Treatment of Somatostatinoma with Metastatic Disease
When somatostatinoma has spread beyond its primary site, management priorities shift toward controlling hormone-driven symptoms and addressing the burden of metastatic disease. The clinical goals are specific and measurable, and the approach involves more than one modality.
Clinical Scenario
This protocol applies to patients with somatostatinoma in the setting of metastatic disease. At this stage, systemic and interventional options are considered alongside efforts to reduce the hormonal effects of the tumour.
Patients with metastatic disease may be treated with systemic chemotherapy.
Treatment Goals
The primary targets are decreased fasting serum somatostatin levels and meaningful improvement in the severity of symptoms.
Approach (Partial Overview)
Management in this setting involves a class of agents that act on somatostatin pathways to reduce hormone levels and symptom burden, combined with systemic chemotherapy. Additional interventional strategies targeting the sites of metastatic disease may also be considered for symptomatic control.
References
DOI: 10.1007/978-3-319-98497-1_117
- Somatostatin analogs have been shown to decrease fasting serum somatostatin levels and improve the severity of symptoms.
- Patients with metastatic disease may be treated with systemic chemotherapy.
- Some have also supported surgical debulking or hepatic artery embolization in the setting of metastatic disease to help with symptomatic control.