Somatostatin analogues (SSA) control the hormonal hypersecretion in pancreatic and midgut neuroendocrine tumours (NETs), with antiproliferative, antiangiogenic and proapoptotic effects.¹Michael M et al. The Oncologist. 2017;22(3):272-285. Lanreotide autogel is a long-acting SSA that is considered the therapy of choice along with octreotide, in controlling symptoms associated with gastroenteropancreatic (GEP)-NETs.¹Michael M et al. The Oncologist. 2017;22(3):272-285.

The CLARINET FORTE trial is a prospective, single-arm, open-label exploratory phase II study exploring the efficacy and safety of increased lanreotide autogel injection dose intervals in patients with metastatic or locally advanced unresectable pancreatic NETs (panNETs) or midgut NETs.²Pavel M. Presented at ESMO 2020. Available at: https://oncologypro.esmo.org/meeting-resources/esmo-virtual-congress-2020/efficacy-and-safety-of-lanreotide-autogel-lan-120-mg-every-14-days-in-progressive-pancreatic-or-midgut-neuroendocrine-tumours-nets-clarinet-fo (Accessed 24 December 2020). The dosing interval was increased from 120mg every 28 days to 120mg every 14 days.²Pavel M. Presented at ESMO 2020. Available at: https://oncologypro.esmo.org/meeting-resources/esmo-virtual-congress-2020/efficacy-and-safety-of-lanreotide-autogel-lan-120-mg-every-14-days-in-progressive-pancreatic-or-midgut-neuroendocrine-tumours-nets-clarinet-fo (Accessed 24 December 2020). This regimen was administered for 48 weeks in pancreatic NET patients, and 96 weeks in midgut NET patients.²Pavel M. Presented at ESMO 2020. Available at: https://oncologypro.esmo.org/meeting-resources/esmo-virtual-congress-2020/efficacy-and-safety-of-lanreotide-autogel-lan-120-mg-every-14-days-in-progressive-pancreatic-or-midgut-neuroendocrine-tumours-nets-clarinet-fo (Accessed 24 December 2020).

In the panNET cohort, median progression-free survival (PFS) was 5.6 months.²Pavel M. Presented at ESMO 2020. Available at: https://oncologypro.esmo.org/meeting-resources/esmo-virtual-congress-2020/efficacy-and-safety-of-lanreotide-autogel-lan-120-mg-every-14-days-in-progressive-pancreatic-or-midgut-neuroendocrine-tumours-nets-clarinet-fo (Accessed 24 December 2020). Post-hoc subgroup analysis demonstrated increased median PFS of 8.0 months vs 2.8 months in patients with Ki67 ≤10% vs those >10%, respectively.²Pavel M. Presented at ESMO 2020. Available at: https://oncologypro.esmo.org/meeting-resources/esmo-virtual-congress-2020/efficacy-and-safety-of-lanreotide-autogel-lan-120-mg-every-14-days-in-progressive-pancreatic-or-midgut-neuroendocrine-tumours-nets-clarinet-fo (Accessed 24 December 2020). In the midgut NET cohort, median PFS was 8.3 months.²Pavel M. Presented at ESMO 2020. Available at: https://oncologypro.esmo.org/meeting-resources/esmo-virtual-congress-2020/efficacy-and-safety-of-lanreotide-autogel-lan-120-mg-every-14-days-in-progressive-pancreatic-or-midgut-neuroendocrine-tumours-nets-clarinet-fo (Accessed 24 December 2020). Disease control rate (DCR) was 43.8% and 58.8% in panNET and midgut NET patients respectively at week 24, and decreasing to 22.9% and 33.3% at week 48.²Pavel M. Presented at ESMO 2020. Available at: https://oncologypro.esmo.org/meeting-resources/esmo-virtual-congress-2020/efficacy-and-safety-of-lanreotide-autogel-lan-120-mg-every-14-days-in-progressive-pancreatic-or-midgut-neuroendocrine-tumours-nets-clarinet-fo (Accessed 24 December 2020).

Treatment-related adverse events (TRAEs) occurred in 37.5% and 51.0% of panNET and midgut NET patients in this trial, with the most common classes of TRAE being gastrointestinal disorders and general disorders/administration site conditions.²Pavel M. Presented at ESMO 2020. Available at: https://oncologypro.esmo.org/meeting-resources/esmo-virtual-congress-2020/efficacy-and-safety-of-lanreotide-autogel-lan-120-mg-every-14-days-in-progressive-pancreatic-or-midgut-neuroendocrine-tumours-nets-clarinet-fo (Accessed 24 December 2020). Only one TRAE was ≥Grade 3, which was fatigue and occurred in a panNET patient.²Pavel M. Presented at ESMO 2020. Available at: https://oncologypro.esmo.org/meeting-resources/esmo-virtual-congress-2020/efficacy-and-safety-of-lanreotide-autogel-lan-120-mg-every-14-days-in-progressive-pancreatic-or-midgut-neuroendocrine-tumours-nets-clarinet-fo (Accessed 24 December 2020).

An increased dosing frequency of lanreotide autogel to 120mg every 14 days showed promising results in PFS and DCR in both pancreatic and midgut NET patients, with a consistent safety profile.²Pavel M. Presented at ESMO 2020. Available at: https://oncologypro.esmo.org/meeting-resources/esmo-virtual-congress-2020/efficacy-and-safety-of-lanreotide-autogel-lan-120-mg-every-14-days-in-progressive-pancreatic-or-midgut-neuroendocrine-tumours-nets-clarinet-fo (Accessed 24 December 2020). In the panNET cohort, outcomes were particularly favourable in patients with Ki67 ≤10%.²Pavel M. Presented at ESMO 2020. Available at: https://oncologypro.esmo.org/meeting-resources/esmo-virtual-congress-2020/efficacy-and-safety-of-lanreotide-autogel-lan-120-mg-every-14-days-in-progressive-pancreatic-or-midgut-neuroendocrine-tumours-nets-clarinet-fo (Accessed 24 December 2020).