• Systemic Treatment Disease Site Group. Major P, Figueredo A, Tandan V, Bramwell V, Charette M, Oliver T. The role of octreotide in the management of patients with cancer [full report]. Toronto (ON): Cancer Care Ontario (CCO); 2004 Aug [online update]. 30 p. (Practice guideline report; no. 12-7). [57 references]

Octreotide in the Treatment of Chemotherapy-Induced Diarrhea

• For chemotherapy-induced diarrhea, octreotide is recommended at a dose of 100 micrograms subcutaneously three times daily and escalating every eight hours by 50 to 100 micrograms until the diarrhea is controlled, to a maximum of 500 micrograms three times daily.

Octreotide Following Pancreatic Surgery

• Octreotide, administered at a dose of 100 micrograms subcutaneously three times daily starting one hour prior to surgery and continuing for seven days is recommended as part of the standard management for patients undergoing pancreatic surgery.

Octreotide for Symptom Relief of Carcinoid and Other Neuroendocrine Tumours

• Octreotide is recommended to control symptoms associated with carcinoid tumours.
• Because the mechanism of action and the pathophysiology of other secretory neuroendocrine tumours are similar to that of carcinoid tumours, it is reasonable to recommend octreotide to control symptoms associated with secretory neuroendocrine tumours.
• It is suggested that octreotide be administered in a subcutaneous dose of 100 micrograms three times daily, or 200 micrograms twice daily, with an increase in the dose of 50 to 100 micrograms every eight or twelve hours until symptom control is achieved.

Octreotide in Patients with Chronic Bowel Obstruction

• In patients with inoperable bowel obstruction due to advanced cancer, the use of octreotide 300 micrograms daily by subcutaneous infusion may be considered for the purpose of reducing symptoms such as nausea, vomiting, and pain, as well as the need for a nasogastric tube.

Octreotide as an Anti-tumor Agent in Advanced Malignancies

• Octreotide cannot be recommended as an anti-tumour agent for the treatment of metastatic breast cancer, advanced pancreatic, or asymptomatic colon cancer.
• Further studies in advanced breast, colon, or pancreatic cancer are unlikely to be productive unless a different formulation or dose schedule is anticipated to be more active.

None provided

The recommendations are supported by randomized controlled trials and meta-analyses.

• Systemic Treatment Disease Site Group. Major P, Figueredo A, Tandan V, Bramwell V, Charette M, Oliver T. The role of octreotide in the management of patients with cancer [full report]. Toronto (ON): Cancer Care Ontario (CCO); 2004 Aug [online update]. 30 p. (Practice guideline report; no. 12-7). [57 references]

Not applicable: The guideline was not adapted from another source.

2003 May 7 (revised 2004 Aug)

Program in Evidence-based Care - State/Local Government Agency [Non-U.S.]

The Practice Guidelines Initiative (PGI) is the main project of the Program in Evidence-based Care (PEBC), a Province of Ontario initiative sponsored by Cancer Care Ontario and the Ontario Ministry of Health and Long-Term Care.

Cancer Care Ontario, Ontario Ministry of Health and Long-Term Care

Provincial Systemic Treatment Disease Site Group

Members of the Systemic Treatment Disease Site Group disclosed potential conflict of interest information.

None available

This NGC summary was completed by ECRI on January 23, 2004. The information was verified by the guideline developer as of February 23, 2004. This NGC summary was updated by ECRI on March 3, 2005. The information was verified by the guideline developer on March 16, 2005.