Somatostatin analog · acromegaly, NETs
Lanreotide is a lab-made, eight-amino-acid version of somatostatin, the body's own brake on several hormones. It is a long-acting prescription injection used to lower growth hormone in acromegaly, to slow certain neuroendocrine tumors of the gut and pancreas, and to ease the flushing and diarrhea of carcinoid syndrome.
Natural somatostatin dampens the release of growth hormone, insulin, glucagon and many gut hormones, but it survives only minutes in the blood. Lanreotide is a ring-shaped octapeptide built to resist breakdown. According to its FDA label, it binds most strongly to somatostatin receptor subtypes 2 and 5 and more weakly to subtypes 1, 3 and 4; activity at 2 and 5 in the pituitary is thought to drive the fall in growth hormone and, downstream, IGF-11. Many neuroendocrine tumors carry the same receptors, so the drug can also restrain their hormone output and, in trials, their growth. It also slows gallbladder emptying and reduces several pancreatic and gut hormones, which explains a number of its side effects1.
The evidence is from human trials in diagnosed disease. In the label's placebo-controlled acromegaly study, 63% of lanreotide-treated patients had growth hormone fall by more than half within four weeks, compared with none on placebo1. In CLARINET, 204 people with advanced, slow-growing (grade 1-2) enteropancreatic neuroendocrine tumors were randomized to lanreotide or placebo for 96 weeks. Lanreotide lengthened progression-free survival: at 24 months, 65% versus 33% were free of progression. Overall survival and quality of life did not differ, and diarrhea was more common on the drug (26% vs 9%)2.
In ELECT, 115 people with carcinoid syndrome needed rescue octreotide on fewer days with lanreotide than with placebo (about 34% vs 49% of days)3. None of these trials studied people without these diseases.
The FDA approved lanreotide in 2007 as Somatuline Depot (Ipsen) for acromegaly; it is also approved for unresectable, advanced gastroenteropancreatic neuroendocrine tumors and for carcinoid syndrome in adults1. Other lanreotide injection products have since been FDA-approved.
Per the FDA label, the most common side effects are diarrhea, abdominal pain, nausea, gallstones and injection-site reactions; in tumor patients, also musculoskeletal pain, vomiting, headache, high blood sugar and high blood pressure. Warnings cover gallstones and their complications (including pancreatitis), high or low blood sugar, a slowed heart rate, reduced thyroid function, and fatty, loose stools from poor fat absorption. A history of allergic reaction to lanreotide, including anaphylaxis, rules it out1.
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