title: Octreotide long-acting repeatable among elderly patients with neuroendocrine tumors: a survival analysis of SEER-Medicare data.
abstract: BACKGROUND
  Octreotide long-acting repeatable (LAR) is approved in the United States for the management of carcinoid syndromes among patients with neuroendocrine tumors (NET). The objective of our study is to evaluate the impact of octreotide LAR on overall survival (OS), as it has not been established.
  
  
  METHODS
  NET patients of 65 years and older diagnosed between January 1999 and December 2009 were identified from the SEER-Medicare database. We compared the OS of NET patients who started octreotide LAR within 12 months of diagnosis with those who did not receive it during the same period. We conducted Kaplan-Meier estimations and Cox proportional hazard models to examine the association between octreotide LAR and OS.
  
  
  RESULTS
  Among 1,176 distant stage patients, 233 (20%) received octreotide LAR within 12 months of diagnosis, compared with 2% (96 in 5,764) of local/regional stage patients. Median OS for patients who started octreotide LAR within 12 months was 35.22 months [95% confidence interval (CI), 27.96-47.77], longer than those who did not receive it (19.15 months; 95% CI, 16.36-22.80; P < 0.0001). Multivariate analysis showed that octreotide LAR was associated with significant survival improvement for distant stage patients (HR, 0.68; P < 0.001) and in the subgroups with (HR, 0.65; P, 0.003) and without (HR, 0.55; P, 0.002) carcinoid syndrome. No survival benefit was found among local/regional stage patients.
  
  
  CONCLUSIONS
  This population-based study suggests potential survival benefits of octreotide LAR among elderly distant stage NET patients, both with or without carcinoid syndrome.
  
  
  CONCLUSIONS
  The study provides population-based evidence of a positive association between octreotide LAR and overall survival among elderly distant stage NET patients.
authors: Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors: Chan
authors: C
authors: Shen
authors: Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors: Ya-Chen Tina
authors: YC
authors: Shih
authors: Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors: Ying
authors: Y
authors: Xu
authors: Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas. jyao@mdanderson.org.
authors: James C
authors: JC
authors: Yao
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008303:Malignant Carcinoid Syndrome / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality; D018358:Neuroendocrine Tumors / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D015282:Octreotide / Q000008:administration & dosage / Q000627:therapeutic use*; D016016:Proportional Hazards Models; D018426:SEER Program; D016019:Survival Analysis
chemical_list: D018931:Antineoplastic Agents, Hormonal; D015282:Octreotide