Self-Administration of Long-Acting Somatostatin Analogues in NET Patients-Does It Affect the Clinical Outcome?

Anna Sowa-Staszczak,Helena Olearska,Joanna Palen-Tytko,Marta Opalińska,Aleksandra Gilis-Januszewska,Alicja Hubalewska-Dydejczyk,Karolina Morawiec-Sławek,Anna Kurzyńska

doi:10.3390/medicina57121287

Anna Sowa-Staszczak, Helena Olearska + Show 6 more

Open Access

https://doi.org/10.3390/medicina57121287

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Abstract

Background and Objectives: Long-acting somatostatin analogues (SSA) (octreotide LAR and lanreotide Autogel) are recommended as first line treatment of locally advanced or metastatic well-differentiated neuroendocrine tumors (NETs) with a good expression of somatostatin receptor (SSTR). Both of these SSAs are usually administered via injections repeated every 4 weeks. The purpose of the study was to compare the route of SSA administration (injection performed by professional medical staff and self-administration of the drug) with progression-free survival. Materials and methods: 88 patients in 2019 and 96 patients in 2020 with locally advanced or metastatic well-differentiated NETs were included in the study. All patients had a good expression of SSTR type 2 and had been treated for at least 3 months with a stable dose of long-acting somatostatin analogue every 4 weeks. All of them had received training on drug self-injections from professional NET nurses at the beginning of the COVID-19 epidemic. Results: The rate of NET progression in the study group in 2020 was higher than in 2019 29.1% vs. 18.1% (28 vs. 16 cases), p = 0.081. Conclusions: The method of administration of long-acting SSA injection performed by professional medical staff vs. self-injection of the drug may significantly affect the risk of NET progression. The unequivocal confirmation of such a relationship requires further observation.

Highlights

Background and ObjectivesLong-acting somatostatin analogues (SSA) are recommended as first line treatment of locally advanced or metastatic welldifferentiated neuroendocrine tumors (NETs) with a good expression of somatostatin receptor (SSTR)
The aim of the study was to determine whether route of SSA administration, forced by the restrictions related to COVID-19 pandemic, has an impact on the efficacy of treatment in NETs patients
All patients were diagnosed with locally advanced or metastatic well-differentiated NET with good expression of SSTR type 2, and had been treated for > or = 3 months with a stable dose of long-acting somatostatin analogue

Summary

Introduction

Long-acting somatostatin analogues (SSA) (octreotide LAR and lanreotide Autogel) are recommended as first line treatment of locally advanced or metastatic welldifferentiated neuroendocrine tumors (NETs) with a good expression of somatostatin receptor (SSTR). Both of these SSAs are usually administered via injections repeated every 4 weeks. Long-acting formulations, usually administered every 4 weeks, have an antiproliferative effect, confirmed in clinical trials [1,2], and were proven to effective in decreasing serum levels of different hormones in the case of hormonally active neuroendocrine tumors (NETs) [3] It can reduce the severity of clinical symptoms in most patients. In the case of lanreotide drug administration, subcutaneous vs. intramuscular injections revealed similar drug efficacy, and the subcutaneous injection is a standard clinical practice [5]

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