Profile of lanreotide autogel and its potential in the treatment of gastroenteropancreatic neuroendocrine tumors

Gastroenteropancreatic neuroendocrine tumors (GEPNETs) comprise a heterogenous group of neoplasm, and their incidence is increasing in the population. Approximately one-third of these tumors are associated with characteristic hormonal syndromes like flushing and diarrhea in carcinoid syndrome. Most GEPNETs express receptors for somatostatin. The somatostatin analogs octreotide and lanreotide constituted a major therapeutic advance in palliating hypersecretion syndromes. Lanreotide autogel is a viscous aqueous solution of lanreotide that is usually administered deep subcutaneously every 4 weeks, but extended dosing intervals have also been proposed. In recent years, increasing evidence has supported the use of somatostatin analogs (SSA) as antitumor agents. In the double-blind, placebo-controlled, Phase III CLARINET trial, lanreotide autogel 120 mg every 4 weeks was associated with a significant prolongation of progression-free survival in patients with nonfunctioning GEPNETs, with a Ki-67 of <10%. This antiproliferative effect and the favorable toxicity profile make lanreotide autogel attractive for long-term treatment in patients with well-differentiated GEPNETs. Further studies are needed to evaluate the role of lanreotide autogel as a combination partner and the efficacy of high-dose lanreotide.