Anti-tumour effects of lanreotide for pancreatic and intestinal neuroendocrine tumours: the CLARINET open-label extension study

Martyn E. Caplin, Marianne Pavel, Jarosław B Ćwikła, Alexandria T Phan, Markus Raderer, Eva Sedláčková, Guillaume Cadiot, Edward M. Wolin, Jaume Capdevila, Lucy Wall, Guido Rindi, Alison Langley, Séverine Martinez, Edda Gomez-Panzani, Philippe Ruszniewski, CLARINET Investigators

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)191-9
Number of pages9
JournalEndocrine-Related Cancer
Volume23
Issue number3
DOIs
Publication statusPublished - Mar 2016
Externally publishedYes

Keywords

  • Antineoplastic Agents
  • Disease-Free Survival
  • Humans
  • Intestinal Neoplasms
  • Neuroendocrine Tumors
  • Pancreatic Neoplasms
  • Peptides, Cyclic
  • Somatostatin
  • Treatment Outcome
  • Clinical Trial
  • Journal Article
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

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