Glucagonoma medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2]
Overview
The predominant therapy for glucagonoma is surgical resection. Adjunctive chemotherapy may be required.
Medical Therapy
Management of primary tumor
- Somatostatin analogs (octreotide) are the treatment of choice to control symptoms. 36
- Doxorubicin and streptozotocin have also been used successfully to selectively damage alpha cells of the pancreatic islets.
Metastasis therapy
Hepatic artery embolization
- Hepatic arterial embolization with or without selective hepatic artery infusion of chemotherapy is a palliative technique in patients with symptomatic hepatic metastases who are not candidates for surgical resection. Embolization can be performed via the infusion through an angiography catheter into hepatic arteries Gelfoam powder in conjunction with chemotherapy radioactive isotopes. 59
Radiofrequency ablation
- Ablation can be performed percutaneously or laparoscopically technique in patients with symptomatic hepatic metastases who are not candidates for surgical resection. Ablation is applicable only to smaller lesions less than 3 cm
Molecularly therapy
- Molecularly targeted agents everolimus, sunitinib have a role in the management of patients with progressive advanced glucagonomas who are not symptomatic from tumor bulk or have rapidly progressive metastatic peptide receptor radioligand therapy with radiolabeled somatostatin analogs
Cytotoxic chemotherapy
- Peptide receptor radioligand therapy with radiolabeled somatostatin analogs