S25 - Real-word analysis on the use of somatostatin analogs (SSAs) in patients with neuroendocrine neoplasms (NENs): results of a survey conducted by the Italian Society of Medical Oncology (AIOM)

Abstract

Background: In neuroendocrine neoplasms (NENs) two somatostatin analogs (SSAs), octreotide and lanreotide, were approved for carcinoid syndrome control in functioning and for tumor growth control in well differentiated non functioning advanced NENs. The full labeled schedule is 30 mg every 4 weeks (/4w) for octreotide long acting repeatable (LAR) and 120 mg/4w for lanreotide depot. We investigated the real-world use of SSAs in NEN patients among the Italian medical oncological community about several aspects. Dose and schedule- related results are reported in the present analysis. Methods: In September 2014 a 27-item online questionnaire was administered to all Italian Association of Medical Oncology (AIOM) members. Results: One hundred and ten members filled out the questionnaire. Almost all were medical oncologists and around two third of them had seen < 20 NEN patients over the latest year. A full labeled dose was used upfront by 43% for lanreotide depot and 69% for octreotide LAR. In functioning NENs while the vast majority of participants had used 30 mg/4w octreotide LAR and 120 mg/4w lanreotide depot as the most dose per administration, more than 70% had used a shorter interval between administrations, up to 3 or even 2 weeks. In non functioning NETs again around 90% of participants had used 30 mg/4w octreotide LAR and 120 mg/4w lanreotide depot as the highest dose per administration, but 62% had used a shorter interval than /4w for octreotide LAR and 43% for lanreotide depot. While in case of incomplete syndrome control at full labeled dose, around 40% of responders shortened administrations interval without changing the total dose per administration both for octreotide and lanreotide, in case of non functioning NETs progressing on full labeled dose the percentage of responders who had shortened the interval was 30-40% for both SSA. This percentage was almost equivalent to that of whom stopped SSA and started other therapies. Conclusions: We presented the results regarding SSA schedule management in NEN patients among Italian medical oncological community. Above-label dose of SSA was applied in both functioning and non functioning NENs. Particularly shortening interval between administrations rather than increasing dose of the single administration was applied. This same survey is currently ongoing among other Italian scientific societes involved in NETs, such as endocrinological and gastroenterological ones.