title: The Antiproliferative Role of Lanreotide in Controlling Growth of Neuroendocrine Tumors: A Systematic Review.
abstract: Neuroendocrine tumors (NETs) are a heterogeneous group of tumors, with >50% of cases involving the gastrointestinal system or pancreas. Somatostatin analogs (SSAs) are used for treating NET-related secretory syndromes and, more recently, for their antiproliferative effects. We conducted a systematic review of published literature on the antiproliferative efficacy and safety of the SSA lanreotide Autogel in the management of NETs to gain a fuller understanding of the evidence and identify future areas of research.
  
  
  
  Searches were conducted in PubMed up to March 16, 2016, and in the proceedings of four congresses from 2013 to 2016.
  
  
  
  Screening of 1,132 publications identified in the searches found 40 relevant publications, including 27 full-length publications and 13 congress abstracts. Twenty-four of these publications reported antiproliferative efficacy data for lanreotide Autogel. The CLARINET study showed that 120 mg lanreotide Autogel every 4 weeks improves progression-free survival (PFS) in patients with gastroenteropancreatic (GEP)-NETs, with grade 1 or grade 2 (Ki-67 <10%) disease, providing class I evidence of its antiproliferative effects. The CLARINET open-label extension study reported a median PFS of 32.8 months with lanreotide Autogel. Other smaller studies generally support CLARINET.
  
  
  
  Current clinical evidence shows that lanreotide Autogel has good antiproliferative activity with favorable safety and tolerability in patients with GEP-NETs, suggesting it should be considered as an early first-line treatment in this population. Further studies are needed to assess the potential benefits of higher doses and the use of lanreotide Autogel in combination therapy and as maintenance therapy in the absence of disease progression following other therapies.The Oncologist2017;22:272-285 IMPLICATIONS FOR PRACTICE: This review presents the current clinical evidence for the antiproliferative activity of lanreotide Autogel in patients with midgut or pancreatic neuroendocrine tumors (NETs) and shows its effectiveness, safety, and tolerability in these patient populations. By systematically presenting all the clinical evidence, the review adds to existing publications by discussing results in a broad range of settings. The review also indicates future directions for investigation of the use of lanreotide Autogel in NETs originating in other locations, in combination therapy, or as maintenance therapy in progressive disease.
authors.affiliation: Neuorendocrine Service & Division of Cancer Medicine, Peter MacCallum Cancer Centre, St. Andrews Place, East Melbourne, Australia Michael.Michael@petermac.org.
authors.forename: Michael
authors.initials: M
authors.lastname: Michael
authors.affiliation: Hospital Universitario Doce de Octubre, Madrid, Spain.
authors.forename: Rocio
authors.initials: R
authors.lastname: Garcia-Carbonero
authors.affiliation: University Hospital Mainz, Mainz, Germany.
authors.forename: Matthias M
authors.initials: MM
authors.lastname: Weber
authors.affiliation: Hôpital Édouard-Herriot, Fédération des spécialités digestives, Lyon, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Lombard-Bohas
authors.affiliation: Neuroendocrine Tumour Unit, Royal Free Hospital, London, United Kingdom.
authors.forename: Christos
authors.initials: C
authors.lastname: Toumpanakis
authors.affiliation: Cancer Imaging & Neuroendocrine Service & Molecular Imaging and Targeted Therapeutics Laboratory, Peter MacCallum Cancer Centre, St. Andrews Place, East Melbourne, Australia.
authors.forename: Rodney J
authors.initials: RJ
authors.lastname: Hicks
mesh_terms: D049109:Cell Proliferation / Q000187:drug effects*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D006801:Humans; D018358:Neuroendocrine Tumors / Q000188:drug therapy*; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000473:pathology; D010456:Peptides, Cyclic / Q000009:adverse effects / Q000627:therapeutic use*; D013004:Somatostatin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D010456:Peptides, Cyclic; C060347:lanreotide; D013004:Somatostatin
keywords: Antiproliferative; Gastroenteropancreatic neuroendocrine tumors; Lanreotide; Neuroendocrine tumors