PATIENT-REPORTED OUTCOMES (PROS) ASSOCIATED WITH LANREOTIDE AUTOGEL (LAN-ATG) FOR SYMPTOM CONTROL OF CARCINOID SYNDROME IN GASTROENTEROPANCREATIC NEUROENDOCRINE TUMOUR (GEP-NET) PATIENTS: RESULTS OF SYMNET, A LARGE INTERNATIONAL MULTICENTRE OBSERVATIONAL STUDY

Background:

Somatostatin analogues are widely used to reduce the incidence and severity of carcinoid syndrome symptoms. However, their impact on patients’ satisfaction with symptom control needs further investigation. SYMNET was a large international multicentre observation study that assessed PROs during LAN-ATG treatment of carcinoid syndrome in GEP-NET patients.

Methods:

At routine clinic visit, patients with diarrhoea related to carcinoid syndrome and receiving LAN-ATG for > 3 months were asked to complete PRO questionnaires on satisfaction and symptoms associated with their treatment. Investigators also assessed patients’ medical records to identify patient characteristics that were potential predictors of treatment satisfaction.

Results:

Of 273 patients enrolled, 56% were male, 57% were aged > 60 years, 66% had small bowel primary tumours, and 80% had liver metastases. Prior to the study, 66% had surgery and 23% other anti-tumour therapy within last three months. Mean time since diagnosis was 4.4 years. Mean LAN-ATG treatment duration was 21.7 months and median dose 120 mg/ month on study day. Most patients (76%) were satisfied with diarrhoea control, and flushing control (73%). More patients indicated no, minimal, or mild diarrhoea at study visit (75%) than did before treatment (33%). Most (79%) patients reported diarrhoea was improved overall with LAN-ATG. Investigators identified a clinically relevant decrease in stool frequency since treatment initiation (median: 4 to 2 episodes/ day). Statistically significant decreases (McNemar paired tests, p < 0.001) were seen in the proportion of patients with urgency (73 to 41%), leakage (21 to 9%), and associated pain (37 to 4%). Predictors of satisfaction with diarrhoea control were initial stool leakage and non-small bowel primary localization.

Conclusion:

GEP-NET patients reported favourable symptom control with LAN-ATG treatment. Improvements in PROs were consistent with those on investigators’ medical assessments. Patients’ satisfaction with symptom control on LAN-ATG may be supported by associated factors.

Supported by the project CZ 1.05/ 2.1.00/ 03.0076 from European Regional Development Fund.