV insulinoma, who underwent excision of the primary pancreatic tumor and multiple hepatic metastases, required further treatment for recurrent hypoglycemic events. The glycemic control achieved with pasireotide LAR was better compared with lanreotide and everolimus. However, none of these treatments showed tumor anti-proliferative effects. CONCLUSIONS: Pasireotide monthly injections achieved improved glycemic control in a patient with malignant insulinoma and recurrent hypoglycemic events compared with other medical treatments.
UNLABELLED: Malignant insulinoma usually has a poor prognosis, as no efficient medical treatment is available. The somatostatin analogs octreotide and lanreotide have limited ability to control the hypoglycemic events. Pasireotide is a multi-receptor targeted somatostatin-analog with improved affinity for SSTR5. There is to date no reported treatment experience with this drug in such tumors. CASE DESCRIPTION: A 72-year-old patient with a G2 stage IV insulinoma, who underwent excision of the primary pancreatic tumor and multiple hepatic metastases, required further treatment for recurrent hypoglycemic events. The glycemic control achieved with pasireotide LAR was better compared with lanreotide and everolimus. However, none of these treatments showed tumor anti-proliferative effects. CONCLUSIONS: Pasireotide monthly injections achieved improved glycemic control in a patient with malignant insulinoma and recurrent hypoglycemic events compared with other medical treatments.
Authors: Maria Luisa Brandi; Sunita K Agarwal; Nancy D Perrier; Kate E Lines; Gerlof D Valk; Rajesh V Thakker Journal: Endocr Rev Date: 2021-03-15 Impact factor: 19.871