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November 2, 1970

Streptozotocin for Metastatic Insulinoma

JAMA. 1970;214(5):907. doi:10.1001/jama.1970.03180050061013

A major difficulty in developing optimum therapy of disseminated cancer has been the crudeness of techniques for accurately measuring therapeutic effects. In fact, the greatest success in therapy has been accomplished in tumors with measurable activity, such as choriocarcinoma with measurable elevation of gonadotropins.

Abnormal levels of blood immunoreactive insulin associated with an abnormal ratio of blood immunoreactive insulin to proinsulin, a precursor of insulin, has been found to be characteristic of some insulinomas.1 Because these abnormalities can be readily measured, they can provide a guide to the therapy of these tumors. Using this guide, Taylor and associates2 treated a patient with metastatic insulinoma with streptozotocin. They chose this antibiotic because of its peculiar specific toxicity to the beta cells of the islets of Langerhans in animals and because of published reports on other successfully treated patients.3,4 As of February 1970, Livingston and Carter of the National