Malignant insulinoma: is combined treatment with verapamil and the long-acting somatostatin analogue octreotide (SMS 201-995) more effective than single therapy with either drug?

The efficacy of treatment with either verapamil (V), the long-acting somatostatin analogue octreotide (OCT) alone, and the combined treatment (V + OCT) were studied in a patient with a symptomatic metastasized malignant insulinoma. Treatment with V alone resulted in a slight increase in blood glucose levels. Treatment with OCT alone resulted in a clear increase in blood glucose levels. Treatment with V + OCT was slightly more effective than single therapy with either drug but could not prevent hypoglycaemic episodes completely. It is also shown that the effect of treatment with V and OCT alone on glucoregulatory hormones is completely different. While treatment with V did not inhibit insulin secretion, treatment with OCT clearly did. Treatment with OCT might also modify counterregulatory hormone secretion during hypoglycaemia.