Clinical benefits of above-standard dose of octreotide LAR in patients with neuroendocrine tumors for control of carcinoid syndrome symptoms: A multicenter retrospective chart review study

Jonathan R. Strosberg, Al B Benson III, Lynn Huynh, Mei Sheng Duh*, Jamie Goldman, Vaibhav Sahai, Alfred W Rademaker, Matthew H. Kulke

*Corresponding author for this work

Research output: Contribution to journalArticle

56 Citations (Scopus)

Abstract

Background. Octreotide LAR is used in patients for control of carcinoid syndrome (CS) and other symptoms of hormone hypersecretion. The aim of this study was to examine reasons for octreotide LAR dose escalation and observe CS symptom improvement in patients with neuroendocrine tumors (NETs) whounderwentoctreotideLARdoseescalation atthreecancer referral centers.

Methods. Medical records for patients with diagnosis of carcinoid or pancreatic NET who had received one dose or more of octreotide LAR above 30 mg every 4 weeks from 2000 to 2012 were reviewed. Reasons for dose escalation and symptomatic outcomes were abstracted for each patient 3 months prior to and up to 12 months following the dose escalation.

Results. Of the evaluated 239 NET patients, 53% were male, mean age at first dose escalation was 60 years (standard deviation [SD]: 11 years), and mean time from octreotide LAR initiation to first dose escalation was 1.7 years (SD: 2.0 years). The primary reasons reported for dose escalation were carcinoid or hormonal syndrome (62%) or radiographic progression (28%). The most common dose changes at the first dose escalation were 40 mg every 4 weeks (71%) and 60 mg every 4 weeks (18%). Of 90 patients in whom flushing was reported prior to first dose escalation, 73 (81%) were reported to have experienced improvement or resolution of their symptoms following the dose escalation. Of 107 patients who were reported to have experienced diarrhea before the first dose escalation, 85 (79%) were reported to have experienced improvement or resolution after first dose escalation.

Conclusion. The goal of improved symptom control is a common reason for dose escalation of octreotide LAR. This study suggests that escalation to above the standard dose of octreotide LAR of 30 mg every 4 weeks may result in improved CS symptom control.

Original languageEnglish (US)
Pages (from-to)930-936
Number of pages7
JournalOncologist
Volume19
Issue number9
DOIs
StatePublished - Jan 1 2014

Fingerprint

Octreotide
Neuroendocrine Tumors
Carcinoid Tumor
Medical Records
Diarrhea
Referral and Consultation
Hormones

Keywords

  • Above-standard dose
  • Carcinoid syndrome symptoms
  • Diarrhea
  • Flushing
  • Neuroendocrine tumor
  • Somatostatin analogs

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

@article{e907f9a031d7417590af675fc32d5c55,
title = "Clinical benefits of above-standard dose of octreotide LAR in patients with neuroendocrine tumors for control of carcinoid syndrome symptoms: A multicenter retrospective chart review study",
abstract = "Background. Octreotide LAR is used in patients for control of carcinoid syndrome (CS) and other symptoms of hormone hypersecretion. The aim of this study was to examine reasons for octreotide LAR dose escalation and observe CS symptom improvement in patients with neuroendocrine tumors (NETs) whounderwentoctreotideLARdoseescalation atthreecancer referral centers.Methods. Medical records for patients with diagnosis of carcinoid or pancreatic NET who had received one dose or more of octreotide LAR above 30 mg every 4 weeks from 2000 to 2012 were reviewed. Reasons for dose escalation and symptomatic outcomes were abstracted for each patient 3 months prior to and up to 12 months following the dose escalation.Results. Of the evaluated 239 NET patients, 53{\%} were male, mean age at first dose escalation was 60 years (standard deviation [SD]: 11 years), and mean time from octreotide LAR initiation to first dose escalation was 1.7 years (SD: 2.0 years). The primary reasons reported for dose escalation were carcinoid or hormonal syndrome (62{\%}) or radiographic progression (28{\%}). The most common dose changes at the first dose escalation were 40 mg every 4 weeks (71{\%}) and 60 mg every 4 weeks (18{\%}). Of 90 patients in whom flushing was reported prior to first dose escalation, 73 (81{\%}) were reported to have experienced improvement or resolution of their symptoms following the dose escalation. Of 107 patients who were reported to have experienced diarrhea before the first dose escalation, 85 (79{\%}) were reported to have experienced improvement or resolution after first dose escalation.Conclusion. The goal of improved symptom control is a common reason for dose escalation of octreotide LAR. This study suggests that escalation to above the standard dose of octreotide LAR of 30 mg every 4 weeks may result in improved CS symptom control.",
keywords = "Above-standard dose, Carcinoid syndrome symptoms, Diarrhea, Flushing, Neuroendocrine tumor, Somatostatin analogs",
author = "Strosberg, {Jonathan R.} and {Benson III}, {Al B} and Lynn Huynh and Duh, {Mei Sheng} and Jamie Goldman and Vaibhav Sahai and Rademaker, {Alfred W} and Kulke, {Matthew H.}",
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Clinical benefits of above-standard dose of octreotide LAR in patients with neuroendocrine tumors for control of carcinoid syndrome symptoms : A multicenter retrospective chart review study. / Strosberg, Jonathan R.; Benson III, Al B; Huynh, Lynn; Duh, Mei Sheng; Goldman, Jamie; Sahai, Vaibhav; Rademaker, Alfred W; Kulke, Matthew H.

In: Oncologist, Vol. 19, No. 9, 01.01.2014, p. 930-936.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Clinical benefits of above-standard dose of octreotide LAR in patients with neuroendocrine tumors for control of carcinoid syndrome symptoms

T2 - A multicenter retrospective chart review study

AU - Strosberg, Jonathan R.

AU - Benson III, Al B

AU - Huynh, Lynn

AU - Duh, Mei Sheng

AU - Goldman, Jamie

AU - Sahai, Vaibhav

AU - Rademaker, Alfred W

AU - Kulke, Matthew H.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Background. Octreotide LAR is used in patients for control of carcinoid syndrome (CS) and other symptoms of hormone hypersecretion. The aim of this study was to examine reasons for octreotide LAR dose escalation and observe CS symptom improvement in patients with neuroendocrine tumors (NETs) whounderwentoctreotideLARdoseescalation atthreecancer referral centers.Methods. Medical records for patients with diagnosis of carcinoid or pancreatic NET who had received one dose or more of octreotide LAR above 30 mg every 4 weeks from 2000 to 2012 were reviewed. Reasons for dose escalation and symptomatic outcomes were abstracted for each patient 3 months prior to and up to 12 months following the dose escalation.Results. Of the evaluated 239 NET patients, 53% were male, mean age at first dose escalation was 60 years (standard deviation [SD]: 11 years), and mean time from octreotide LAR initiation to first dose escalation was 1.7 years (SD: 2.0 years). The primary reasons reported for dose escalation were carcinoid or hormonal syndrome (62%) or radiographic progression (28%). The most common dose changes at the first dose escalation were 40 mg every 4 weeks (71%) and 60 mg every 4 weeks (18%). Of 90 patients in whom flushing was reported prior to first dose escalation, 73 (81%) were reported to have experienced improvement or resolution of their symptoms following the dose escalation. Of 107 patients who were reported to have experienced diarrhea before the first dose escalation, 85 (79%) were reported to have experienced improvement or resolution after first dose escalation.Conclusion. The goal of improved symptom control is a common reason for dose escalation of octreotide LAR. This study suggests that escalation to above the standard dose of octreotide LAR of 30 mg every 4 weeks may result in improved CS symptom control.

AB - Background. Octreotide LAR is used in patients for control of carcinoid syndrome (CS) and other symptoms of hormone hypersecretion. The aim of this study was to examine reasons for octreotide LAR dose escalation and observe CS symptom improvement in patients with neuroendocrine tumors (NETs) whounderwentoctreotideLARdoseescalation atthreecancer referral centers.Methods. Medical records for patients with diagnosis of carcinoid or pancreatic NET who had received one dose or more of octreotide LAR above 30 mg every 4 weeks from 2000 to 2012 were reviewed. Reasons for dose escalation and symptomatic outcomes were abstracted for each patient 3 months prior to and up to 12 months following the dose escalation.Results. Of the evaluated 239 NET patients, 53% were male, mean age at first dose escalation was 60 years (standard deviation [SD]: 11 years), and mean time from octreotide LAR initiation to first dose escalation was 1.7 years (SD: 2.0 years). The primary reasons reported for dose escalation were carcinoid or hormonal syndrome (62%) or radiographic progression (28%). The most common dose changes at the first dose escalation were 40 mg every 4 weeks (71%) and 60 mg every 4 weeks (18%). Of 90 patients in whom flushing was reported prior to first dose escalation, 73 (81%) were reported to have experienced improvement or resolution of their symptoms following the dose escalation. Of 107 patients who were reported to have experienced diarrhea before the first dose escalation, 85 (79%) were reported to have experienced improvement or resolution after first dose escalation.Conclusion. The goal of improved symptom control is a common reason for dose escalation of octreotide LAR. This study suggests that escalation to above the standard dose of octreotide LAR of 30 mg every 4 weeks may result in improved CS symptom control.

KW - Above-standard dose

KW - Carcinoid syndrome symptoms

KW - Diarrhea

KW - Flushing

KW - Neuroendocrine tumor

KW - Somatostatin analogs

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