Therapeutic response to octreotide in patients with refractory CPT-11 induced diarrhea

Purpose. Severe diarrhea can represent a dose-limiting toxicity with the us e of CPT-11. Conventional therapy is ineffective in some patients and is al so limited by patient compliance. We report our observation on the effectiv eness of octreotide acetate in the treatment of CPT-11-induced diarrhea ref ractory to opioids. Patients and methods. We describe 4 patients with metas tatic gastrointestinal tumors who developed severe diarrhea following treat ment with CPT-11 (65-125 mg/m(2)/weekly for 4 weeks every 6 weeks). Diarrhe a was refractory to treatment with loperamide and diphenoxylate and was tre ated with octreotide acetate. Results. Complete resolution of diarrhea was observed within 2-4 days of octreotide acetate treatment. Three patients re sponded to SC octreotide given every 8 hours and the 4(th) patient to octre otide given by continuous SC infusion. Conclusions. Our preliminary observa tion suggests value of octreotide in the control of CPT-11 induced refracto ry diarrhea. Prospective studies are warranted.