What is Lanreotide (Somatostatin analogue)?

From the Guidelines

Lanreotide is a somatostatin analogue used to treat neuroendocrine tumors, acromegaly, and carcinoid syndrome, with a recommended dosage of 60 to 120 mg every 4 weeks as a deep subcutaneous injection. The medication works by mimicking the action of somatostatin, inhibiting the release of growth hormone, insulin, and gastrointestinal hormones, as stated in the study published in the Journal of the National Comprehensive Cancer Network 1. According to the study published in Annals of Oncology, lanreotide has been shown to prolong time to tumor progression in patients with metastatic gastroenteropancreatic neuroendocrine neoplasms (GEP-NETs) 1.

Key Points

• Lanreotide is used to treat neuroendocrine tumors, acromegaly, and carcinoid syndrome
• The recommended dosage is 60 to 120 mg every 4 weeks as a deep subcutaneous injection
• The medication works by inhibiting the release of growth hormone, insulin, and gastrointestinal hormones
• Common side effects include injection site reactions, gastrointestinal disturbances, and gallstone formation
• Regular monitoring of blood glucose levels is recommended as lanreotide can affect glucose metabolism

Clinical Evidence

The CLARINET study demonstrated the efficacy of lanreotide in patients with locally advanced or metastatic nonfunctioning pancreatic or intestinal NETs, with a median progression-free survival (PFS) of more than 27 months compared to 18 months in the placebo arm 1. The study published in the Journal of the National Comprehensive Cancer Network also recommends lanreotide as a treatment option for patients with locoregional advanced and/or metastatic gastrointestinal tract primary NETs with clinically significant tumor burden or progressive disease 1.

Treatment Considerations

When considering lanreotide as a treatment option, it is essential to weigh the benefits and risks, including the potential for injection site reactions, gastrointestinal disturbances, and gallstone formation. Regular monitoring of blood glucose levels is also crucial, as lanreotide can affect glucose metabolism. According to the study published in Annals of Oncology, lanreotide can be recommended for tumor growth control in advanced SSTR-positive, slowly-growing GI and Pan-NETs up to a Ki-67 of 10% 1.

From the FDA Drug Label

Lanreotide acetate is a synthetic cyclical octapeptide analog of the natural hormone, somatostatin. Lanreotide, the active component of Lanreotide Injection, is an octapeptide analog of natural somatostatin. The mechanism of action of lanreotide is believed to be similar to that of natural somatostatin.

Lanreotide is a somatostatin analogue, which is a synthetic octapeptide with a biological activity similar to naturally occurring somatostatin. It is used to treat various conditions, including acromegaly and gastroenteropancreatic neuroendocrine tumors (GEP-NETs) 2, 2, 2.

• Key characteristics:
  • Synthetic cyclical octapeptide analog of somatostatin
  • Biological activity similar to naturally occurring somatostatin
  • Mechanism of action believed to be similar to that of natural somatostatin
  • Used to treat acromegaly, GEP-NETs, and carcinoid syndrome 2

From the Research

Definition and Mechanism of Lanreotide

• Lanreotide is an eight-amino acid peptide and an analog of the native somatostatin peptide, a physiological inhibitor of growth hormone (GH) 3.
• It shows high binding affinity for somatostatin receptors, SSTR2 and SSTR5, which is the primary mechanism considered to be responsible for decreasing GH secretion and GH cell proliferation in acromegaly 3.

Forms and Administration of Lanreotide

• Two different formulations of lanreotide are currently available: lanreotide slow release, which requires intramuscular injection every 7-14 days, and lanreotide autogel, which requires deep subcutaneous injection every 4-8 weeks 3.
• Lanreotide Autogel is a prolonged-release, supersaturated aqueous gel formulation of the somatostatin analogue lanreotide acetate that acts via somatostatin receptors to reduce both growth hormone and insulin-like growth factor-I levels 4.

Efficacy of Lanreotide in Acromegaly

• Lanreotide has been found to be effective in reducing GH and IGF-I levels in patients with acromegaly, with antisecretory efficacy reported in 35%-70% of cases 3.
• It also has antitumoral effects, inducing a decrease in tumor volume of at least 25% in 30%-70% of patients 3.
• Lanreotide Autogel has been shown to provide hormonal control and improve both health-related quality of life and acromegaly symptoms in most patients 4.

Tolerability and Safety of Lanreotide

• Lanreotide is generally well tolerated, with the most frequently reported adverse events being mild or moderate transient gastrointestinal symptoms 4.
• Side effects are rare, with the most frequent being gastrointestinal discomfort and increased risk of gallstone formation, and glucose metabolism modifications 3.
• Lanreotide Autogel has the advantage of being available in a convenient pre-filled syringe and is given subcutaneously rather than intramuscularly 4.

Dosage and Administration Interval

• The interval between injections of lanreotide Autogel can be prolonged from once every 4 weeks to once every 6 weeks in patients with normal IGF-I and GH concentrations without losing efficacy 5.
• Reducing the interval to once every 3 weeks is rarely beneficial in patients whose acromegaly is not controlled on a dose of 120 mg every 4 weeks 5.