Gastrointestinal carcinoid tumors are cancers that can cause flushing, diarrhea, and shortness of breath, a group of symptoms often referred to as
carcinoid syndrome. A drug called octreotide, given by injection 2 to 3 times per day, is commonly used to relieve these symptoms. Now, researchers report that a new drug, lanreotide, may offer the same results with significantly less frequent injections.
Gastrointestinal carcinoid tumors are rare, slow-growing cancers that develop in the gastrointestinal (digestive) system, which consists of the stomach, intestines (including the colon and rectum), and the appendix. Eventually, these cancers can spread to the liver. Depending on the location and stage (extent of disease at diagnosis) of the disease, treatment options to control the cancer may include surgery, chemotherapy administered through a vein, or chemotherapy administered through the artery near the liver. Gastrointestinal carcinoid tumor cells produce substances, such as serotonin, which can cause symptoms of flushing, diarrhea, and shortness of breath. A treatment commonly used to relieve this carcinoid syndrome is the drug octreotide. Octreotide, which must be injected under the skin 2 to 3 times per day, works by lowering the blood levels of serotonin. A new long-acting drug, lanreotide, works by a similar method, but requires injections into the muscle only 2 to 3 times per month.
Researchers from several medical centers assigned 33 persons with carcinoid syndrome to receive either A) octreotide 2 to 3 times per day or B) lanreotide every 10 days. The results showed a disappearance or improvement in flushing of 54% of persons receiving lanreotide and in 68% of those receiving octreotide. Diarrhea disappeared or improved in 45% of persons receiving lanreotide and in 50% of those receiving octreotide. Laboratory tests revealed similar findings for the 2 drugs. Both treatments were well tolerated, with the major side effects being abdominal pain and nausea in 14% of those in the lanreotide group and 29% of those in the octreotide group.
These researchers concluded that both octreotide and lanreotide are effective in controlling the symptoms of gastrointestinal carcinoid tumors. The patients generally preferred lanreotide because of the more convenient, less frequent injection schedule. Persons with carcinoid syndrome who want a more convenient treatment schedule may wish to talk with their doctor about the risks and benefits of the lanreotide regimen, or of participating in a clinical trial in which other new treatments for carcinoid syndrome or carcinoid tumors are being studied. Sources of information on ongoing clinical trials that can be discussed with a doctor include a comprehensive, easy-to-use service provided by the National Cancer Institute (cancer.gov) and the Clinical Trials section and service offered by Cancer Consultants.com (www.411cancer.com). (Cancer, Volume 88, No 4, pp 770-776, 2000)