CLARINET: lanreotide in metastatic enteropancreatic neuroendocrine tumours
The long-acting somatostatin analogue lanreotide roughly halved the risk of progression in non-functioning gut and pancreatic neuroendocrine tumours, extending the use of these drugs from symptom control to slowing tumour growth.
Overview
Phase 3 placebo-controlled trial of 204 patients with advanced, well- or moderately differentiated, non-functioning, somatostatin receptor-positive enteropancreatic neuroendocrine tumours (Ki-67 under 10 percent) randomised to lanreotide autogel 120 mg monthly or placebo.
Median progression-free survival was not reached with lanreotide against 18.0 months with placebo (hazard ratio 0.47), with benefit in pancreatic and midgut tumours and in patients with high hepatic tumour load.
- Progression-free survival hazard ratio 0.47.
- 24-month progression-free survival 65.1 percent vs 33.0 percent.
Somatostatin analogues are the standard first-line antiproliferative treatment for grade 1 to 2 gastroenteropancreatic neuroendocrine tumours whether or not they cause a hormone syndrome.
- Most patients had stable disease at entry, so the natural history was slow.
- No overall survival benefit shown.
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