Treatment of carcinoid syndrome - A prospective crossover evaluation of lanreotide versus octreotide in terms of efficacy, patient acceptability, andtolerance

Citation
D. O'Toole et al., Treatment of carcinoid syndrome - A prospective crossover evaluation of lanreotide versus octreotide in terms of efficacy, patient acceptability, andtolerance, CANCER, 88(4), 2000, pp. 770-776
Citations number
27
Categorie Soggetti
Oncology,"Onconogenesis & Cancer Research
Journal title
CANCER
ISSN journal
0008543X → ACNP
Volume
88
Issue
4
Year of publication
2000
Pages
770 - 776
Database
ISI
SICI code
0008-543X(20000215)88:4<770:TOCS-A>2.0.ZU;2-#
Abstract
BACKGROUND. The somatostatin analogues lanreotide and octreotide have previ ously been shown to be effective in controlling flushing and diarrhea in p atients with carcinoid syndrome. As lanreotide requires injection only ever y 10 days, compared with twice-daily injections of octreoeide, a direct com parison between these two treatments in terms of patient acceptability, pat ient preference, and efficacy in controlling symptoms was performed in pati ents with carcinoid syndrome. METHODS. Thirty-three patients with carcinoid syndrome were included in an open, multicenter, crossover study. Waif of the patients received octreotid e 200 mu g subcutaneously twice or thrice daily for 1 month followed by lan reotide 30 mg intramuscularly every 10 days for 1 month, while the other ha lf commenced with lanreotide followed by octreotide in a similar fashion. Q uality-of-life assessments were performed at each visit and patient prefere nce for one of the two treatments evaluated. The number and intensity of fl ushing episodes and bowel movements, urinary 5-hydroxyindoleacetic acid (5H IAA) levels, and plasma serotonin levels were recorded. RESULTS. No significant differences were found between lanreotide and octre otide in terms of quality of life. The majority of patients (68%) preferred lanreotide (P = 0.03), largely due to its simplified mode of administratio n. Disappearance or improvement in flushes, occurred in 53.8% of patients ( 14 of 26) while on lanreotide and in 68% (17 of 25) on octreotide. A disapp earance or improvement of diarrhea in 45.4% (10 of 22) on lanreotide, compa red with 50% (11 of 22) on octreotide, was also observed. Lanreotide and oc treotide were equally effective in reducing urinary 5HIAA levels and plasma serotonin levels. Both treatments were well tolerated, with mild symptoms of abdominal pain and nausea observed in 29% and 14% receiving octreotide a nd lanreotide, respectively. CONCLUSIONS. Lanreotide and octreotide are equally efficacious in terms of symptom control and reduction in tumor cell markers for patients with carci noid syndrome. Due to its simplified mode of administration. most patients prefer treatment with lanreotide. (C) 2000 American Cancer Society.