Glucagonoma Medication

Updated: May 14, 2015
  • Author: Luigi Santacroce, MD; Chief Editor: George T Griffing, MD  more...
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Medication

Medication Summary

Worldwide, octreotide is the only drug used for the treatment of glucagonomas. [11, 14, 15] In patients with diffuse metastases, antiproliferative drugs may be useful for palliating symptoms.

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Somatostatin Analogs

Class Summary

These medications include drugs with a multitude of endocrine and nonendocrine effects, including the inhibition of glucagon, VIP, and GI peptides. [14]

Octreotide (Sandostatin)

Synthetic analog of the hypothalamic peptide somatostatin that inhibits the secretion of pituitary and GI hormones, inducing an increase in the intestinal absorption of water and electrolytes, a decrease in pancreatic and gastric acid secretions, and a delay in intestinal transit time. Octreotide acts primarily on somatostatin receptor subtypes II and V. It inhibits GH secretion and has a multitude of other endocrine and nonendocrine effects, including the inhibition of glucagon, VIP, and GI peptides.

Lanreotide (Somatuline Depot)

Lanreotide is an analog of somatostatin, which is a peptide inhibitor of multiple endocrine, neuroendocrine, and exocrine mechanisms. It is indicated for unresectable, well-or moderately-differentiated, locally advanced or metastatic gastroenteropancreatic neuroendocrine tumors (GEP-NETs) to improve progression-free survival.

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Antineoplastic agents

Class Summary

These medications inhibit cell growth and differentiation.

Everolimus (Afinitor)

Rapamycin-derivative kinase inhibitor. Indicated for progressive neuroendocrine tumors located in the pancreas (PNET) that are metastatic or are not surgically resectable. Reduces cell proliferation and angiogenesis by inhibition of mTOR pathway.

Sunitinib (Sutent)

Mulitkinase inhibitor that targets several tyrosine kinase inhibitors implicated in tumor growth, pathologic angiogenesis, and metastatic progression. Inhibits platelet-derived growth factor receptors (ie, PDGFR-alpha, PDGFR-beta), vascular endothelial growth factor receptors (ie, VEGFR1, VEGFR2, VEGFR3), stem cell factor receptor (KIT), Fms-like tyrosine kinase-3 (FLT3), colony-stimulating factor receptor type 1 (CSF-1R), and the glial cell-line–derived neurotrophic factor receptor (RET).

Indicated for progressive, well-differentiated pancreatic neuroendocrine tumors in patients with unresectable locally advanced or metastatic disease.

Doxorubicin (Adriamycin, Rubex)

May be helpful for the palliation of symptoms in patients with progressive disease. The dosage is related to body surface area.

Fluorouracil (Adrucil)

Useful for the palliation of symptoms in patients with progressive disease.

Streptozocin (Zanosar)

Helpful for the palliation of symptoms in patients with progressive disease. The dosage is related to body surface area. Streptozocin may sometimes cause complete disease remission. The drug's administration must be suspended only when the desired response or toxicity occurs. Streptozocin may induce severe nephrotoxic effects.

Dacarbazine (DTIC-Dome)

Administration in patients with glucagonoma not established; however, dacarbazine may be helpful for the palliation of symptoms in patients in whom surgery is not feasible. Complete disease remission has been reported in only 1 patient.

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