title: Long-term results of treatment of malignant carcinoid syndrome with prolonged release Lanreotide (Somatuline Autogel).
abstract: BACKGROUND
  Somatostatin analogues are the mainstay of therapy for malignant carcinoid syndrome. There is clear evidence that the once monthly intramuscular formulation, Octreotide LAR, controls symptoms of carcinoid syndrome, and recent data also suggests an antitumour effect. There is limited data on prolonged release Lanreotide (Somatuline Autogel, Ipsen Pharma Biotech, Signes, France) and no long-term data to date.
  
  
  OBJECTIVE
  To present long-term results of prolonged release Lanreotide in a large cohort of patients with malignant carcinoid syndrome, assessing clinical and objective response and tolerance.
  
  
  METHODS
  Seventy six patients with metastatic midgut neuroendocrine tumours and carcinoid syndrome were included in this 9-year retrospective study. Clinical response was based on symptom score with radiological assessment based on RECIST (Response Evaluation Criteria In Solid Tumours).
  
  
  RESULTS
  Data were available in 69 patients. Ninety four percent achieved symptomatic response at first follow-up visit. Forty six percent had loss of symptomatic response, but 44% of these achieved control with an increase in dose of prolonged release Lanreotide. Overall, symptoms were well controlled throughout the study period with prolonged release Lanreotide alone in 74% of patients. Twenty six percent required additional treatment despite good initial response. Only 30% demonstrated radiological progression. Eleven patients who were switched from Octreotide LAR had return of symptomatic control. No significant adverse effects were experienced.
  
  
  CONCLUSIONS
  Prolonged release Lanreotide provides good symptomatic control of diarrhoea and flushing as well as tumour stability in patients with malignant carcinoid syndrome.
authors.affiliation: Neuroendocrine Tumour Unit, Centre for Gastroenterology, Royal Free Hospital, London, UK.
authors.forename: M S
authors.initials: MS
authors.lastname: Khan
authors.forename: F
authors.initials: F
authors.lastname: El-Khouly
authors.forename: P
authors.initials: P
authors.lastname: Davies
authors.forename: C
authors.initials: C
authors.lastname: Toumpanakis
authors.forename: M E
authors.initials: ME
authors.lastname: Caplin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008303:Malignant Carcinoid Syndrome / Q000188:drug therapy*; D008875:Middle Aged; D010456:Peptides, Cyclic / Q000627:therapeutic use*; D012189:Retrospective Studies; D013004:Somatostatin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D013997:Time Factors
chemical_list: D000970:Antineoplastic Agents; D010456:Peptides, Cyclic; C060347:lanreotide; D013004:Somatostatin