INSIGHTS FROM: ZOZO GREENHOLZ, RN; ANDREW E. HENDIFAR, MD; ERIC LIU, MD, FACS; MARIAH MAHOTZ, RN, BSN, OCN
Thursday, January 23, 2020
Andrew E. Hendifar, MD: There have been several studies performed to investigate the role of somatostatin analogue therapies in patients with neuroendocrine tumors. The PROMID study was designed to look at the use of octreotide long-acting release [LAR] in patients with metastatic midgut neuroendocrine tumors and those who have progressed over time. In that study, in patients with midgut neuroendocrine tumors, the progression-free survival was found to be significantly improved with those who receive octreotide LAR.
In the CLARINET study, these findings were expanded to other disease groups, including not only the midgut tumors but the hindgut tumors, which include the rectum and colon, the pancreatic and neuroendocrine tumors, and other GI [gastrointestinal] or other tumors known as GEP-NETs [gastroenteropancreatic neuroendocrine tumors]. We commonly use somatostatin analogue treatments for all well-differentiated neuroendocrine tumors that express the somatostatin receptor. We tend to use gallium [Ga] 68-DOTATATE PET [positron emission tomography] or CT [computed tomography] imaging to confirm the receptor expression. However, an OctreoScan is also a suitable test for this indication.
The primary end point in the CLARINET study was progression-free survival for patients who had a well-differentiated neuroendocrine tumor of the gastroenteropancreatic system, including pancreatic tumors, midgut tumors, hindgut tumors, and gastric tumors. Based on this study, lanreotide was approved to be used as first-line treatment in patients with progressive neuroendocrine tumors.
It’s also important to mention that the findings of the CLARINET study were further expanded by the ELECT study, and that lanreotide is now approved and used for carcinoid syndrome as well.