Lanreotide

Lanreotide is a synthetic cyclic octapeptide developed as BIM-23014. Somatuline Depot in the US, called Somatuline Autogel elsewhere, is a long-acting gel in a prefilled syringe. It maintains exposure for weeks after deep subcutaneous injection, generally around every four weeks. US approval began in 2007.

Somatostatin receptor subtypes 2 and 5 on hormone-secreting and tumor cells mediate suppression of GH, IGF-1 and gut-hormone release. In well-differentiated neuroendocrine tumors, antiproliferative signaling can slow progression as well as address hormone symptoms.

CLARINET studied metastatic enteropancreatic neuroendocrine tumors. Median progression-free survival was not reached on lanreotide versus 18 months on placebo, a significant difference. “Not reached” does not mean progression never occurs.

FDA approval for acromegaly dates to 2007; gastroenteropancreatic neuroendocrine tumors were added in 2014, followed by carcinoid syndrome. Somatuline Depot is prescribed for acromegaly, unresectable/metastatic GEP-NETs to slow progression, and carcinoid syndrome to reduce the need for short-acting somatostatin analogs.

Common effects include diarrhea, abdominal pain, nausea, gallstones, injection reactions and slowed heart rate. Longer-term gallbladder disease, altered glucose or thyroid function and cardiac conduction effects require attention. These are systemic product effects, not simply a local injection concern.