Somatostatin Analogue(SMS 201-995) Decreases Plasma Levels of Corticotropin(ACTH) and Corticotropin-Releasing Hormone in a Patient with Ectopic ACTH-Producing Tumors.

Abstract

Effects of long-acting somatostain analogue (SMS 201-995) on plasma corticotropin (ACTH) and corticotropin-releasing hormone (CRH) levels were studied in a patient (63-year-old woman) with ectopic ACTH-producing tumors associated with type I multiple endocrine neoplasia (MEN-I). The patient had undergone bilateral adrenalectomy.Plasma CRH, as well as plasma ACTH, beta-endorphin and alpha-MSH, increased.The hormone levels were dramatically decreased by acute administration of SMS 201-995.Moderately higher doses of dexamethasone (0.05 or 0.1mg/kg a day) did not decrease plasma CRH or ACTH. An extremely high dose of dexamethasone (0.2mg/kg a day), however, decreased plasma ACTH, but failed to decrease plasma CRH.Acute administration of SMS 201-995 further lowered the level of plasma ACTH even in this condition.In addition to the decrease inACTH, SMS 201-995 decreased plasma CRH. Chronic administration of SMS 201-995 continuously decreased plasma CRH, ACTH and beta-endorphin. The decrease in these hormone concentrations accompanied the disappearance of hyperpigmentation.These results suggested that SMS 201-995 inhibits hypersecretion not only of ACTH but also of CRH, and that the agent is therapeutically useful in normalizing the hypersecretion of these hormones.

Ectopic ACTH secretion due to a bronchopulmonary carcinoid localized by somatostatin receptor scintigraphy

“…In our case the decrease in ACTH level after administration of a long-acting somatostatin analog characterizes these receptors as functional active ones, as has been reported by Suzuki et al [13] and De Rosa et al [1], too. SRS has been emphasized as a new approach in the diagnostic work-up of patients with neuroendocrine tumors, since the sensitivity of SRS significantly exceeds the sensitivity of well-established radiological imaging procedures, as has been evaluated in large series of gastroenteropancreatic neuroendocrine malignancies [2,[6][7][8][9].…”

Pharmacological Therapy of Cushings Syndrome: Drugs and Indications

“…A stabilization or even reduction in tumor volume has also been reported [81]. Further studies have confirmed initial results in patients with ectopic ACTH secretion [76,84,90,97,98], although some authors have reported negative results [99,100] or variable responsiveness to octreotide [101]. In summary, a review of patients with the ectopic ACTH syndrome showed that an acute response to octretide has been observed in 24 of 38 patients with the ectopic ACTH syndrome [102].…”