Rapid and sustained relief from the symptoms of carcinoid syndrome: results from an open 6-month study of the 28-day prolonged-release formulation of lanreotide.
This 6-month, open, non-controlled, multicenter, dose-titration study evaluated the efficacy and safety of 28-day prolonged-release (PR) lanreotide in the treatment of carcinoid syndrome. Eligible patients had a carcinoid tumor with > or =3 stools/day and/or > or =1 moderate/severe flushing episodes/day. Six treatments of 28-day PR lanreotide were administered by deep subcutaneous injection. The dose for the first two injections was 90 mg. Subsequent doses could be titrated (60, 90, 120 mg) according to symptom response. Seventy-one patients were treated. Flushing decreased from a mean of 3.0 at baseline to 2.3 on day 1, and 2.0 on day 2, with a daily mean of 2.1 for the first week post-treatment (p < 0.05). Diarrhea decreased from a mean of 5.0 at baseline to 4.3 on day 1 (p < 0.05), and 4.5 on day 2, with a daily mean of 4.4 for the first week post-treatment (p < 0.001). Symptom frequency decreased further after the second and third injections, and reached a plateau after the fourth injection. By month 6, flushing and diarrhea had significantly decreased from baseline by a mean of 1.3 and 1.1 episodes/day, respectively (both p < or = 0.001); 65% of patients with flushing as the target symptom and 18% of diarrhea-target patients achieved > or =50% reduction from baseline. Median urinary 5-hydroxyindoleacetic acid and chromogranin A levels decreased by 24 and 38%, respectively. Treatment was well tolerated. 28-day PR lanreotide was effective in reducing the symptoms and biochemical markers associated with carcinoid syndrome.
Ruszniewski
Philippe
P
Hôpital Beaujon, Clichy, France. philippe.ruszniewski@bjn.ap-hop-paris.fr
Ish-Shalom
Sofia
S
Wymenga
Machteld
M
O'Toole
Dermot
D
Arnold
Rudolf
R
Tomassetti
Paola
P
Bax
Nigel
N
Caplin
Martyn
M
Eriksson
Barbro
B
Glaser
Benjamin
B
Ducreux
Michel
M
Lombard-Bohas
Catherine
C
de Herder
Wouter W
WW
Delle Fave
Gianfranco
G
Reed
Nick
N
Seitz
Jean François
JF
Van Cutsem
Eric
E
Grossman
Ashley
A
Rougier
Philippe
P
Schmidt
Wolfgang
W
Wiedenmann
Bertram
B
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002864:Chromogranins / Q000097:blood; D003692:Delayed-Action Preparations / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004341:Drug Evaluation / Q000379:methods; D005260:Female; D005483:Flushing / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000652:urine; D008297:Male; D008303:Malignant Carcinoid Syndrome / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D008875:Middle Aged; D010456:Peptides, Cyclic / Q000097:blood / Q000627:therapeutic use*; D011788:Quality of Life; D013004:Somatostatin / Q000031:analogs & derivatives* / Q000097:blood / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D003969:Vipoma / Q000188:drug therapy / Q000503:physiopathology
D002864:Chromogranins; D003692:Delayed-Action Preparations; D010456:Peptides, Cyclic; C060347:lanreotide; D013004:Somatostatin; D006897:Hydroxyindoleacetic Acid