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

Purpose. Severe diarrhea can represent a dose-limiting toxicity with the use of CPT-11. Conventional therapy is ineffective in some patients and is also limited by patient compliance. We report our observation on the effectiveness of octreotide acetate in the treatment of CPT-11-induced diarrhea refractory to opioids. Patients and methods. We describe 4 patients with metastatic gastrointestinal tumors who developed severe diarrhea following treatment with CPT-11 (65-125 mg/m²/weekly for 4 weeks every 6 weeks). Diarrhea was refractory to treatment with loperamide and diphenoxylate and was treated with octreotide acetate. Results. Complete resolution of diarrhea was observed within 2-4 days of octreotide acetate treatment. Three patients responded to SC octreotide given every 8 hours and the 4^th patient to octreotide given by continuous SC infusion. Conclusions. Our preliminary observation suggests value of octreotide in the control of CPT-11 induced refractory diarrhea. Prospective studies are warranted.