TREATMENT OF THE CARCINOID-SYNDROME WITH THE LONGACTING SOMATOSTATIN ANALOG LANREOTIDE - A PROSPECTIVE-STUDY IN 39 PATIENTS

Background-Somatostatin analogues effectively control flushing and dia rrhoea in patients with the carcinoid syndrome. The octapeptide lanreo tide is available in slow release form, which could eliminate the nece ssity of twice a day injections as with octreotide. Patients and Metho ds-39 patients with carcinoid syndrome were included in a prospective multicentre study. Patients received lanreotide 30 mg intramuscularly every 14 days for six months. The number and intensity of flushing epi sodes and bowel movements, urinary 5 hydroxyindolacetic acid (5 HIAA) concentrations, and variations of tumour mass were recorded. Results-A fter one month of treatment, flushing episodes (median (range)) decrea sed significantly (3 (0.3-24) episodes per day v 1 (0-15), p=0.04) and completely resolved in 39% of the patients. A significant decrease wa s seen in the number of bowel movements and discomfort related to diar rhoea. Urinary 5 HIAA concentrations were unchanged in 57% of the pati ents and decreased in 18%. After six months of treatment, the actuaria l proportions of patients with at least a 50% decrease in the number o f flushing episodes and bowel movements were 54% and 56%, respectively . Forty two per cent of the patients who were treated for six months h ad at least a 50% reduction in 5 HIAA values. No clear signs of regres sion of tumours were seen in any of the patients. Lanreotide was well tolerated despite transient mild pain or erythema at the injection sit e in 25% of the patients. Biliary lithiasis appeared in two patients a fter six months of lanreotide. Conclusion-Lanreotide, 30 mg intramuscu larly every other week, is an effective and convenient treatment in pa tients with the carcinoid syndrome.