Treatment of the malignant carcinoid syndrome. Evaluation of a long-acting somatostatin analogue

N Engl J Med. 1986 Sep 11;315(11):663-6. doi: 10.1056/NEJM198609113151102.


We studied the effects of a long-acting analogue of somatostatin (SMS 201-995, Sandoz) in 25 patients with histologically proved metastatic carcinoid tumors and the carcinoid syndrome. This drug was self-administered by subcutaneous injection at a dose of 150 micrograms three times daily. Flushing and diarrhea associated with the syndrome were promptly relieved in 22 patients. All 25 patients had an elevated 24-hour urinary excretion of 5-hydroxyindoleacetic acid (5-HIAA) (mean, 265 mg per 24 hours; range, 14 to 1079), which served as an objective indicator of disease activity. Eighteen of the 25 patients (72 percent) had a decrease of 50 percent or more in their urinary 5-HIAA levels, as compared with the pretreatment values. The median duration of this biochemical response was more than 12 months (range, 1 to greater than 18). Since no serious toxicity was observed, we conclude that SMS 201-995 may be appropriate for use as early therapy in patients with symptoms due to the carcinoid syndrome who have not responded to simpler measures.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / therapeutic use*
  • Diarrhea / drug therapy
  • Female
  • Flushing / therapy
  • Humans
  • Hydroxyindoleacetic Acid / urine
  • Injections, Subcutaneous
  • Male
  • Malignant Carcinoid Syndrome / drug therapy*
  • Malignant Carcinoid Syndrome / urine
  • Middle Aged
  • Octreotide
  • Self Administration
  • Somatostatin / administration & dosage
  • Somatostatin / analogs & derivatives*
  • Somatostatin / therapeutic use


  • Antineoplastic Agents
  • Somatostatin
  • Hydroxyindoleacetic Acid
  • Octreotide