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Somatostatin Analogs in Cancer Management
  1. S J Mather

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It may be common practice to publish book versions of journal supplements but this is the first such example to reach the desk of this reviewer (reprint of Chemotherapy 2001:47:supplement 2). In this age of instant electronic information retrieval the idea of producing such a hard copy version seems rather retrogressive, but for frequent referral it is still easier and quicker to reach for a book from the shelf than to suffer the vagaries of Internet access. But is this a book that needs to be at one’s fingertips?

The book consists of a preface and introduction by the editor followed by a series of 10 invited reviews of different aspects of therapy with somatostatin analogues. These include overviews of the pharmacology and clinical applications of these compounds plus more specific chapters concerned with their use in the treatment of cancer of the breast, lung, prostate, gastrointestinal tract, pancreas, and liver, while the book ends with a quite comprehensive look into the future.

The book suffers from the shortcoming of nearly all textbooks in that it is not up to date. One would perhaps have expected better from a journal supplement but only a handful of the numerous references in this book date from later than 1998. That would not necessarily be a problem if the field had matured to the extent that recent developments would not significantly affect the take home message from the text, but that is not the case here where the molecular biology of the SRIF receptors has developed considerably in the last few years. The book also suffers from a high degree of repetition. If you did not know there were five receptor subtypes before reading this book, then you would be left in no doubt by the end since all 12 chapters would have told you so! Less facetiously the take home message from nearly all of the chapters is also the same—octreotide therapy should work but it doesn’t. The rationale for a cytotoxic/-taxic mechanism is clearly stated—indirectly through suppression of the GF/IGF-1 axis, inhibition of angiogenesis, reduction in T lymphocyte production, etc, and direct antiproliferative actions. However, with the exception of promising activity in the treatment of primary liver cancer, all of the proposed clinical indications fail to show any meaningful efficacy although many of the authors call for more controlled studies.

It is disappointing that despite featuring the use of targeted radiation on the front cover of the book, none of the chapters is devoted to this promising new modality although it merits several passing mentions.

This book represents a snapshot of the state of clinical application of somatostatin analogues in cancer in the late 1990s. There is undoubted utility in the palliation of the effects of hypersecretion of peptide hormones but no real indication of any useful cytotoxic activity in most cancers. Only time will tell if this turns out to be the end of the story.