Anti tumour effects of lanreotide for pancreatic and intestinal neuroendocrine tumours: the CLARINET open label extension study
In the CLARINET study, lanreotide Autogel (depot in USA) significantly prolonged progression free survival (PFS) in patients with metastatic pancreatic/intestinal neuroendocrine tumours (NETs) We report long term safety and additional efficacy data from the open label extension (OLE) Patients with metastatic grade 1/2 (Ki 67 =10% non functioning NET and documented baseline tumour progression status received lanreotide Autogel 120 mg (n=101) or placebo (n=103) for 96 weeks or until death/progressive disease (PD) in CLARINET study. Patients with stable disease (SD) at core study end (lanreotide/placebo) or PD (placebo only) continued or switched to lanreotide in the OLE. In total, 88 patients (previously: lanreotide, n=41; placebo, n=47) participated: 38% had pancreatic, 39% midgut and 23% other/unknown primary tumours. Patients continuing lanreotide reported fewer adverse events (AEs) (all and treatment related) during OLE than core study. Placebo to lanreotide switch patients reported similar AE rates in OLE and core studies, except more diarrhoea was considered treatment related in OLE (overall diarrhoea unchanged) Median lanreotide PFS (core study randomisation to PD in core/OLE; n=101) was 32.8 months (95% CI: 30.9, 68.0) A sensitivity analysis, addressing potential selection bias by assuming that patients with SD on lanreotide in the core study and not entering the OLE (n=13) had PD 24 weeks after last core assessment, found median PFS remaining consistent: 30.8 months (95% CI: 30.0, 31.3) Median time to further PD after placebo to lanreotide switch (n=32) was 14.0 months (10.1; not reached) This OLE study suggests long term treatment with lanreotide Autogel 120 mg maintained favourable safety/tolerability. CLARINET OLE data also provide new evidence of lanreotide anti tumour benefits in indolent and progressive pancreatic/intestinal NETs.
Endocrine related cancer