Glucagonoma medical therapy

The predominant medical therapy for primary glucagonoma is somatostatin analogs (octreotide). Metastatic tumors need hepatic artery embolization, radiofrequency ablation, and molecular therapy.

• Somatostatin analogs (octreotide) are the treatment of choice to control symptoms.^[1]
• Doxorubicin and streptozotocin have also been used successfully to selectively damage alpha cells of the pancreatic islets.

Preferred regimen (1): Octreotide 400 micrograms/day

• Hepatic arterial embolization is a palliative treatment 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.

• Ablation can be performed percutaneously or laparoscopically in patients with symptomatic hepatic metastases who are not candidates for surgical resection.
• Ablation is applicable only to smaller lesions less than 3 cm.^[2]

• Sunitinib is a radio-labeled somatostatin analog which has a role in the management of glucagonoma’s that are not symptomatic or have rapidly progressive metastasis.

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