Intermittent everolimus administration for malignant insulinoma

Summary Insulinoma is a rare form of insulin-secreting pancreatic islet cell neuroendocrine (NE) tumor. The medical treatment of the malignant NE disease of the pancreas deeply changed in the last years, thanks to the introduction of new target molecules, as everolimus. Even if the exact mechanism i...

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Bibliographic Details
Published in:Endocrinology, diabetes & metabolism case reports diabetes & metabolism case reports, 2014, Vol.2014, p.140047-140047
Main Authors: Baratelli, Chiara, Brizzi, Maria Pia, Tampellini, Marco, Scagliotti, Giorgio Vittorio, Priola, Adriano, Terzolo, Massimo, Pia, Anna, Berruti, Alfredo
Format: Article
Language:English
Subjects:
Adolescent/young adult
Carboplatin
CT scan
Diazoxide
Endocrine-related cancer
Everolimus
Gastroenterology
Glucagon
Glucose
Glucose (blood)
Hypoglycaemia
Insulin
Insulinoma
Italy
Liver masses
Male
Metastatic tumour
Octreotide
Pancreas
Pasireotide
Radiotherapy
Somatostatin analogues
SPECT scan
Unusual Effects of Medical Treatment
White
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Summary:Summary Insulinoma is a rare form of insulin-secreting pancreatic islet cell neuroendocrine (NE) tumor. The medical treatment of the malignant NE disease of the pancreas deeply changed in the last years, thanks to the introduction of new target molecules, as everolimus. Even if the exact mechanism is not actually known, one of the side effects of everolimus, hyperglycemia, has been demonstrated to be useful to contrast the typical hypoglycemia of the insulinoma. We report the case of a patient with a metastatic malignant insulinoma treated with intermittent everolimus, obtaining an important improvement in the quality of life; this suggests the necessity of preclinical studies to analyze the cellular pathways involved in insulin-independent gluconeogenesis. Learning points Effect of somatostatin analogs is long-lasting in the control of functioning NE tumors. Persistent everolimus control of hypoglycemia despite serum insulin levels and disease progression. Open issue: are disease progression and the increase in serum markers the only valid criteria to reject a treatment?
ISSN:2052-0573
2052-0573
DOI:10.1530/EDM-14-0047