Dr Heloisa Soares Discusses the Roles of Somatostatin Analogs in GEP-NETs

Somatostatin analogs have 2 roles: treating symptoms related to gastroenteropancreatic neuroendocrine tumors (GEP-NETS) and controlling tumor growth, explained Heloisa Soares, MD, assistant professor, University of New Mexico Cancer Center-Albuquerque.

How have somatostatin analogs enhanced the treatment landscape of gastroenteropancreatic neuroendocrine tumors?

So, somatostatin analogs are extremely important. They have 2 roles. They have the role to treat symptoms related to these tumors because many of these tumors will secrete hormones, and we can control some of that with the use of somatostatin analogs. But, it’s also very important as a treatment in terms of controlling tumor growth. We know from the CLARINET and the PROMID trials that the use of somatostatin analogs as first-line treatment in the metastatic setting or in patients with locally advanced disease delays tumor growth of these tumors.

So, it’s extremely fundamental for the treatment landscape of neuroendocrine tumors, the use of somatostatin analogs.

How does sequential treatment with these therapies impact clinical outcomes?
We typically use somatostatin analogs as the first line for patients, and the general consensus in the neuroendocrine tumors field is that they are very interchangeable. So, you start with one, and then when you progress, you should change classes of treatment. However, there is some interesting new data, a retrospective analysis coming out and saying that perhaps there might be a role to switching somatostatin analogs before jumping to a completely different class of therapies.

We truly don’t know that, so for the time being, so we typically will use 1 of the 2 commercially available somatostatin analogs as the first line, and then at the time of progression, if you’re just doing it for tumor control and patients don’t have any symptoms, then you will switch to a completely different class of treatment or intervention. But, I’m very interested in this new data coming out that perhaps there might be a role of sequention with somatostatin analogs. It’s too early to tell, but we’ll see when more studies come out.
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