Gastrointestinal neuroendocrine tumors treated with high dose octreotide-LAR: A systematic literature review

Table 2 Efficacy of octreotide long-acting repeatable > 30 mg/mo

Ref.	Symptoms	Disease markers2	Tumor response/Disease progression
Anthony et al[11] 2011	NA/NR	NA/NR	Complete response rates: 2% (20 mg), 1% (30 mg), 0% (40 mg), 2% (60 mg); partial response: 6% (20mg), 8% (30 mg), 4% (40 mg), 10% (60 mg); stable disease: 57% (20 mg), 57% (30 mg), 55% (40 mg), 50% (60 mg); progression: 21% (20 mg), 25% (30 mg), 18% (40 mg), 29% (60 mg)
Chadha et al[12] 2009	NA/NR	NA/NR	Median time to intervention was 2.9 mo (conventional dose group) vs 17.7 mo (high-dose) (P = 0.12)
Costa et al[13] 20061	NA/NR	NA/NR	After evidence of progressive disease in liver, disease stabilization was achieved with increase to 30 mg and to 40 mg/mo
Ferolla et al[14] 2012	Complete normalization: 40%; partial symptom control: 60%; flushing (normalized in 71.4%, improved in 28.6%), diarrhea (70%, 30%); pain (disappeared in 33%; improved in 67%); bronchospasm improved in 100%; hypoglycemia improved in 100%; weakness/well-being improved in all pts	30% of pts. with elevated markers responded to higher dose; significant response to high dose SLAR was in 30% of pts. with high CgA, 57.1% of pts. with high 5-HIAA, and 100% of pts. with high gastrin; median time-to-biochemical progression was 30 mo (SLAR 30 mg/21 d) vs 14 mo (standard dose) (P < 0.01)	Partial response in 7.2%, stable disease in 92.8%; median time to progression was 30 mo. (SLAR 30 mg/21 d) vs 9 mo. (standard dose) (P < 0.0001);
Koumarianou et al[15] 20101	NA/NR	NA/NR	75% (9/12) with > 50% tumor size reduction, and 25% had stable disease; median PFS was 24.6 wk
Markovich et al[16] 20121	NA/NR	NA/NR	Partial response in 3.2%, stable disease in 80.7%, progressed in 16.1%; tumor growth control in 83.9%, pts. had biochemical response and symptom relief (results not broken down by dose)
Valle et al[17] 20011	Improvement in flushing, diarrhea, and bronchospasm (results not broken down by dose)	pts. with dose-escalation of SLAR had increased 5-HIAA, suggesting increased disease activity
Weber et al[18] 20121	In pts., with increased doses of SLAR for refractory CS, 62% had improvement in diarrhea and 56% had improvement in flushing	NA/NR	NA/NR
Wolin et al[19] 20131	At month 6, symptom response was 21% (9/43) in pasireotide-LAR vs 27% (12/45) in ocrteotide-LAR arms (OR = 0.73; 95%CI: 0.27-1.97; P = 0.53); 36.5% ± 29.1% had a reduction in diarrhea/d and a 49.4% ± 36.7% in flushing/2 wk	NA/NR	Median PFS was 6.8 mo in octreotide-LAR vs 11.8 mo pasireotide-LAR arms (HR = 0.46; P = 0.045)
Woltering et al[20] 2006	Flushing not controlled in 0% (20 mg), 11.1% (30 mg), vs 7.1% (60 mg) SLAR groups (P = 1.0); diarrhea not controlled in 0% of pts. (20 mg), 27.8% (30 mg), vs 30.8% (60 mg) groups (P = 0.3182)	Mean absolute serum CgA: 53.1 (20 mg SLAR), 65.8 (30 mg), 70.7 (60 mg) (P = 0.9847); mean absolute plasma CgA: 56.6 (20 mg), 66.2 (30 mg), 65.2 (60 mg) (P = 0.9092)	NA/NR

¹Conference abstract;

²Disease makers: 5-hydroxyindoleacetic acid (5-HIAA), chromogranin A (CgA), gastrin, and insulin. NA/NR: Not applicable/not reported; CS: Carcinoid syndrome; SLAR: Octreotide long-acting repeatable; PFS: Progression free survival.