Use of somatostatin analogues can be considered in pancreatic NET G1/G2 as a first-line therapy. This retrospective study aimed to compare the efficacy of octreotide long-acting release (OCT) and lanreotide Autogel (LAN) in patient with advanced G1/G2 pNETs, comparison between LAN and OCT in naïve patients, based on progression free survival (PFS).
Ninety-two patients with histological proven G1 or G2 pNETs were retrospectively analyzed (41 men; 51 women; mean age 53.7years [range 21-87 years]). The patients were assigned randomly to OCT (n = 42) and LAN (n = 50) groups. Evaluations included comparison of PFS between groups with LAN and OCT administered at 28-day intervals, objective response rate (ORR) calculated based on CT/MRI imaging performed every 6 month. The clinical efficacy was based on PFS and time to subsequent death/PD using Kaplan –Meier, radiological response was classified according to RECIST 1.0 criteria.
Medain PFS for all patients was 16.0 months (CI 22.8-34.9); in LAN group PFS 22 months (CI 21.9-39.5) vs OCT 15 (CI 18.1-35,1), P = 0.28 (Cox Mantel test). The significant difference was noted in group of patients with G2 tumors LAN 22 months (CI 19.5-35.0) vs. OCT 7 months (CI 8.2-22.2) P = 0.01. Even higher significant difference was obtained in males group G2: LAN 23.5 (CI 16-44.6) vs. OCT 6.0 months (CI 3.3-14.3). There was no significant difference in female patients: LAN 17.5 mo (CI 15.4-34.8) vs. OCT 13 months (CI 8.2-29.4), but the trend favorable LAN over OCT. Additional analysis in patients with liver metastasis showed similar trend, but no significant difference. There was no difference in PFS between groups with G1 tumors in male or female patients and those without liver involvement.
Lanreotide Autogel is preferable SST therapy in G2 pNET, especially in male patients. Additional it seems to be also more effective in female patients but without statistical significance. The trend of better efficacy in terms of increase PFS seems to be in favor of LAN in patients with liver involvement as well. There was no significant difference in groups of patients with G1 pNEN and those without liver involvement.
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All authors have declared no conflicts of interest.