Resolution of refractory chemotherapy-induced diarrhea (CID) with octreotide long-acting formulation in cancer patients: 11 case studies

Rosenoff, Stephen H.

doi:10.1007/s00520-003-0507-z

Cited by 23 publications

(11 citation statements)

References 21 publications

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“…Approximately 65% of patients with CID require a lower dose (i.e., fewer mg/kg) at some point in their chemotherapy courses, 45% require fewer doses (i.e., less often), and 71% experience a temporary or permanent cessation of treatment (96). Pharmacologic treatments for CID include loperamide as well as some off-label use of octreotide and tincture of opium, all of which offer limited benefit in mild diarrhea and minimal benefit in severe CID (101, 110–114). More complicated cases require vigilant medical monitoring, aggressive pharmacologic treatment, intravenous fluids in outpatient settings, and even hospitalization (101).…”

Section: Alleviating Irinotecan-induced Enteropathymentioning

confidence: 99%

Understanding and Modulating Mammalian-Microbial Communication for Improved Human Health

Mani

Boelsterli

Redinbo

2014

Annu. Rev. Pharmacol. Toxicol.

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The fact that the bacteria in the human gastrointestinal (GI) tract play a symbiotic role was noted as early as 1885, well before we began to manage microbial infections using antibiotics. However, even with the first antimicrobial compounds used in humans, the sulfa drugs, microbes were recognized to be critically involved in the biotransformation of these therapeutics. Thus, the roles played by the microbiota in physiology and in the management of human health have long been appreciated. Detailed examinations of GI symbiotic bacteria that started in the early 2000s and the first phases of the Human Microbiome Project that were completed in 2012 have ushered in an exciting period of granularity with respect to the ecology, genetics, and chemistry of the mammalian-microbial axes of communication. Here we review aspects of the biochemical pathways at play between commensal GI bacteria and several mammalian systems, including both local-epithelia and nonlocal responses including inflammation, immunology, metabolism, and neurobiology. Finally, we discuss how the microbial biotransformation of therapeutic compounds, such as anticancer or nonsteroidal anti-inflammatory drugs, can be modulated to reduce toxicity and potentially improve therapeutic efficacy.

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Section: Alleviating Irinotecan-induced Enteropathymentioning

confidence: 99%

Understanding and Modulating Mammalian-Microbial Communication for Improved Human Health

Mani

Boelsterli

Redinbo

2014

Annu. Rev. Pharmacol. Toxicol.

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“…For patients with refractory CID, octreotide LAR may shorten the duration of diarrhoea, thus improving the quality of life by decreasing abdominal cramping and diarrhoea. 22 Based on results from clinical studies, octreotide LAR may be administered as a prophylactic agent prior to chemotherapy or the next cycle of chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…In several patients who developed refractory CID towards conventional therapy, octreotide LAR sped up the resolution of CID and limited further episodes of diarrhoea during subsequent cycles of chemotherapy. 22 Another study indicated that octreotide LAR can be used as a secondary preventive approach in patients experiencing grade 2–4 CID, and monthly injections reduced the incidence of diarrhoea while the chemotherapeutic regimen was completed. 23 However, inconsistent results were also reported.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of long-acting release octreotide for preventing chemotherapy-induced diarrhoea: protocol for a systematic review

Deng

Jia

et al. 2017

BMJ Open

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IntroductionDiarrhoea is a common adverse effect induced by chemotherapy that can reduce the dose of chemotherapeutic drugs or interrupt the chemotherapy schedule. The current treatment strategies have various limitations. It has been shown that long-acting release octreotide (octreotide LAR) can decrease the occurrence and severity of diarrhoea, yet the efficacy of octreotide LAR in preventing chemotherapy-induced diarrhoea (CID) remains to be assessed. The main objective of this paper was to draw up a protocol for systematic review to evaluate the protective effects of octreotide LAR on CID.Methods and analysisWe searched Medline, EMBASE, the Cochrane Library, Chinese National Knowledge Infrastructure, Wanfang Data and the VIP Database without language restrictions from inception until 1 September 2016. The references of relevant studies were also manually searched. Two investigators independently accessed the selected studies, extracted data and assessed the reliability of the studies. Any discrepancies were resolved by a third investigator. The effect size of the selected studies was assessed by different measures based on the type of data. The selected studies were descriptively analysed. We then chose a fixed-effect model or a random-effect model based on statistical homogeneity, and pooled data from the studies for meta-analysis, if possible. The primary outcome was the incidence of diarrhoea. The secondary outcomes were the duration of diarrhoea, incidence of diarrhoea-associated symptoms, physical function and quality of life. All statistical analyses were performed by Review Manager V.5.3.Ethics and disseminationThis systematic review did not require ethics approval, because it included aggregated published data, and not individual patient data. The review was published in a peer-reviewed journal.Trial registrationThis systematic review protocol was registered with PROSPERO (registration number: CRD 42016048573).

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“…This formulation has demonstrated efficacy in resolving severe diarrhea and preventing further episodes of diarrhea in patients receiving ongoing therapy. 70 Other Agents. Budesonide is an orally administered, topically active steroid with high activity in IBD, a 90% first pass effect in the liver and, therefore, low systemic availability.…”

Section: Antidiarrheal Medicationsmentioning

confidence: 99%

Evaluation and Management of Treatment-Related Diarrhea in Patients with Advanced Cancer: A Review

Cherny

2008

Journal of Pain and Symptom Management

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Diarrhea is a common and significant problem among patients with advanced cancer. Treatment-induced diarrhea can be severe and be associated with life-threatening dehydration and electrolyte abnormalities. The causes of diarrhea among patients with advanced cancer are diverse and some causes of diarrhea require specific therapies. Thus, careful evaluation of the underlying cause is necessary. Palliative care clinicians, particularly those dealing with patients receiving ongoing disease-modifying therapies, must be familiar with the common causes of diarrhea among cancer patients and the strategies to evaluate and manage these common and distressing symptoms. This article addresses four major issues: 1) a review of the causes of treatment-related diarrhea, focusing on diarrhea caused by chemotherapy, targeted therapies, and radiotherapy; 2) differential diagnosis and an approach to evaluation; 3) general management considerations; and 4) cause-specific issues in management.

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Resolution of refractory chemotherapy-induced diarrhea (CID) with octreotide long-acting formulation in cancer patients: 11 case studies

Cited by 23 publications

References 21 publications

Understanding and Modulating Mammalian-Microbial Communication for Improved Human Health

Understanding and Modulating Mammalian-Microbial Communication for Improved Human Health

Efficacy of long-acting release octreotide for preventing chemotherapy-induced diarrhoea: protocol for a systematic review

Evaluation and Management of Treatment-Related Diarrhea in Patients with Advanced Cancer: A Review

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