Lanreotide Depot: An Antineoplastic Treatment of Carcinoid or Neuroendocrine Tumors.
OBJECTIVE
Peptide drugs for antineoplastic therapies usually have low oral bioavailability and short in vivo half-lives, requiring less preferred delivery methods. Lanreotide depot is a sustained-release somatostatin analog (SSA) formulation produced via an innovative peptide self-assembly method. Lanreotide is approved in the USA and Europe to improve progression-free survival (PFS) in patients with unresectable gastroenteropancreatic neuroendocrine tumors (GEP-NETs) and also approved in Europe for symptom control in carcinoid syndrome associated with GEP-NETs. This review discusses how the distinct molecule and formulation of lanreotide depot provide advantages to patients and health care providers, as well as the most recent clinical evidence demonstrating the safety and efficacy of lanreotide depot in inhibiting tumor growth and controlling hormonal symptoms in GEP-NETs.


RESULTS
The lanreotide depot formulation confers a remarkable pharmacokinetic profile with no excipients, comprised only of lanreotide acetate and water. Of note, lanreotide depot constitutes an example for peptide self-assembly based formulations, providing insights that could help future development of sustained-release formulations of other antineoplastic peptides. Most patients with GEP-NETs will present with inoperable or incurable disease; thus, medical management for symptoms and tumor control plays a crucial role. Recent long-term clinical studies have demonstrated that lanreotide depot is well tolerated, prolongs PFS in GEP-NET patients, and significantly reduces symptoms related to carcinoid syndrome.


CONCLUSIONS
The unique depot formulation and delivery method of lanreotide confer advantages in the treatment of metastatic GEP-NETs, contributing to improvements in NET-related symptoms and PFS without reducing quality of life in this patient population.
Medical Oncology, Montifiore Einstein Center for Cancer Care, 1695 Eastchester Rd., Second Floor, Bronx, NY, 10461, USA. ewolin@montefiore.org.
Edward M
EM
Wolin
Clinical Pharmacokinetics and Drug Metabolism, Ipsen Innovation, 5 Avenue du Canada, 91140, Les Ulis, France.
Amandine
A
Manon
Peptide Development, Beaufour Ipsen Industrie, Rue Ethe Virton, 28109, Dreux, France.
Christophe
C
Chassaing
Peptide Development, Beaufour Ipsen Industrie, Rue Ethe Virton, 28109, Dreux, France.
Andy
A
Lewis
Peptide Development, Beaufour Ipsen Industrie, Rue Ethe Virton, 28109, Dreux, France.
Laurent
L
Bertocchi
Peptide Development, Beaufour Ipsen Industrie, Rue Ethe Virton, 28109, Dreux, France.
Joel
J
Richard
Houston Methodist Hospital, 6410 Fannin St, Houston, TX, 77030, USA.
Alexandria T
AT
Phan
D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002276:Carcinoid Tumor / Q000188:drug therapy* / Q000473:pathology; D018278:Carcinoma, Neuroendocrine / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D010456:Peptides, Cyclic / Q000008:administration & dosage / Q000627:therapeutic use*; D013004:Somatostatin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use
D000970:Antineoplastic Agents; D010456:Peptides, Cyclic; C060347:lanreotide; D013004:Somatostatin
Depot preparations; Drug formulation; Lanreotide; Neuroendocrine tumors