EFFECTS OF SOMATOSTATIN-14 IN THE CARCINOID-SYNDROME - CLINICAL AND BIOLOGICAL STUDIES IN 2 CASES

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  • 1 January 1983
    • journal article
    • research article
    • Vol. 7  (12) , 1016-1022
Abstract
The effects of synthetic cyclic somatostatin 14 (ST14) were studied in 3 patients with carcinoid syndrome. The 3-h i.v. administration of somatostatin (250 .mu.g/h) resulted in the disappearance of flushing [paroxysmal vasomotor accidents] in the 1st patient, but was without any clinical effect in the 2nd subject who remained chronically cyanotic. Lowered plasma levels of motilin, prostaglandins (E1, E2 and F2.alpha.) and to a lesser extent of catecholamines were observed in both patients, whereas the serotonin level was not altered. ST14 administration was followed by a rebound effect with recurrence of severe flushing in the 1st paient and was associated with a dramatic increase of prostaglandin, substance P and catecholamine levels in both patients. The inhibitory effect of somatostatin and the occurrence of a rebound effect at the end of infusion were confirmed by infusing ST14 (6 mg/day) during 48 h in the 1st patients. Somatostatin is an effective drug in carcinoid syndrome with severe flushing; and several mediators are affected in carcinoid syndrome. However it could not be excluded that increased circulating levels of prostaglandins, substance P and catecholamines may represent unrelated secondary events. ST14 may primarily inhibit the release rather than the synthesis of tumor products. Due to the severity of the rebound effect, treatment of carcinoid syndrome with ST14 must be undertaken with precaution until specific long-acting analogs are available.