Pancreatic Islet Cell Carcinoma

TLDR

Streptozotocin (NSC‑85998) was administered intravenously to 44 and intra‑arterially to 8 patients with metastatic islet cell carcinoma, typically weekly at 0.6–1.0 g/m², and its clinical experience in 52 patients was analyzed. In 52 patients, streptozotocin induced biochemical responses in 64% of evaluable functional cases and measurable disease responses in 50%, with insulin responses occurring 2–3 weeks after treatment, and responders had a doubled median survival and a higher 1‑year survival rate, though acute toxicity was common (nausea/vomiting 98%, renal 65%, hepatic 67%, hematologic 20%) and five patients died of renal failure.

Abstract

The clinical experience with streptozotocin (NSC-85998) in 52 patients with metastatic islet cell carcinoma was analyzed. The drug was given intravenously in 44 patients and intra-arterially in 8 patients, most often on a weekly schedule of administration of 0.6 to 1.0 g/m2 body surface area. Biochemical responses were seen in 64% of evaluable functional cases, and measurable disease responses were seen in 50% of these cases. Insulin responses occurred 2 to 3 weeks after drug administration at a total dose of about 2 to 4 g/m2 body surface area. A significant increase in 1-year survival rate and a doubling of median survival were shown for the responders as compared with the nonresponders. Acute toxicity, consisting of nausea and vomiting, was observed in 98% of the cases, whereas renal or hepatic toxicity was seen in 65% and 67% of the cases, respectively. Hematological toxicity, observed in 20% of the cases, was mild. Renal and hepatic toxicity were usually reversible, but five patients died in renal failure.