18 months: Zanosar is indicated in the treatment of metastatic islet cell carcinoma of the pancreas. Responses have been obtained with both functional and nonfunctional carcinomas. Because of its inherent renal toxicity, therapy with this drug should be limited to patients with symptomatic or progressive metastatic disease. 36 months: Zanosar is indicated for the systemic treatment of adult patients with inoperable, advanced or metastatic, progressive and/or symptomatic, welldifferentiated, G1 or G2 neuroendocrine tumours of pancreatic origin, in combination with 5-Fluorouracil.

18 months: ZANOSAR sterile powder should be administered intravenously by rapid injection or short/prolonged infusion. It is not active orally. Although it has bee administered intraarterially, this is not recommended pending further evaluation of the possibility that adverse renal effects may be evoked more rapidly by this route of administration. 36 months: Zanosar should be administered intravenously by infusion. The duration of infusion should be between 30 minutes and 4 hours. The administration of Zanosar requires hyperhydration. This medicinal product is vesicant in nature and as such should be administered with caution through a free-flowing line. In case of extravasation, administration should be stopped immediately. Healthcare professionals should take appropriate protection measures. The initial aim is to minimize the volume of extravasated product into the surrounding tissues and to aspirate as much as possible product from the canula with a syringe. Cold packs should be applied and appropriate medical monitoring should be performed.