TELEPRO: Patient-Reported Carcinoid Syndrome Symptom Improvement Following Initiation of Telotristat Ethyl in the Real World

Strosberg, Jonathan R.; Joish, Vijay N.; Giacalone, Susan; Perez-Olle, Raul; Fish‐Steagall, Ann; Kapoor, Kamal K.; Dharba, Sam; Lapuerta, Pablo; Benson, Al B.

doi:10.1634/theoncologist.2018-0921

Cited by 20 publications

(26 citation statements)

References 15 publications

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We read with great interest the recent work by Strosberg et al reporting on the results of the TELEPRO study [1]. This study highlights the benefit of telotristat ethyl in improving other symptoms of carcinoid syndrome as well as diarrhea.

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mentioning

confidence: 69%

Regarding “TELEPRO: Patient-Reported Carcinoid Syndrome Symptom Improvement Following Initiation of Telotristat Ethyl in the Real World”

Hota

Srirajaskanthan

2020

The Oncologist

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confidence: 69%

Regarding “TELEPRO: Patient-Reported Carcinoid Syndrome Symptom Improvement Following Initiation of Telotristat Ethyl in the Real World”

Hota

Srirajaskanthan

2020

The Oncologist

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“…Improvements in CS symptoms and health indicators were consistent with those from other real-world studies of TE. 11,12,19 The TELEPRO real-world study showed improvements in CS symptoms through 3 months of TE treatment, including improvements among those with a relatively low burden of CSD (≤3 daily bowel movements). 11,19 The RELAX registry showed 75% of patients to have maintained or gained weight after 6 months of TE treatment (22% reported weight gain).…”

Section: Discussionmentioning

confidence: 99%

“…11,12,19 The TELEPRO real-world study showed improvements in CS symptoms through 3 months of TE treatment, including improvements among those with a relatively low burden of CSD (≤3 daily bowel movements). 11,19 The RELAX registry showed 75% of patients to have maintained or gained weight after 6 months of TE treatment (22% reported weight gain). 12 We observed weight maintenance or gain in 86% of patients (28% weight gain) over an average of 12 months of TE treatment in the overall TELEACE population.…”

Section: Discussionmentioning

confidence: 99%

“…8 TE has demonstrated improvement in CSD and CS symptoms in clinical trials 9,10 and real-world clinical practice studies. 11,12 Considering the mechanism of TE therapeutic activity and its indication for use with an SSA, it would be of interest to understand the potential impact of TE treatment on tumor growth and clinical outcomes in the clinical practice setting. The SSAs lanreotide (Somatuline® Depot, Ipsen Biopharmaceuticals, Inc., Cambridge, MA, USA) and long-acting octreotide (Sandostatin® LAR Depot, Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA) have shown therapeutic effect on tumor progression and survival, supporting their use in first-line NET treatment.…”

Section: Introductionmentioning

confidence: 99%

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<p>Survival and Clinical Outcomes with Telotristat Ethyl in Patients with Carcinoid Syndrome</p>

Metz¹,

Liu²,

Joish³

et al. 2020

CMAR

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Purpose: The TELEACE study showed reductions in tumor size in patients with neuroendocrine tumors, receiving telotristat ethyl in US clinical practice. Here, we report progression-free survival, time to tumor progression, changes in carcinoid syndrome symptoms, and indictors of overall health. Patients and Methods: This was a retrospective, single arm, pre-post medical chart review of patients with locally advanced or metastatic neuroendocrine tumors and documented carcinoid syndrome receiving telotristat ethyl for at least 6 months. Patients with poorly differentiated tumors, mixed tumor types or conflicting clinical trial enrollment were excluded. Descriptive statistics, Kaplan-Meier and chi-square tests were used to evaluate PFS, tumor progression, changes in symptoms, body weight and ECOG performance status before and after telotristat ethyl initiation. Subgroup analyses were conducted in patients with the same pre-and post-telotristat ethyl background treatment. Results: Anonymized data for 200 patients were provided by 114 physicians; patients received telotristat ethyl for a median of 9 months. Median time to tumor progression was 39.8 months (IQR, 18.7-39.8); most had no tumor progression at 6 (92%) and 12 months (87%). Median progression-free survival was 23.7 months (17.8-39.8); most had progression-free survival at 6 (90%) and 12 months (80%). Results were consistent in the subgroup of 65 patients with the same pre/post background treatment. Nearly all patients had improved carcinoid syndrome symptoms, stable or improved weight and ECOG performance status. Conclusion: Patients showed improvements in clinical outcomes and indicators of overall health following treatment with telotristat ethyl in this exploratory pilot study, consistent with previously observed reductions in tumor size.

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“…Telotristat ethyl is a prodrug that is converted into its active metabolite telotristat etiprate after oral administration (22). In CS patients, telotristat ethyl has been associated with significant improvement in the symptoms of CS, including diarrhea, over 1-3 mo, of therapy (23). In addition, in the TELESTAR study in patients with CS, treatment with telotristat ethyl was associated with significant, dose-dependent weight gain and reduced severity of diarrhea in approximately one-third of cases (24).…”

Section: Treatment Of Csmentioning

confidence: 99%

Role of Diet in the Management of Carcinoid Syndrome: Clinical Recommendations for Nutrition in Patients with Neuroendocrine Tumors

Artale

Barzaghi

Grillo

et al. 2020

Nutrition and Cancer

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Nutrition and metabolism are altered in patients with gastroenteropancreatic neuroendocrine tumors, which is related to excessive production of gastrointestinal hormones, peptides, and amines that can cause maldigestion, diarrhea, steatorrhea, and altered gastrointestinal motility. Patients with carcinoid syndrome are at risk of malnutrition due to tryptophan depletion, reduced intake of food, and loss of appetite because of diarrhea and/ or flushing. To date, there is limited information on the nutritional issues faced by patients with neuroendocrine tumors, and on what specific recommendations should be made to patients concerning nutrition at various stages of the disease process. Dietary planning should therefore be an integral part of multidisciplinary management for patients with neuroendocrine tumors. Herein, we review current guidance for nutrition in patients with neuroendocrine tumors, focusing on intake of amines and foods to avoid, as well as concurrent medications. We also propose a new and practical food pyramid based on the principles of Mediterranean diet 4.0 that can be easily adapted according to the unmet needs of patients with neuroendocrine tumors at all stages of disease. The overarching goal of the present review is to create greater awareness of nutritional care and considerations that should be given to patients with neuroendocrine tumors.

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TELEPRO: Patient-Reported Carcinoid Syndrome Symptom Improvement Following Initiation of Telotristat Ethyl in the Real World

Cited by 20 publications

References 15 publications

Regarding “TELEPRO: Patient-Reported Carcinoid Syndrome Symptom Improvement Following Initiation of Telotristat Ethyl in the Real World”

Regarding “TELEPRO: Patient-Reported Carcinoid Syndrome Symptom Improvement Following Initiation of Telotristat Ethyl in the Real World”

<p>Survival and Clinical Outcomes with Telotristat Ethyl in Patients with Carcinoid Syndrome</p>

Role of Diet in the Management of Carcinoid Syndrome: Clinical Recommendations for Nutrition in Patients with Neuroendocrine Tumors

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