Effects of sandostatin on neuroendocrine tumours of the gastrointestinal system.

Sandostatin is a drug of immense importance in the management of NETs of the gastrointestinal tract. Its effect in some syndromes is life-saving, in particular in VIPoma. Dramatic effects have also been reported in the glucagonoma syndrome. The quality of life is considerably improved in the carcinoid syndrome and it is potentially life-saving in carcinoid crises. The drug is effective in gastrinomas, but other therapy is more effective. Its value is controversial in insulinoma although some patients are clearly improved. Not all patients respond and this may be related to the abundance of Sandostatin receptors on the tumour or simply to tumour bulk. There is no clear-cut evidence that Sandostatin has an anti-tumour effect in these patients.