Postoperative treatment with octreotide in patients with gastroesophageal cancer: An open-label phase 2 study

Summary: Background & Aims: Dietary peptides are hypothesized to contribute to persistent weight loss following gastrectomy or esophagectomy in cancer patients. Previous studies have suggested that this effect might be partially mitigated by Octreotide. This study aimed to evaluate the safe...

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Main Authors: Anders Holmén, Maria Lampi, Ioannis Rouvelas, Berit Sunde, Thorhallur Agustsson, Greger Lindberg, Fredrik Klevebro
Format: Article
Language:English
Published: Elsevier 2025-10-01
Series:Clinical Nutrition Open Science
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Online Access:http://www.sciencedirect.com/science/article/pii/S2667268525000580
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author Anders Holmén
Maria Lampi
Ioannis Rouvelas
Berit Sunde
Thorhallur Agustsson
Greger Lindberg
Fredrik Klevebro
author_facet Anders Holmén
Maria Lampi
Ioannis Rouvelas
Berit Sunde
Thorhallur Agustsson
Greger Lindberg
Fredrik Klevebro
author_sort Anders Holmén
collection DOAJ
description Summary: Background & Aims: Dietary peptides are hypothesized to contribute to persistent weight loss following gastrectomy or esophagectomy in cancer patients. Previous studies have suggested that this effect might be partially mitigated by Octreotide. This study aimed to evaluate the safety and tolerability of intramuscular Sandostatin® (Octreotide Long-Acting Release [LAR] depot 10mg) focusing on the incidence and characterization of adverse events. Methods: A prospective open-label phase-2 study was conducted from September 2021 to October 2023. Twenty patients (10 undergoing gastrectomy and 10 undergoing esophagectomy) were enrolled. Each patient received three doses of intramuscular Sandostatin® LAR depot 10mg at 7 days, 1 month, and 2 months post-surgery. All patients were evaluated at 7 days and at 1-, 2-, 3-, and 6-months post-surgery.The primary endpoint was safety, assessed by the incidence and characterization of adverse events, with no occurrence of serious adverse events defined as successful. Tolerability was defined as at the completion of the treatment protocol by at least 90% of patients.Secondary endpoints included weight loss (percentage from baseline), Health-Related Quality of Life (assessed by the European Organisation for Research and Treatment of Cancer Core Quality of life Questionnaire [EORTC-QLQ-C30] and Quality of life Questionnaire for Oesophago-Gastric symptoms [EORTC-QLQ-OG25]) at baseline and at 1-, 2-, 3-, and 6-months post-surgery, and the proportion of patients requiring enteral nutrition via jejunostomy. Results: The study was completed by 95% of participants. Serious adverse events were observed but were not attributed to the Octreotide treatment. Median weight loss at 6 months was 11% (3 months: 7%, 2 months: 4%, 1 month: 5%). Mean Global Quality of Life, as assessed by the of EORTC-QLQ-C30, declined at 1 month after surgery but promptly recovered to align with the baseline level (67.6 at baseline vs. 67.2 at 6 months). Among patients undergone esophagectomy, the percentage of patients requiring enteral nutrition was 80%, 60%, and 30% at 1-, 2-, and 3-months, respectively. Conclusions: This study demonstrates that Octreotide treatment was well tolerated and safe, with no serious adverse events attributed to the Octreotide treatment. Observed weight loss, Health-Related Quality of Life, and the proportion of patients requiring enteral nutrition aligned with expectations. Future studies should consider a double-blinded randomized controlled design preferably with a dose-response assessment to enable a more robust investigation.
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spelling doaj-art-dbc6580c834d40ac9e24bcddbc0edcb12025-07-23T05:25:16ZengElsevierClinical Nutrition Open Science2667-26852025-10-01633043Postoperative treatment with octreotide in patients with gastroesophageal cancer: An open-label phase 2 studyAnders Holmén0Maria Lampi1Ioannis Rouvelas2Berit Sunde3Thorhallur Agustsson4Greger Lindberg5Fredrik Klevebro6Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Surgery and Oncology, Karolinska Institutet, Stockholm, Sweden; Department of Surgery, Södersjukhuset AB, Stockholm, Sweden; Corresponding author. Department of Surgery, Södersjukhuset AB, Sjukhusbacken 10, SE-11883 Stockholm, Sweden. Tel.: 0046 08 123 61736.Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Surgery and Oncology, Karolinska Institutet, Stockholm, Sweden; Department of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm, SwedenDepartment of Clinical Science, Intervention and Technology (CLINTEC), Division of Surgery and Oncology, Karolinska Institutet, Stockholm, Sweden; Department of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm, SwedenDepartment of Clinical Science, Intervention and Technology (CLINTEC), Division of Surgery and Oncology, Karolinska Institutet, Stockholm, Sweden; Department of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm, SwedenDepartment of Surgery, Södersjukhuset AB, Stockholm, Sweden; Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, SwedenDepartment of Medicine (MedH), Karolinska Institutet, Stockholm, Sweden; Medical Unit for Gastroenterology, Dermatology, and Rheumatology, Karolinska University Hospital, Stockholm, SwedenDepartment of Clinical Science, Intervention and Technology (CLINTEC), Division of Surgery and Oncology, Karolinska Institutet, Stockholm, Sweden; Department of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm, SwedenSummary: Background & Aims: Dietary peptides are hypothesized to contribute to persistent weight loss following gastrectomy or esophagectomy in cancer patients. Previous studies have suggested that this effect might be partially mitigated by Octreotide. This study aimed to evaluate the safety and tolerability of intramuscular Sandostatin® (Octreotide Long-Acting Release [LAR] depot 10mg) focusing on the incidence and characterization of adverse events. Methods: A prospective open-label phase-2 study was conducted from September 2021 to October 2023. Twenty patients (10 undergoing gastrectomy and 10 undergoing esophagectomy) were enrolled. Each patient received three doses of intramuscular Sandostatin® LAR depot 10mg at 7 days, 1 month, and 2 months post-surgery. All patients were evaluated at 7 days and at 1-, 2-, 3-, and 6-months post-surgery.The primary endpoint was safety, assessed by the incidence and characterization of adverse events, with no occurrence of serious adverse events defined as successful. Tolerability was defined as at the completion of the treatment protocol by at least 90% of patients.Secondary endpoints included weight loss (percentage from baseline), Health-Related Quality of Life (assessed by the European Organisation for Research and Treatment of Cancer Core Quality of life Questionnaire [EORTC-QLQ-C30] and Quality of life Questionnaire for Oesophago-Gastric symptoms [EORTC-QLQ-OG25]) at baseline and at 1-, 2-, 3-, and 6-months post-surgery, and the proportion of patients requiring enteral nutrition via jejunostomy. Results: The study was completed by 95% of participants. Serious adverse events were observed but were not attributed to the Octreotide treatment. Median weight loss at 6 months was 11% (3 months: 7%, 2 months: 4%, 1 month: 5%). Mean Global Quality of Life, as assessed by the of EORTC-QLQ-C30, declined at 1 month after surgery but promptly recovered to align with the baseline level (67.6 at baseline vs. 67.2 at 6 months). Among patients undergone esophagectomy, the percentage of patients requiring enteral nutrition was 80%, 60%, and 30% at 1-, 2-, and 3-months, respectively. Conclusions: This study demonstrates that Octreotide treatment was well tolerated and safe, with no serious adverse events attributed to the Octreotide treatment. Observed weight loss, Health-Related Quality of Life, and the proportion of patients requiring enteral nutrition aligned with expectations. Future studies should consider a double-blinded randomized controlled design preferably with a dose-response assessment to enable a more robust investigation.http://www.sciencedirect.com/science/article/pii/S2667268525000580CancerEsophagusStomachOctreotide long-acting releaseHealth-related quality of lifeWeight-loss
spellingShingle Anders Holmén
Maria Lampi
Ioannis Rouvelas
Berit Sunde
Thorhallur Agustsson
Greger Lindberg
Fredrik Klevebro
Postoperative treatment with octreotide in patients with gastroesophageal cancer: An open-label phase 2 study
Clinical Nutrition Open Science
Cancer
Esophagus
Stomach
Octreotide long-acting release
Health-related quality of life
Weight-loss
title Postoperative treatment with octreotide in patients with gastroesophageal cancer: An open-label phase 2 study
title_full Postoperative treatment with octreotide in patients with gastroesophageal cancer: An open-label phase 2 study
title_fullStr Postoperative treatment with octreotide in patients with gastroesophageal cancer: An open-label phase 2 study
title_full_unstemmed Postoperative treatment with octreotide in patients with gastroesophageal cancer: An open-label phase 2 study
title_short Postoperative treatment with octreotide in patients with gastroesophageal cancer: An open-label phase 2 study
title_sort postoperative treatment with octreotide in patients with gastroesophageal cancer an open label phase 2 study
topic Cancer
Esophagus
Stomach
Octreotide long-acting release
Health-related quality of life
Weight-loss
url http://www.sciencedirect.com/science/article/pii/S2667268525000580
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