As with the other pancreatic neuroendocrine tumors, the mainstay of therapy is surgical resection, and extended survival is possible even when the disease is metastatic. Resection of metastases is also a consideration when feasible.
Standard treatment options:
- Single small lesion in head or tail of pancreas:[1-4]
- Enucleation, if feasible.
- Large lesion in the head of the pancreas that is not amenable to enucleation:[1-4]
- Single large lesion in body/tail:[1-4]
- Distal pancreatectomy.
- Multiple lesions:[1-4]
- Enucleation, if feasible.
- Resect body and tail otherwise.
- Metastatic disease: lymph nodes or distant sites:[5-12]
- Resect when possible.
- Consider radiofrequency or cryosurgical ablation, if not resectable.
- Unresectable disease:[13-22]
- Combination chemotherapy.
- Somatostatin analogue therapy. Necrotizing erythema of glucagonoma may be relieved in 24 hours with somatostatin analogue, with nearly complete disappearance within 1 week.
Patients with hepatic-dominant disease and substantial symptoms caused by tumor bulk or hormone-release syndromes may benefit from procedures that reduce hepatic arterial blood flow to metastases (hepatic arterial occlusion with embolization or with chemoembolization).[6,8-12] Such treatment may also be combined with systemic chemotherapy in selected patients.Current Clinical Trials
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with glucagonoma. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.
General information about clinical trials is also available from the NCI Web site.References
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