Lanreotide Depot to Treat Gastroenteropancreatic Neuroendocrine Tumors in a US Community Oncology Setting: A Prospective, Observational Study

Abstract

Introduction Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) can result in symptoms such as diarrhea, flushing, abdominal pain, and fatigue and are often associated with a significant disease burden and poor prognosis. This non-interventional, prospective, observational study evaluated the real-world safety and effectiveness of lanreotide depot, a somatostatin analog (SSA) used to treat GEP-NETs, in a community setting. Methods In this prospective, non-interventional study (NCT02730104), adult patients with locally advanced (inoperable), metastatic GEP-NETs treated with lanreotide depot were evaluated by their physician every 6 months from enrollment for 24 months. Clinically defined time to disease progression (TTDP) and overall survival (OS) were estimated for the total population and by primary tumor type (gastrointestinal [GI], pancreatic, unknown origin), and an exploratory analysis determined the rate of progression-free survival (PFS) at 12 and 24 months. Patient satisfaction was evaluated via the Treatment Satisfaction Questionnaire for Medication (TSQM-9), and safety information was recorded. Results Of 99 patients, the 24-month PFS rate was 73.7% (95% confidence interval [CI] 63.1–81.7) and 24-month OS rate was 84.2% (95% CI 74.0–90.7). Median TTDP was not reached because few patients experienced disease progression during the study period. The majority of responding patients expressed satisfaction with treatment on each domain of the TSQM-9. Treatment-related adverse events (AEs) occurred in 19.2% of patients, while no serious AEs (SAEs) were related to the study drug. Conclusions Lanreotide depot is an effective and well-tolerated treatment for GEP-NETs in the real-world community setting. Trial registration ClinicalTrials.gov identifier, NCT02730104. Supplementary Information The online version contains supplementary material available at 10.1007/s40487-022-00208-1.

Epidemiology of Neuroendocrine Neoplasms and Results of Their Treatment with [177Lu]Lu-DOTA-TATE or [177Lu]Lu-DOTA-TATE and [90Y]Y-DOTA-TATE—A Six-Year Experience in High-Reference Polish Neuroendocrine Neoplasm Center

“…Long-lasting octreotide is registered in midgut NEN and functional NEN of the stomach, intestines, and pancreas. These distinctive differences and the fact that the application of lanreotide in autogel is more accessible and can be performed by the patient themselves or by an educated family member; these are the advantages of this treatment [60][61][62][63]. Ryan et al's study compared octreotide and lanreotide, finding no differences in their biochemical outcomes.…”

Neuroendocrine Tumor Chromogranin A Response following Synthetic Somatostatin analog (Lanreotide): First Observations from an Isolated Duodenal Neoplasm

“…Some 60% of NETs have either a pancreatic or gastrointestinal primary source (i.e., appendix, colon, intestine, rectum, stomach), collectively termed gastroenteropancreatic NETs [6]. Approximately 30% of NETs are functionally secretory, producing bioactive peptides and neuroamines which can cause fatigue, abdominal discomfort, muscle weakness, or dermal flushing/cutaneous vasodilation [7]. Among all NETs, those of duodenal origin comprise only 1-3% with clinical manifestations similar to other digestive tract tumors, resulting in nonspecific and variable clinical symptoms [8].…”

Neuroendocrine Neoplasia: From Pathophysiology to Novel Therapeutic Approaches

“…The median progression-free survival rate was similar, being 12 months (octreotide LAR) and 10.8 months (lanreotide depot) [33]. Another prospective, real-world setting study on adults with locally inoperable, metastatic GEP NENs using lanreotide depot identified a 2-year progression-free survival rate of 73% and a 2-year overall survival rate of 84%, while the rate of therapy-related adverse events was observed for 19.2% of patients, with a rate of 0% being observed for serious adverse effects [34].…”