A pilot study of long-acting octreotide for symptomatic malignant ascites

Aminah Jatoi, Jorge J. Nieva, Rui Qin, Charles Lawrence Loprinzi, Edward J. Wos, Paul J. Novotny, Dennis F. Moore, Rex B. Mowat, Naftali Bechar, Eduardo R. Pajon, Lynn C. Hartmann

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: Effective, non-invasive, palliative strategies for symptomatic malignant ascites are unavailable. This trial explored whether octreotide, an inhibitor of vascular endothelial growth factor, a putative mediator of ascites, prolongs the interval to next paracentesis. Methods: After a baseline paracentesis and a test of short-acting agent, patients with symptomatic ascites were randomly assigned to long-acting octreotide (Sandostatin LAR®) depot 30 mg intramuscularly every month versus 0.9% sodium chloride administered similarly. Patients were then monitored for recurrent, symptomatic ascites. Results: Thirty-three patients were enrolled: 16 assigned to the octreotide and 17 to the control arm. The median time to next paracentesis was 28 and 14 days in the octreotide and placebo arm, respectively (p = 0.17). After adjustment for extracted ascites volume and abdominal girth change, no statistically significant difference between the groups was observed (hazard ratio = 0.52, with a 95% confidence interval of 0.21-1.28; p = 0.15, per Cox model). Octreotide-treated patients described less of abdominal bloating (p = 0.01), abdominal discomfort (p = 0.02), and shortness of breath (p = 0.007) at one month, although other quality of life symptoms were comparable between the arms. Long-acting octreotide was reasonably well tolerated. Conclusion: As prescribed in this trial, octreotide did not seem effective in prolonging the time to next paracentesis, although improvements in symptoms suggest that vascular endothelial growth factor inhibition merits further investigation.

Original languageEnglish (US)
Pages (from-to)315-320
Number of pages6
JournalOncology (Switzerland)
Volume82
Issue number6
DOIs
StatePublished - Jul 2012

Fingerprint

Octreotide
Ascites
Paracentesis
Vascular Endothelial Growth Factor A
Proxy
Proportional Hazards Models
Sodium Chloride
Dyspnea
Placebos
Quality of Life
Confidence Intervals

Keywords

  • Malignant ascites
  • Octreotide
  • Paracentesis

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

A pilot study of long-acting octreotide for symptomatic malignant ascites. / Jatoi, Aminah; Nieva, Jorge J.; Qin, Rui; Loprinzi, Charles Lawrence; Wos, Edward J.; Novotny, Paul J.; Moore, Dennis F.; Mowat, Rex B.; Bechar, Naftali; Pajon, Eduardo R.; Hartmann, Lynn C.

In: Oncology (Switzerland), Vol. 82, No. 6, 07.2012, p. 315-320.

Research output: Contribution to journalArticle

Jatoi, A, Nieva, JJ, Qin, R, Loprinzi, CL, Wos, EJ, Novotny, PJ, Moore, DF, Mowat, RB, Bechar, N, Pajon, ER & Hartmann, LC 2012, 'A pilot study of long-acting octreotide for symptomatic malignant ascites', Oncology (Switzerland), vol. 82, no. 6, pp. 315-320. https://doi.org/10.1159/000337246
Jatoi, Aminah ; Nieva, Jorge J. ; Qin, Rui ; Loprinzi, Charles Lawrence ; Wos, Edward J. ; Novotny, Paul J. ; Moore, Dennis F. ; Mowat, Rex B. ; Bechar, Naftali ; Pajon, Eduardo R. ; Hartmann, Lynn C. / A pilot study of long-acting octreotide for symptomatic malignant ascites. In: Oncology (Switzerland). 2012 ; Vol. 82, No. 6. pp. 315-320.
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AU - Jatoi, Aminah

AU - Nieva, Jorge J.

AU - Qin, Rui

AU - Loprinzi, Charles Lawrence

AU - Wos, Edward J.

AU - Novotny, Paul J.

AU - Moore, Dennis F.

AU - Mowat, Rex B.

AU - Bechar, Naftali

AU - Pajon, Eduardo R.

AU - Hartmann, Lynn C.

PY - 2012/7

Y1 - 2012/7

N2 - Background: Effective, non-invasive, palliative strategies for symptomatic malignant ascites are unavailable. This trial explored whether octreotide, an inhibitor of vascular endothelial growth factor, a putative mediator of ascites, prolongs the interval to next paracentesis. Methods: After a baseline paracentesis and a test of short-acting agent, patients with symptomatic ascites were randomly assigned to long-acting octreotide (Sandostatin LAR®) depot 30 mg intramuscularly every month versus 0.9% sodium chloride administered similarly. Patients were then monitored for recurrent, symptomatic ascites. Results: Thirty-three patients were enrolled: 16 assigned to the octreotide and 17 to the control arm. The median time to next paracentesis was 28 and 14 days in the octreotide and placebo arm, respectively (p = 0.17). After adjustment for extracted ascites volume and abdominal girth change, no statistically significant difference between the groups was observed (hazard ratio = 0.52, with a 95% confidence interval of 0.21-1.28; p = 0.15, per Cox model). Octreotide-treated patients described less of abdominal bloating (p = 0.01), abdominal discomfort (p = 0.02), and shortness of breath (p = 0.007) at one month, although other quality of life symptoms were comparable between the arms. Long-acting octreotide was reasonably well tolerated. Conclusion: As prescribed in this trial, octreotide did not seem effective in prolonging the time to next paracentesis, although improvements in symptoms suggest that vascular endothelial growth factor inhibition merits further investigation.

AB - Background: Effective, non-invasive, palliative strategies for symptomatic malignant ascites are unavailable. This trial explored whether octreotide, an inhibitor of vascular endothelial growth factor, a putative mediator of ascites, prolongs the interval to next paracentesis. Methods: After a baseline paracentesis and a test of short-acting agent, patients with symptomatic ascites were randomly assigned to long-acting octreotide (Sandostatin LAR®) depot 30 mg intramuscularly every month versus 0.9% sodium chloride administered similarly. Patients were then monitored for recurrent, symptomatic ascites. Results: Thirty-three patients were enrolled: 16 assigned to the octreotide and 17 to the control arm. The median time to next paracentesis was 28 and 14 days in the octreotide and placebo arm, respectively (p = 0.17). After adjustment for extracted ascites volume and abdominal girth change, no statistically significant difference between the groups was observed (hazard ratio = 0.52, with a 95% confidence interval of 0.21-1.28; p = 0.15, per Cox model). Octreotide-treated patients described less of abdominal bloating (p = 0.01), abdominal discomfort (p = 0.02), and shortness of breath (p = 0.007) at one month, although other quality of life symptoms were comparable between the arms. Long-acting octreotide was reasonably well tolerated. Conclusion: As prescribed in this trial, octreotide did not seem effective in prolonging the time to next paracentesis, although improvements in symptoms suggest that vascular endothelial growth factor inhibition merits further investigation.

KW - Malignant ascites

KW - Octreotide

KW - Paracentesis

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