From the Guidelines
Octreotide, a somatostatin analogue, has a limited but valuable role in managing symptoms of ovarian cancer, particularly in cases of malignant bowel obstruction when surgical intervention is not feasible, as evidenced by its ability to reduce gastrointestinal secretions and alleviate nausea and vomiting 1. The medication works primarily by binding to somatostatin receptors, inhibiting the release of various hormones and reducing fluid secretion in the gastrointestinal tract. Some key points to consider when using octreotide for symptom management in ovarian cancer include:
- Typical dosing ranges from 300-600 mcg/day subcutaneously, often starting at 100-150 mcg three times daily and titrating based on symptom response.
- For longer-term management, long-acting formulations such as Octreotide LAR (10-30 mg intramuscularly every 4 weeks) may be considered, as they have produced significant improvement in the quality of life of patients with neuroendocrine tumors and have comparable or better efficacy than short-acting octreotide 1.
- Octreotide is not a primary treatment for ovarian cancer itself but rather a palliative measure for symptom control.
- Common side effects include injection site reactions, abdominal discomfort, and potential for gallstone formation with long-term use.
- Blood glucose monitoring is recommended as octreotide can affect glucose metabolism. This intervention should be considered as part of a comprehensive palliative care approach in advanced ovarian cancer cases with bowel obstruction symptoms. It's worth noting that the use of octreotide in ovarian cancer is not directly addressed in the provided evidence, which primarily focuses on its use in neuroendocrine tumors, but its mechanism of action and effects on symptom control can be extrapolated to other conditions involving similar pathophysiology, such as malignant bowel obstruction in ovarian cancer 1.
From the Research
Role of Octreotide in Managing Ovarian Cancer Symptoms
- Octreotide, a somatostatin analogue, has been studied for its potential in managing symptoms of ovarian cancer, particularly in cases of bowel obstruction 2, 3, 4.
- The evidence suggests that octreotide can help control vomiting and reduce gastrointestinal secretions in patients with inoperable bowel obstruction due to advanced ovarian cancer 3, 4.
- A study published in 2005 found that long-acting octreotide (Sandostatin LAR Depot) was safe and effective in reducing bowel obstruction symptoms in advanced ovarian cancer patients 2.
- Another study from 1996 demonstrated that octreotide controlled vomiting in all cases and provided complete relief of symptoms within 3.07 days in patients with terminal ovarian cancer and inoperable gastrointestinal obstruction 3.
- A randomized clinical trial in 2015 compared octreotide and scopolamine butylbromide in symptom control of patients with inoperable bowel obstruction due to advanced ovarian cancer, and found that octreotide was more effective in controlling gastrointestinal symptoms 4.
Mechanism of Action and Potential Benefits
- Octreotide has been shown to inhibit the release of various peptides and hormones, which may contribute to its therapeutic effects in ovarian cancer 5.
- A study in 2016 found that octreotide reversed the resistance of ovarian cancer cells to paclitaxel chemotherapy in vitro, suggesting a potential role in enhancing the effectiveness of chemotherapy 6.
- The same study found that octreotide inhibited ovarian cancer cell proliferation and promoted apoptosis via the cell surface expression of somatostatin receptor 2 (SSTR2) 6.
Key Findings and Implications
- The available evidence suggests that octreotide may be a useful adjunct in managing symptoms of ovarian cancer, particularly in cases of bowel obstruction 2, 3, 4.
- Further studies are needed to fully understand the potential benefits and limitations of octreotide in the management of ovarian cancer symptoms 2, 4.
- The potential for octreotide to enhance the effectiveness of chemotherapy and inhibit ovarian cancer cell growth warrants further investigation 6.