This protocol addresses patients with advanced insulinoma — unresectable or metastatic disease — in whom a prior course of somatostatin analogue therapy did not achieve adequate control of insulin levels or prevention of hypoglycaemic episodes.
Advanced insulinoma with unresectable or metastatic disease. Management of the functioning syndrome in this setting is complex: it requires a multimodal approach combining supportive, medical, interventional, and surgical strategies.
The preceding treatment line used somatostatin analogues — octreotide, lanreotide, or, in refractory cases, pasireotide — targeting reduction of insulin levels and prevention of hypoglycaemic episodes. When these goals are not reached, escalation to this next line is indicated.
In cases refractory to somatostatin analogues — particularly where disease is also progressing — a peptide receptor radionuclide-based therapy is among the approaches considered. The clinical goal is disappearance of hypoglycaemic symptoms. The complete structured regimen remains available via the link below.