Treatment of the carcinoid syndrome with the longacting somatostatin analogue lanreotide: a prospective study in 39 patients.

P Ruszniewski, M Ducreux, J A Chayvialle, J Blumberg, D Cloarec, H Michel, J M Raymond, J L Dupas, H Gouerou, R Jian, E Genestin, P Bernades, P Rougier

Department of Gastroenterology, Hôpital Beaujon, Clichy, France.

BACKGROUND: Somatostatin analogues effectively control flushing and diarrhoea in patients with the carcinoid syndrome. The octapeptide lanreotide is available in slow release form, which could eliminate the necessity of twice a day injections as with octreotide. PATIENTS AND METHODS: 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 episodes and bowel movements, urinary 5 hydroxy-indolacetic acid (5 HIAA) concentrations, and variations of tumour mass were recorded. RESULTS: After one month of treatment, flushing episodes (median (range)) decreased 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 was seen in the number of bowel movements and discomfort related to diarrhoea. Urinary 5 HIAA concentrations were unchanged in 57% of the patients and decreased in 18%. After six months of treatment, the actuarial proportions of patients with at least a 50% decrease in the number of flushing episodes and bowel movements were 54% and 56%, respectively. Forty two per cent of the patients who were treated for six months had at least a 50% reduction in 5 HIAA values. No clear signs of regression of tumours were seen in any of the patients. Lanreotide was well tolerated despite transient mild pain or erythema at the injection site in 25% of the patients. Biliary lithiasis appeared in two patients after six months of lanreotide. CONCLUSION: Lanreotide, 30 mg intramuscularly every other week, is an effective and convenient treatment in patients with the carcinoid syndrome.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• CHADHA, M. K., LOMBARDO, J., MASHTARE, T., WILDING, G. E., LITWIN, A., RACZYK, C., GIBBS, J. F., KUVSHINOFF, B., JAVLE, M. M., IYER, R. V. (2009). High-dose Octreotide Acetate for Management of Gastroenteropancreatic Neuroendocrine Tumors. Anticancer Res 29: 4127-4130 [Abstract] [Full Text]  
• Bajetta, E., Catena, L., Procopio, G., Bichisao, E., Ferrari, L., Della Torre, S., De Dosso, S., Iacobelli, S., Buzzoni, R., Mariani, L., Rosai, J. (2005). Is the new WHO classification of neuroendocrine tumours useful for selecting an appropriate treatment?. Ann Oncol 16: 1374-1380 [Abstract] [Full Text]  
• Ramage, J K, Davies, A H G, Ardill, J, Bax, N, Caplin, M, Grossman, A, Hawkins, R, McNicol, A M, Reed, N, Sutton, R, Thakker, R, Aylwin, S, Breen, D, Britton, K, Buchanan, K, Corrie, P, Gillams, A, Lewington, V, McCance, D, Meeran, K, Watkinson, A, on behalf of UKNETwork for neuroendocrine tumours, (2005). Guidelines for the management of gastroenteropancreatic neuroendocrine (including carcinoid) tumours. Gut 54: iv1-iv16 [Full Text]  
• Delaunoit, T., Rubin, J., Neczyporenko, F., Erlichman, C., Hobday, T. J. (2005). Somatostatin Analogues in the Treatment of Gastroenteropancreatic Neuroendocrine Tumors. Mayo Clin Proc. 80: 502-506 [Abstract]  
• Kaltsas, G. A., Besser, G. M., Grossman, A. B. (2004). The Diagnosis and Medical Management of Advanced Neuroendocrine Tumors. Endocr. Rev. 25: 458-511 [Abstract] [Full Text]  
• Reubi, J. C. (2003). Peptide Receptors as Molecular Targets for Cancer Diagnosis and Therapy. Endocr. Rev. 24: 389-427 [Abstract] [Full Text]  
• Hofland, L. J., Lamberts, S. W. J. (2003). The Pathophysiological Consequences of Somatostatin Receptor Internalization and Resistance. Endocr. Rev. 24: 28-47 [Abstract] [Full Text]  
• Waldherr, C., Pless, M., Maecke, H. R., Schumacher, T., Crazzolara, A., Nitzsche, E. U., Haldemann, A., Mueller-Brand, J. (2002). Tumor Response and Clinical Benefit in Neuroendocrine Tumors After 7.4 GBq 90Y-DOTATOC. JNM 43: 610-616 [Abstract] [Full Text]  
• Rossmeisl, J. H. Jr., Forrester, S. D., Robertson, J. L., Cook, W. T. (2002). Chronic Vomiting Associated With a Gastric Carcinoid in a Cat. Journal of the American Animal Hospital Association 38: 61-66 [Abstract] [Full Text]  
• POP-BUSUI, R., CHEY, W., STEVENS, M. J. (2000). Severe Hypertension Induced by the Long-Acting Somatostatin Analogue Sandostatin LAR in a Patient with Diabetic Autonomic Neuropathy. J. Clin. Endocrinol. Metab. 85: 943-946 [Abstract] [Full Text]  
• Vitale, G., Tagliaferri, P., Caraglia, M., Rampone, E., Ciccarelli, A., Bianco, A. R., Abbruzzese, A., Lupoli, G. (2000). Slow Release Lanreotide in Combination with Interferon-{alpha}2b in the Treatment of Symptomatic Advanced Medullary Thyroid Carcinoma. J. Clin. Endocrinol. Metab. 85: 983-988 [Abstract] [Full Text]  
• Wymenga, A.N.M., Eriksson, B., Salmela, P.I., Jacobsen, M.B., Van Cutsem, E.J.D.G., Fiasse, R.H., Valimaki, M.J., Renstrup, J., de Vries, E.G.E., Oberg, K.E. (1999). Efficacy and Safety of Prolonged-Release Lanreotide in Patients With Gastrointestinal Neuroendocrine Tumors and Hormone-Related Symptoms. JCO 17: 1111-1111 [Abstract] [Full Text]  
• Kulke, M. H., Mayer, R. J. (1999). Carcinoid Tumors. NEJM 340: 858-868 [Full Text]  
• Drange, M. R., Melmed, S. (1998). Long-Acting Lanreotide Induces Clinical and Biochemical Remission of Acromegaly Caused by Disseminated Growth Hormone-Releasing Hormone-Secreting Carcinoid. J. Clin. Endocrinol. Metab. 83: 3104-3109 [Abstract] [Full Text]