Premium
Treatment of carcinoid syndrome
Author(s) -
O'Toole Dermot,
Ducreux Michel,
Bommelaer Gilles,
Wemeau JeanLouis,
Bouché Olivier,
Catus France,
Blumberg Joëlle,
Ruszniewski Philippe
Publication year - 2000
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(20000215)88:4<770::aid-cncr6>3.0.co;2-0
Subject(s) - lanreotide , octreotide , medicine , carcinoid syndrome , somatostatin , gastroenterology , urinary system , diarrhea , urology , surgery , hormone , growth hormone , acromegaly
BACKGROUND The somatostatin analogues lanreotide and octreotide have previously been shown to be effective in controlling flushing and diarrhea in patients with carcinoid syndrome. As lanreotide requires injection only every 10 days, compared with twice‐daily injections of octreotide, a direct comparison between these two treatments in terms of patient acceptability, patient preference, and efficacy in controlling symptoms was performed in patients with carcinoid syndrome. METHODS Thirty‐three patients with carcinoid syndrome were included in an open, multicenter, crossover study. Half of the patients received octreotide 200 μg subcutaneously twice or thrice daily for 1 month followed by lanreotide 30 mg intramuscularly every 10 days for 1 month, while the other half commenced with lanreotide followed by octreotide in a similar fashion. Quality‐of‐life assessments were performed at each visit and patient preference for one of the two treatments evaluated. The number and intensity of flushing episodes and bowel movements, urinary 5‐hydroxyindoleacetic acid (5HIAA) levels, and plasma serotonin levels were recorded. RESULTS No significant differences were found between lanreotide and octreotide in terms of quality of life. The majority of patients (68%) preferred lanreotide ( P = 0.03), largely due to its simplified mode of administration. 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 disappearance or improvement of diarrhea in 45.4% (10 of 22) on lanreotide, compared with 50% (11 of 22) on octreotide, was also observed. Lanreotide and octreotide 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 and lanreotide, respectively. CONCLUSIONS Lanreotide and octreotide are equally efficacious in terms of symptom control and reduction in tumor cell markers for patients with carcinoid syndrome. Due to its simplified mode of administration, most patients prefer treatment with lanreotide. Cancer 2000;88:770–6. © 2000 American Cancer Society.