Therapeutic Response to Octreotide in Patients with Refractory CPT-11 Induced Diarrhea

Abstract

Purpose. Severe diarrhea can represent adose-limiting toxicity with the use ofCPT-11. Conventional therapy isineffective in some patients and is alsolimited by patient compliance. We reportour observation on the effectiveness ofoctreotide acetate in the treatment ofCPT-11-induced diarrhea refractory toopioids. Patients and methods. We describe 4 patientswith metastaticgastrointestinal tumors who developedsevere diarrhea following treatment withCPT-11 (65–125 mg/m²/weekly for 4weeks every 6 weeks). Diarrhea wasrefractory to treatment with loperamide anddiphenoxylate and was treated withoctreotide acetate. Results. Complete resolution ofdiarrhea was observed within 2–4 days of octreotideacetate treatment. Three patientsresponded to SC octreotide given every 8hours and the 4th patient tooctreotide given by continuous SC infusion.Conclusions. Our preliminary observation suggestsvalue of octreotide in the control of CPT-11induced refractory diarrhea. Prospectivestudies are warranted.