Slow Release Octreotide Increases survival in Carcinoid Syndrome
Data presented by Lowell Anthony MD, of the Louisiana State University health Science Center, New Orleans, at the 2005 Gastrointestinal Cancer Symposium (abstract 101) shows that use of long-acting release (LAR) octreotide (Sandostatin LAR depot) is associated with longer survival compared to used of conventional three-times daily formulation, in patients with malignant carcinoid syndrome.
The median survival in 143 patients who received the Sandostatin LAR Depot was 229 months. This is statistically significant when compared to cohort controls treated with conventional short acting octreotide, who had a median survival of 143 months (p<0.0001, hazard ratio 0.34).
We were surprised at the magnitude of the survival difference, but with hindsight, it seems reasonable. " Dr. Anthony said "The original dose must be administered subcutaneously three times per day. Many patients have problems with this schedule, and we know form clinical experience that many only take two doses per day. Since each dose covers only 6 hours, patients who are receiving drug for only about 12 hours per day. The LAR dose provides much better coverage and essentially takes the compliance issue out of the equation."
The study was conducted between 1995 and 2004 on 229 consecutive patients and the results were compared to 90 control patients who were treated with short acting octreotide between 1986 and 1994.
The study should be used with caution since this is not a randomized trial. Many variable that may have occurred between the study periods including but not limited to advancement of debulking surgery such as hepatic resection, radio-frequency ablation, and embolization were not taken in to account in evaluating the study. Dr. Anthony does not think these variables cannot account for such dramatic increase in survival in patients who received the LAR preparation.