Biologic study of the effects of octreotide-LAR on growth hormone in unresectable and metastatic hepatocellular carcinoma

Steven Attia, Kyle D. Holen, James P. Thomas, Kelly Richie, Torie Dzelak, Kristine Teeter, Deb Warren, Andrea Bilger, Jason Fine, Jens Eickhoff, Norman Drinkwater, Daniel Mulkerin, Sherry Morgan-Meadows

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Background: Animal models suggest that growth hormone participates in hepatocarcinogenesis. Objective: To correlate the effect of octreotide long-acting release (LAR) on insulin-like growth factor-I (ICF-I) and -II (IGF-II) with response and survival in patients with unresectable and metastatic hepatocellular carcinoma. Methods: We conducted a phase II, single-institution trial of octreotide-LAR (30.mg intramuscularly every 4 weeks) in 15 patients while monitoring serum IGF-I and -II levels. Results: Patients (median CLIP score 2, Okuda stage II, and ECOG performance status 1) were treated for a median of 2.0 cycles. No responses occurred. Median overall survival was 116 days (range, 27-937 days) and median progression-free survival was 60 clays (range, 27-444 clays). One patient had prolonged stable disease (16 months). There were no grade 4 and four grade 3 toxicities: abdominal cramping, elevated creatinine, diarrhea, and dyspnea. Median serum IGF-I decreased from baseline (42.2 ng/mL; range, 14.2-109 ng/mL) to day 29 (27.9ng/mL; range 5.7-71.1 ng/mL), and median serum, IGF-II decreased from baseline (25,000 ng/mL; range, 12,400-93,600 ng/mL) to day 29 (18,400 ng/mL; range, 4,061-79,400 ng/mL; 2-sided P<.006 and P<.04, respectively; Wilcoxon signed rank test). This suppression did not correlate with clinical activity. Baseline serum IGF-I >30 ng/mL was associated with greater progression-free survival and over-all survival (P=.0005 and P=.0173, respectively; 2-sided log-rank test). Conclusions: Octreotide-LAR lowered serum IGF-I and -II levels; however, this loweringdid not correlate with clinical activity. There were no responses, and progression-free survival and overall survival were similar to historical patients not on treatment. Baseline serum IGF-I predicted prognosis.

Original languageEnglish (US)
Pages (from-to)44-54
Number of pages11
JournalClinical Advances in Hematology and Oncology
Volume6
Issue number1
StatePublished - Jan 2008
Externally publishedYes

    Fingerprint

Keywords

  • Growth hormone
  • Hepatocellular carcinoma
  • Hepatoma
  • Insulin-like growth factor
  • Octreotide

ASJC Scopus subject areas

  • Oncology
  • Hematology

Cite this

Attia, S., Holen, K. D., Thomas, J. P., Richie, K., Dzelak, T., Teeter, K., Warren, D., Bilger, A., Fine, J., Eickhoff, J., Drinkwater, N., Mulkerin, D., & Morgan-Meadows, S. (2008). Biologic study of the effects of octreotide-LAR on growth hormone in unresectable and metastatic hepatocellular carcinoma. Clinical Advances in Hematology and Oncology, 6(1), 44-54.