Somatostatin analogues (octreotide, lanreotide)
Monthly injections of a synthetic hormone that both quiets tumour hormone symptoms and slows tumour growth, the first treatment for most neuroendocrine tumours.
Octreotide (1988) controls carcinoid syndrome; PROMID (2009) showed octreotide LAR delays progression in midgut NETs (TTP 14.3 vs 6.0 months); CLARINET (2014) showed lanreotide improves PFS across enteropancreatic NETs (median not reached vs 18 months, HR 0.47). Standard first-line antiproliferative therapy for SSTR-positive grade 1-2 disease; also premedication against carcinoid crisis.
1.Binds SSTR2 on tumour cell
- Route
- Deep subcutaneous or intramuscular depot
- Schedule
- Octreotide LAR 30 mg or lanreotide 120 mg every 4 weeks; short-acting octreotide for breakthrough symptoms
- Monitoring
- Gallstones, glucose, vitamin B12
- Medicare
- Part B (clinician-administered)
Given by infusion or injection in a clinic or hospital outpatient department, so it is a Part B drug: Medicare pays 80% after the Part B deductible and the patient owes 20% coinsurance, uncapped in Original Medicare unless a Medigap policy applies. Long-acting depot injections (Sandostatin LAR, Somatuline Depot, lanreotide generics) given in the clinic are Part B. Self-injected short-acting octreotide is Part D.
- Commercial insurance
- covered with prior authorisation
Covered for neuroendocrine tumours and carcinoid syndrome with prior authorisation; plans may prefer lanreotide (now multi-source) over Sandostatin LAR.
- Assistance programmes
- Ipsen Cares
- Novartis Patient Support (Patient Assistance NOW Oncology)
- PAN Foundation — Disease-specific co-pay and premium funds; open and closed funds change monthly.
- HealthWell Foundation
- CancerCare Co-Payment Assistance Foundation
- Patient Advocate Foundation Co-Pay Relief
20% Part B coinsurance on a high-cost infusion adds up quickly: Medigap Plan G or N, Medicare Advantage maximum out-of-pocket, Medicaid dual eligibility, or a charity fund are the usual buffers.
Sources: Medicare.gov: Chemotherapy · Medicare.gov: Prescription drugs (outpatient, Part B). Not medical or financial advice; verify with your plan.
- Notes
- Octreotide and lanreotide are long-established for functional NET symptoms and tumour control (CLARINET, PROMID); funded routinely without a TA.
- NHS England
- Routinely funded for the appraised indication (or via managed access)
Sources: NICE search: somatostatin analogues. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
Approvals
| Region | Year | Indication |
|---|---|---|
| US | 1988 | Carcinoid syndrome symptoms (octreotide) |
| US | 2014 | Unresectable GEP-NETs to improve PFS (lanreotide) |
| Adverse event | Any grade | Grade 3+ |
|---|---|---|
| Diarrhoea/steatorrhoea | 26% | — |
| Cholelithiasis | 10% | — |
| Hyperglycaemia | 5% | — |
CLARINET. Events listed without rates were not read from a primary source; see the label. Blank cells mean the figure was not sourced, not that it is zero.
Trials
topRecruiting now (live from ClinicalTrials.gov)
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Landmark trials in OnCo
Latest papers
topQuery for this drug: (TITLE:"Somatostatin analogues" OR ABSTRACT:"Somatostatin analogues" OR TITLE:"octreotide, lanreotide" OR ABSTRACT:"octreotide, lanreotide" OR TITLE:"Sandostatin LAR" OR ABSTRACT:"Sandostatin LAR" OR TITLE:"Somatuline Depot" OR ABSTRACT:"Somatuline Depot") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Somatostatin analogues (octreotide, lanreotide), not a curated reading list.