Klin Onkol 2016; 29(4): 253-258. DOI: 10.14735/amko2016253.
Background: Somatostatin analogs (SSAs) are antisecretory agents that have been used to control hormonal syndromes associated with neuroendocrine tumors for more than 20 years. Recent phase III randomized, placebo controlled trials demonstrated their antiproliferative eff ects. The PROMID study showed that octreotide LAR (long-acting repeatable) treatment had anti-tumor eff ects. CLARINET, an international multicenter controlled study, provides new evidence that lanreotide has antiproliferative eff ects. Depot lanreotide signifi cantly prolonged progression-free survival among patients with metastatic gastroenteropancreatic neuroendocrine tumors (GEP-NETs). Because GEP-NETs are bio logically diverse in terms of primary tumor site and functional status, preventing progression can be diffi cult. Aim: This review summarizes data supporting the role of SSAs, in particular lanreotide, as antiproliferative agents for the treatment of patients with GEP-NETs. Conclusion: The CLARINET study is the most powerful (in sence of data, results, clinical aplication) randomized study of the antiproliferative eff ects of SSA in GEP-NET patients. The median lanreotide-associated progression-free survival in the CLARINET core study or in open-label extension study was 32.8 vs. 18 months for placebo. Thus, early treatment with lanreotide is expected to prolong progression-free survival. Lanreotide is now recommended for the treatment of patients with well-diff erentiated metastatic grade 1 and grade 2 GEP-NETs (i.e., those with a Ki-67 proliferative index < 10%) located in the pancreas, small intestine, or in cases where the location of the primary tumor is unknown, regardless of the degree of liver involvement.
