Octreotide Is Ineffective in Treating Tumor‐Induced Osteomalacia: Results of a Short‐Term Therapy |
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| Authors: | Diana Ovejero Diala El‐Maouche Beth A Brillante Azar Khosravi Rachel I Gafni Michael T Collins |
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| Affiliation: | 1. Skeletal Clinical Studies Unit, Craniofacial and Skeletal Disease Branch, National Institute of Dental and Craniofacial Research (NIDCR), National Institutes of Health (NIH), Bethesda, MD, USA;2. Clinical Center, National Institutes of Health (NIH), Bethesda, MD, USA;3. Department of Endocrinology, Diabetes and Metabolism City of Hope National Medical Center, Duarte, CA, USA |
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| Abstract: | Tumor‐induced osteomalacia (TIO) is a rare paraneoplastic syndrome in which unregulated hypersecretion of fibroblast growth factor 23 (FGF23) by phosphaturic mesenchymal tumors (PMT) causes renal phosphate wasting, hypophosphatemia, and osteomalacia. The resulting mineral homeostasis abnormalities and skeletal manifestations can be reversed with surgical resection of the tumor. Unfortunately, PMTs are often difficult to locate, and medical treatment with oral phosphate and vitamin D analogues is either insufficient to manage the disease or not tolerated. Octreotide has been proposed as a potential treatment for TIO due to the presence of somatostatin receptors (SSTR) on PMTs; however, the role of somatostatin signaling in PMTs and the efficacy of treatment of TIOs with somatostatin analogues is not clear. In an effort to evaluate the efficacy of octreotide therapy in TIO, five subjects with TIO were treated with octreotide for 3 days. Blood intact FGF23, phosphate, and 1,25(OH)2D3, and tubular reabsorption of phosphate (TRP) were measured at frequent time points during treatment. Octreotide's effects were assessed by comparing group means of the biochemical parameters at each time‐point to mean baseline values. There were no significant changes in blood phosphate, FGF23, 1,25(OH)2D3, or TRP during octreotide treatment, consistent with a lack of efficacy of octreotide in treating TIO. © 2017 American Society for Bone and Mineral Research. |
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| Keywords: | TUMOR‐INDUCED BONE DISEASE CANCER OSTEOMALACIA AND RICKETS DISEASES AND DISORDERS OF/RELATED TO BONE PTH/VIT D/FGF23 CELL/TISSUE SIGNALING ENDOCRINE PATHWAYS |
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