P-0129 Long-Term, Open-Label Pasireotide in Patients with Neuroendocrine Tumors Experiencing Carcinoid Symptoms: Case Presentations

Abstract

ABSTRACT Introduction The novel somatostatin analog (SSA) pasireotide (SOM230) long-acting release (LAR) is under investigation for the treatment of patients with neuroendocrine tumors (NET) experiencing carcinoid disease refractory or resistant to available SSAs. Described here are case presentations of three patients, all from the same center, who had progressive disease while receiving the SSA octreotide long-acting repeatable (LAR) and who have long-term stable disease while receiving pasireotide LAR. Methods Patient A was a 50-year-old Caucasian woman with low-grade small intestinal NET diagnosed in August 2006. She underwent surgical resection of abdominal mass and liver mass in November 2006 and disease recurrence in March 2007, and she was administered octreotide LAR (60 mg IM q28d) from November 2006 through April 2007 (5 months). Patient B was a 42-year-old Asian man with low-grade small bowel NET diagnosed in June 2001. He underwent surgical resection of the small bowel in June 2002; his most recent recurrence of NET was in March 2007. He was administered interferon from February 2003 through March 2007 (49 months), octreotide LAR (30 mg IM q28d) from January 2002 through April 2003 (16 months), and octreotide LAR (60 mg IM q28d) from May 2003 through March 2007 (47 months). Patient C was a 75-year-old Caucasian woman with low-grade small intestinal NET diagnosed in January 2006. She underwent surgical resection of the ileum in January 2006, resection of pancreatic masses in May 2006, and ileocolectomy and right hemicolectomy in July 2006, and she was administered octreotide LAR (100 µg IM) from May 2006 through March 2007 (11 months). No patient had a history of radiotherapy. Results For each patient, pasireotide LAR was initiated approximately 3 months after halting octreotide LAR. Pasireotide LAR IM injections were initiated every 28 days beginning July 9, 2007, for patient A (60 mg); June 26, 2007, for patient B (20 mg); and June 18, 2007, for patient C (40 mg). As of March 2012, all 3 patients have received pasireotide LAR for approximately 58 months, have stable disease, and continue to receive pasireotide LAR. Conclusion The novel SSA pasireotide LAR enables some patients with small intestinal NET and carcinoid syndrome to experience long-term stable disease after disease progression that occurred while they were receiving octreotide LAR.