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

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.

Evaluating home injection compared with healthcare-setting injection of somatostatin analogs: a systematic literature review

“…In patients with NETs, comparable efficacy/effectiveness in the home and healthcare administration settings was also observed when assessing the proportion of patients with tumor progression, time to progression, and the proportion of participants with symptomatic control of diarrhea and flushing (n = 2 studies) [39,41].…”

“…S1). Seven studies were observational [33][34][35][36][37][38][39], alongside three interventional trials [40][41][42], and two budget impact models [43,44]. Seven studies were conducted in Europe [33-35, 37, 39-41], two in the US, and one in Israel [36,38,42].…”

“…Five and six studies evaluated patients with acromegaly [34,36,38,40,42] and NETs, respectively [33,35,37,39,41,44]. One of the budget impact models analyzed SSA usage in both acromegaly and NETs patient populations [43].…”

“…The majority of studies evaluated home injection of LAN only (7/12 studies) [33,35,36,38,[40][41][42]. A further four studies investigated patients treated with LAN or OCT [37,39,43,44]. One study did not specify which SSA treatment patients were administered [34].…”

“…Across the two indications, three clinical trials assessed treatment efficacy [40][41][42], and an additional three realworld evidence studies examined treatment effectiveness (Table 1 and Table S8) [36,38,39].…”