Verhelst J, De Longueville M, Ongena P, Denis L, Mahler C
Department of Endocrinology, A.Z. Middelheim, Antwerp, Belgium.
Acta Urol Belg. 1994 Apr;62(1):83-8.
Since somatostatin analogues have been shown to possess inhibitory activity on prostatic cancer cells in animal models, we studied the clinical effects of the long-acting somatostatin analogue octreotide in the treatment of advanced prostatic cancer. Five patients with metastatic prostatic cancer in relapse under hormonal treatment and with rapidly increasing levels of prostate specific antigen (PSA) received a subcutaneous infusion of octreotide in a dose of 400 to 1,000 micrograms/day for a period of 2 to 6 months. Patients were followed clinically and by monthly measurement of PSA levels. During treatment 3/5 patients showed a temporary halt in rising PSA levels, while another patient had a small decrease. This inhibitory effect however was lost after 1 to 3 months of therapy in 3 patients. The remaining patient died after 4 months before an escape of PSA levels was seen. Side effects consisted of mild diarrhoea in three patients. From this very preliminary data, it appears that octreotide in a dose of 400 to 1,000 micrograms/day may give only a moderate and temporary inhibition of tumor growth in patients with advanced prostatic cancer. Because of the limited effects the study was interrupted prematurely. Since higher doses, other somatostatin-analogues or the combination of LHRH analogues may give better results, further studies are needed to determine the potential therapeutic role of somatostatin-analogues in this group of patients.
由于在动物模型中已证明生长抑素类似物对前列腺癌细胞具有抑制活性,我们研究了长效生长抑素类似物奥曲肽在治疗晚期前列腺癌中的临床效果。五名接受激素治疗后复发且前列腺特异性抗原(PSA)水平迅速升高的转移性前列腺癌患者,接受了皮下注射奥曲肽,剂量为每日400至1000微克,持续2至6个月。对患者进行临床随访并每月测量PSA水平。治疗期间,3/5的患者PSA水平暂时停止上升,另一名患者略有下降。然而,3名患者在治疗1至3个月后这种抑制作用消失。其余一名患者在4个月后死亡,此时尚未观察到PSA水平升高。副作用包括三名患者出现轻度腹泻。从这些非常初步的数据来看,每日剂量为400至1000微克的奥曲肽可能仅对晚期前列腺癌患者的肿瘤生长产生中度和暂时的抑制作用。由于效果有限,该研究提前中断。由于更高剂量、其他生长抑素类似物或促性腺激素释放激素类似物的联合使用可能会产生更好的效果,因此需要进一步研究来确定生长抑素类似物在这类患者中的潜在治疗作用。