Octreotide for meningioma – pro
Lay Summary: Case reports usggest that octreotide may casue regression of some meningiomas.
For more than a decade, In-111 octreotide has been known to accumulate in meningiomas as a result of the expression of subtype 2 somatostatin receptors. Improved imaging characteristics can be expected with the recently developed radiotracer Tc-99m depreotide, which also binds to subtype 2 somatostatin receptors. SPECT with Tc-99m depreotide and orm In-111 octreotide imaging are both useful.
Therapeutically, octreotide has also been reported to cause regressions. The first report was in 1993. Garcia-Luna et al reported on the clinical use ofoctreotide, a long-acting somatostatin agonist, in 3patients with unresectable meningiomas. Doses usedwere gradually increased up to 1000, 900, and 1500µg/24 hours during 16, 6, and 7 weeks, respectively.Patient tolerance to the drug was excellent, withabdominal discomfort and diarrhea observed in only 1patient. Findings included the subjective improvementof headache in 2 patients and objective transientimprovement in ocular movements in 1 patient. In allcases, computed tomography scans observed nochange in meningioma size. This report confirms thesafety of octreotide but was too small to draw any mean-ingful conclusions. Since then a number of other case reports have appeard but no prospsective studies have been published.
For more than a decade, In-111 octreotide has been known to accumulate in meningiomas as a result of the expression of subtype 2 somatostatin receptors. Improved imaging characteristics can be expected with the recently developed radiotracer Tc-99m depreotide, which also binds to subtype 2 somatostatin receptors. SPECT with Tc-99m depreotide and orm In-111 octreotide imaging are both useful.
Therapeutically, octreotide has also been reported to cause regressions. The first report was in 1993. Garcia-Luna et al reported on the clinical use ofoctreotide, a long-acting somatostatin agonist, in 3patients with unresectable meningiomas. Doses usedwere gradually increased up to 1000, 900, and 1500µg/24 hours during 16, 6, and 7 weeks, respectively.Patient tolerance to the drug was excellent, withabdominal discomfort and diarrhea observed in only 1patient. Findings included the subjective improvementof headache in 2 patients and objective transientimprovement in ocular movements in 1 patient. In allcases, computed tomography scans observed nochange in meningioma size. This report confirms thesafety of octreotide but was too small to draw any mean-ingful conclusions. Since then a number of other case reports have appeard but no prospective studies have been published.
Jaffrain-Rea ML, Minniti G, Santoro A, et al. Visual improvement during octreotide therapy in a case of episellar meningioma. Clin Neurol Neurosurg. Mar 1998;100(1):40-3.
Garcia-Luna PP, Relimpio F, Pumar A, et al. Clinical use of octreotide in unresectable meningiomas: a report of three cases. J Neurosurg Sci. 1993;37:237-241.
Marc C. Chamberlain, MD, Michael J. Glantz, MD and Camilo E. Fadul, MDRecurrent meningioma
Salvage therapy with long-acting somatostatin analogue NEUROLOGY 2007;69:969-973