Octreotide acetate long-acting release in patients with metastatic neuroendocrine tumors pretreated with lanreotide

1569-8041

depot lanreotide ; neuroendocrine tumors ; octreotide LAR

Springer Online Journal Archives 1860-2000

Medicine

Abstract Background:In the present study we investigated the efficacy andtolerability of i.m. octreotide acetate (octreotide LAR) in patients withmetastatic neuroendocrine tumors (NETs) previously treated and failed on i.m.lanreotide. Patients and methods:Fifteen patients (8 females, 7 males, medianage 67 years, range 28–81 years) with metastatic NETs (8 endocrinepancreatic tumors, 7 midgut carcinoids) were enrolled in the study. Allpatients were in progressive disease (objective: 11 patients, symptomatic: 10patients, biochemical: 11 patients) after treatment with slow releaselanreotide, 30 mg every 14 days for a median time of 8 months (range3–19 months). All patients had measurable disease; 12 patients hadelevated serum and/or urine markers and 11 were symptomatic. Octreotidescintigraphy was positive in 13 of 15 patients. Octreotide LAR wasadministered as i.m. injection at the dose of 20 mg every four weeks untildisease progression. Results:An objective partial response (PR) was documented in onepatient (7%), no change (NC) in six (40%), and progressivedisease (PD) in eight patients (53%). The PR was observed in onepatient with non-functioning endocrine pancreatic tumor with progressive liverand lymph node metastases after 16 months of i.m. lanreotide therapy. Themedian duration of disease stabilization was 7.5 months (range 6–12+months). The overall biochemical response rate was 41%, including CRs(33%) and PRs (8%); biochemical responses were observed incarcinoids as well as in endocrine pancreatic tumors; the median duration ofresponse was 5 months for CRs and 7.5 months for PRs. The overall symptomaticresponse rate was 82%. The median duration of response for diarrhoea,abdominal pain, or both was 6.5 months (range 3–12+ months). Improvementin performance status (PS) was obtained in 5 of 11 patients with PS of 1 atstudy entry. Median duration of octreotide LAR treatment was seven months (range3–12+ months). No serious adverse events were reported; mild sideeffects were reported in 26% of patients. Conclusions:Octreotide LAR 20 mg shows significant efficacy interms of objective response rate (PR + SD), biochemical and symptomaticcontrol in patients with metastatic NETs of the GEP system pretreated andprogressing on slow release lanreotide.

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