Streptozotocin for Malignant Insulinomas and Carcinoid Tumor

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Abstract
Four patients with metastatic insulinoma were treated with streptozotocin, with one complete remission lasting for one year. This patient received a total of 4.0 gm, equivalent to lowest dose producing a response. No objective response was observed in four patients with malignant carcinoid. We report a case of major bone marrow depression following treatment with streptozotocin. Serum half-life of streptozotocin was 15 minutes. For all drug dose levels, peak serum concentrations obtained were similar since infusion rate was limited by pain at injection site. Despite limited response observed in this study, our experience and data reviewed from the literature suggest that streptozotocin is the best form of chemotherapy presently available for malignant insulinoma.