Somatuline Depot (lanreotide acetate) for carciniod syndrome – pro

Somatuline Depot (lanreotide acetate) is an injectable, sustained-release formulation of lanreotide, an octapeptide somatostatin analog that inhibits Insulin-like growth factor-1 (IGF-1) and growth hormone (GH).

Somatuline is specifically indicated for the long-term treatment of acromegalic patients who have had an inadequate response to surgery and/or radiotherapy, or for whom surgery and/or radiotherapy is not an option. However, in Europe it is also approved for carcinoid syndrome.

Unfortunately, about 15% of carcinoid patients cannot tolerate Sandostatin or cannot receive IM injections and it will not help them. Subcutaneous monthly (there is also an IM formulation fore very 1-14 day injection) Somatuline would appear to be a resonable option for such patients. In the USA, it is still in a study NCT00774930: An Efficacy and Safety Study of Somatuline Depot (Lanreotide) Injection to Treat Carcinoid Syndrome. Two open multicentre studies in small groups of adult patients (n = 39, n = 18) have been conducted with lanreotide LA for the management of carcinoid syndrome; one is published in full and the other as an abstract report. In both of these studies lanreotide LA significantly reduced the symptoms of flushing and diarrhoea.

Ruszniewski P, Ducreux M, Chayvialle JA, Blumberg J, Cloarec D et al. Treatment of the carcinoid syndrome with the long-acting somatostatin analogue lanreotide: a prospective study in 39 patients. Gut 1996; 39: 279-283.

Kvols L, Woltering E (2006). “Role of somatostatin analogs in the clinical management of non-neuroendocrine solid tumors”. Anticancer Drugs 17 (6): 601–8.

Susini C, Buscail L (2006). “Rationale for the use of somatostatin analogs as antitumor agents”. Ann Oncol 17 (12): 1733–42.

K. Öberg et al, Consensus report on the use of somatostatin analogs for the management of neuroendocrine tumors of the gastroenteropancreatic system Ann Oncol (2004) 15 (6): 966-973.

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