{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T03:17:13Z","timestamp":1784171833856,"version":"3.55.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2023,3,30]],"date-time":"2023-03-30T00:00:00Z","timestamp":1680134400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Biostatistics and Bioinformatics Shared Resource Facility of the University of Kentucky Markey Cancer Center","award":["P30CA177558"],"award-info":[{"award-number":["P30CA177558"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,6,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Treatment recommendations for patients with neuroendocrine tumors (NETs) include the use of octreotide long-acting release (LAR) for long-term therapy and immediate-release (IR) as rescue therapy to control the breakthrough symptoms of carcinoid syndrome (CS). High doses of LAR are commonly used in clinical practice. This study aimed to evaluate the real-world utilization of LAR and preceding IR use at the prescription and patient levels.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We used an administrative claims database (2009-2018) containing privately insured enrollees. We calculated the normalized LAR dose from pharmacy claims and the initial mean IR daily dose at the prescription level. At the patient level, we conducted a retrospective cohort study that included patients continuously enrolled with \u22651 pharmacy claim of LAR and evaluated the frequency and the clinical reason for dose escalation of LAR. The definition of the above-label maximum dose of LAR was \u226530 mg\/4 weeks.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Nineteen percent of LAR prescriptions had an above-label maximum dose. Only 7% of LAR prescriptions had preceding IR use. There were 386 patients with NETs or CS vs. 570 with an unknown diagnosis. Comparing patients with NETs or CS to those with an unknown diagnosis, 22.3% vs. 11.0 % experienced dose escalations and 29.0% vs. 26.6% had IR use before dose escalation, respectively. LAR dose escalation occurred in 50.9% vs. 39.2% for symptom control, 12.3% vs. 7.1% for tumor progression control, and 16.6% vs. 6.0% for both reasons in NETs\/CS and unknown groups, respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Octreotide LAR dosing above the label-maximum dose is common and IR rescue dosing appears to be underutilized.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/oncolo\/oyad057","type":"journal-article","created":{"date-parts":[[2023,3,30]],"date-time":"2023-03-30T23:57:55Z","timestamp":1680220675000},"page":"479-485","source":"Crossref","is-referenced-by-count":3,"title":["Prescribing Characteristics of Octreotide Immediate-Release and Long-Acting Release in Patients with Neuroendocrine Tumors"],"prefix":"10.1093","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5715-6095","authenticated-orcid":false,"given":"Yue","family":"Cheng","sequence":"first","affiliation":[{"name":"Department of Pharmacy Practice and Science, College of Pharmacy, University of Kentucky , Lexington, KY , USA"},{"name":"Institute of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Kentucky , Lexington, KY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lowell","family":"Anthony","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Medical Oncology, Markey Cancer Center, University of Kentucky , Lexington, KY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7214-0326","authenticated-orcid":false,"given":"Chris","family":"Delcher","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice and Science, College of Pharmacy, University of Kentucky , Lexington, KY , USA"},{"name":"Institute of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Kentucky , Lexington, KY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela C","family":"Moga","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice and Science, College of Pharmacy, University of Kentucky , Lexington, KY , USA"},{"name":"Institute of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Kentucky , Lexington, KY , USA"},{"name":"Department of Epidemiology, College of Public Health, University of Kentucky , Lexington, KY , USA"},{"name":"Sanders-Brown Center on Aging, University of Kentucky , Lexington, KY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aman","family":"Chauhan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Medical Oncology, Markey Cancer Center, University of Kentucky , Lexington, KY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Cancer Biostatistics, Department of Internal Medicine, College of Medicine, University of Kentucky , Lexington, KY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Val","family":"Adams","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice and Science, College of Pharmacy, University of Kentucky , Lexington, KY , USA"},{"name":"Institute of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Kentucky , Lexington, KY , USA"},{"name":"Department of Internal Medicine, Division of Medical Oncology, Markey Cancer Center, University of Kentucky , Lexington, KY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,3,30]]},"reference":[{"key":"2023060913483582300_CIT0001","doi-asserted-by":"crossref","first-page":"e1171","DOI":"10.1002\/onco.13847","article-title":"Opportunities to improve symptom control with somatostatin congeners in GEP-NETs: a review of key issues","volume":"26","author":"Anthony","year":"2021","journal-title":"Oncologist"},{"key":"2023060913483582300_CIT0002","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1001\/jamaoncol.2017.0589","article-title":"Trends in the incidence, prevalence, and survival outcomes in patients with neuroendocrine tumors in the United States","volume":"3","author":"Dasari","year":"2017","journal-title":"JAMA Oncol"},{"key":"2023060913483582300_CIT0003","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1016\/S1470-2045(17)30110-9","article-title":"Frequency of carcinoid syndrome at neuroendocrine tumour diagnosis: a population-based study","volume":"18","author":"Halperin","year":"2017","journal-title":"Lancet Oncol"},{"key":"2023060913483582300_CIT0004","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1097\/MPA.0b013e3182328045","article-title":"Comparison of health-related quality of life in patients with neuroendocrine tumors with quality of life in the general US population","volume":"41","author":"Beaumont","year":"2012","journal-title":"Pancreas"},{"key":"2023060913483582300_CIT0005","doi-asserted-by":"crossref","first-page":"4656","DOI":"10.1200\/JCO.2009.22.8510","article-title":"Placebo-controlled, double-blind, prospective, randomized study on the effect of octreotide LAR in the control of tumor growth in patients with metastatic neuroendocrine midgut tumors: a report from the PROMID Study Group","volume":"27","author":"Rinke","year":"2009","journal-title":"JCO"},{"key":"2023060913483582300_CIT0006","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1056\/NEJMoa1316158","article-title":"Lanreotide in metastatic enteropancreatic neuroendocrine tumors","volume":"371","author":"Caplin","year":"2014","journal-title":"N Engl J Med"},{"key":"2023060913483582300_CIT0007","volume-title":"Sandostatin\u00ae LAR Depot (octreotide acetate for injectable suspension). Full prescribing information","author":"Novartis Pharmaceuticals lnc.","year":"2021"},{"key":"2023060913483582300_CIT0008","volume-title":"Sandostatin\u00ae (octreotide acetate). 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patients with gastrointestinal neuroendocrine tumors","volume":"23","author":"Cai","year":"2017","journal-title":"World J Gastroenterol"},{"key":"2023060913483582300_CIT0019","doi-asserted-by":"crossref","first-page":"2050312117694795","DOI":"10.1177\/2050312117694795","article-title":"Prescription patterns of long-acting somatostatin analogues","volume":"5","author":"Machado-Alba","year":"2017","journal-title":"SAGE Open Med"},{"key":"2023060913483582300_CIT0020","doi-asserted-by":"crossref","first-page":"4274","DOI":"10.1200\/jco.2004.22.90140.4274","article-title":"Octreotide LAR doses used in clinical practice: Results from an internet survey and a clinical practice","volume":"22","author":"Anthony","year":"2004","journal-title":"JCO"},{"key":"2023060913483582300_CIT0021","doi-asserted-by":"crossref","first-page":"e14579","DOI":"10.1200\/jco.2012.30.15_suppl.e14579","article-title":"Above-label doses of octreotide-LAR in patients with metastatic small-intestinal carcinoid 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