{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T04:45:18Z","timestamp":1778042718805,"version":"3.51.4"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2019,4,23]],"date-time":"2019-04-23T00:00:00Z","timestamp":1555977600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100013733","name":"Ipsen Biopharmaceuticals","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013733","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Although recent pivotal trials (PROMID, CLARINET) have established somatostatin analogs (SSAs) as first-line agents for neuroendocrine tumors (NETs), their use in clinical practice is largely unknown. We aimed to understand real-world management and treatment of gastroenteropancreatic (GEP) NETs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>Patients with metastatic GEP-NETs treated with SSAs, lanreotide depot or octreotide long-acting release (LAR), between January 1, 2015, and December 31, 2015, were identified from a U.S. claims database supplemented with chart review for a subset of patients. Descriptive statistics summarized patients\u2019 demographics, clinical characteristics, treatment patterns, and healthcare resource use. Univariate and multivariate comparisons were made across SSA groups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 548 patients treated with an SSA for metastatic GEP-NET (lanreotide = 108; octreotide = 440), demographic and clinical characteristics were similar across groups, except more patients with pancreatic NETs were treated with lanreotide (38.7% vs. 6.3%, p &amp;lt; .01). More octreotide patients had a diagnosis of carcinoid syndrome compared with lanreotide patients (19.8% vs. 11.1%, p = .02). Approximately 1.1% of patients received lanreotide (&amp;gt;120 mg every 4 weeks [Q4W]) at a dose above label compared with 12.7% of octreotide patients (&amp;gt;30 mg Q4W; p &amp;lt; .01). At 1.5 years after SSA initiation, 85.7% (95% confidence interval, 74.3%\u201392.3%) were still on index SSA as reported by the physician. Variances between chart review and claims data were significant.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>SSAs were common in first-line systemic intervention, but dose escalations and dosing deviations outside of label were noted. Variances between claims and chart review warrant additional research to compare methodologies. With an increasing focus on value-based care in oncology, it is critical to understand the use of, and outcomes with, these agents in community practices.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Implications for Practice<\/jats:title>\n                  <jats:p>The aim of this study was to enhance understanding of real-world management and treatment of metastatic neuroendocrine tumors (NETs), with particular focus on systemic therapy with a somatostatin analog (SSA). As per published guidelines, SSAs are common in first-line systemic intervention, but dose escalations and dosing deviations outside of the label are noted for symptom control. Nevertheless, oncologists must weigh the implications of the use of above-label dosing of SSAs to manage and treat patients with metastatic NET within a value-based care framework.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1634\/theoncologist.2018-0798","type":"journal-article","created":{"date-parts":[[2019,4,23]],"date-time":"2019-04-23T19:54:17Z","timestamp":1556049257000},"page":"1331-1339","source":"Crossref","is-referenced-by-count":11,"title":["Patterns of Care Among Real-World Patients with Metastatic Neuroendocrine Tumors"],"prefix":"10.1093","volume":"24","author":[{"given":"Andrew J.","family":"Klink","sequence":"first","affiliation":[{"name":"Cardinal Health Specialty Solutions, Dublin, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce","family":"Feinberg","sequence":"additional","affiliation":[{"name":"Cardinal Health Specialty Solutions, Dublin, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hsing-Ting","family":"Yu","sequence":"additional","affiliation":[{"name":"Cardinal Health Specialty Solutions, Dublin, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Ray","sequence":"additional","affiliation":[{"name":"Ipsen Biopharmaceuticals, Inc., Basking Ridge, New Jersey, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonia","family":"Pulgar","sequence":"additional","affiliation":[{"name":"Ipsen Biopharmaceuticals, Inc., Basking Ridge, New Jersey, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandria","family":"Phan","sequence":"additional","affiliation":[{"name":"University of Texas Health Science Tyler School of Medicine, Tyler, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron","family":"Vinik","sequence":"additional","affiliation":[{"name":"Eastern Virginia Medical School, Norfolk, Virginia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,4,23]]},"reference":[{"key":"2021122508024769700_onco12944-bib-0001","doi-asserted-by":"crossref","first-page":"R163","DOI":"10.1530\/ERC-12-0024","article-title":"Neuroendocrine tumor disease: An evolving landscape","volume":"19","author":"Frilling","year":"2012","journal-title":"Endocr Relat Cancer"},{"issue":"suppl 1","key":"2021122508024769700_onco12944-bib-0002","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1159\/000080731","article-title":"Epidemiology of neuroendocrine tumours","volume":"80","author":"Taal","year":"2004","journal-title":"Neuroendocrinology"},{"key":"2021122508024769700_onco12944-bib-0003","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1634\/theoncologist.2012-0434","article-title":"Targeted therapies in neuroendocrine tumors (NET): Clinical trial challenges and lessons learned","volume":"18","author":"Yao","year":"2013","journal-title":"The Oncologist"},{"key":"2021122508024769700_onco12944-bib-0004","author":"National Comprehensive Cancer Network","year":"2018"},{"key":"2021122508024769700_onco12944-bib-0005"},{"key":"2021122508024769700_onco12944-bib-0006","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":"2021122508024769700_onco12944-bib-0007","volume-title":"DEPOT (lanreotide) INJECTION [package insert]","author":"SOMATULINE","year":"2014"},{"key":"2021122508024769700_onco12944-bib-0008","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":"2021122508024769700_onco12944-bib-0009","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":"J Clin Oncol"},{"key":"2021122508024769700_onco12944-bib-0010","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1007\/s11912-015-0492-7","article-title":"Octreotide and lanreotide in gastroenteropancreatic neuroendocrine tumors","volume":"18","author":"Pokuri","year":"2016","journal-title":"Curr Oncol Rep"},{"key":"2021122508024769700_onco12944-bib-0011","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1002\/cam4.435","article-title":"Association of dose escalation of octreotide long-acting release on clinical symptoms and tumor markers and response among patients with neuroendocrine tumors","volume":"4","author":"Al-Efraij","year":"2015","journal-title":"Cancer Med"},{"key":"2021122508024769700_onco12944-bib-0012","doi-asserted-by":"crossref","first-page":"495","DOI":"10.2147\/CEOR.S140866","article-title":"Budget impact of somatostatin analogs as treatment for metastatic gastroenteropancreatic neuroendocrine tumors in US hospitals","volume":"9","author":"Ortendahl","year":"2017","journal-title":"Clinicoecon Outcomes Res"},{"key":"2021122508024769700_onco12944-bib-0013","author":"Broder","year":"2013"},{"key":"2021122508024769700_onco12944-bib-0014","doi-asserted-by":"crossref","first-page":"142","DOI":"10.5603\/EP.2015.0022","article-title":"Dosage and costs of lanreotide Autogel 120 mg administered as part of routine acromegaly care in Poland - two years of data from Lanro-Study","volume":"66","author":"Orlewska","year":"2015","journal-title":"Endokrynol Pol"},{"key":"2021122508024769700_onco12944-bib-0015","first-page":"471","article-title":"A review of the use of somatostatin analogs in oncology","volume":"6","author":"Keskin","year":"2013","journal-title":"Onco Targets Ther"},{"key":"2021122508024769700_onco12944-bib-0016","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1002\/(SICI)1097-0142(20000215)88:4<770::AID-CNCR6>3.0.CO;2-0","article-title":"Treatment of carcinoid syndrome: A prospective crossover evaluation of lanreotide versus octreotide in terms of efficacy, patient acceptability, and tolerance","volume":"88","author":"O'Toole","year":"2000","journal-title":"Cancer"},{"issue":"suppl","key":"2021122508024769700_onco12944-bib-0017","doi-asserted-by":"crossref","first-page":"337a","DOI":"10.1200\/JCO.2018.36.4_suppl.337","article-title":"Treatment adherence, healthcare resource utilization and cost in patients with gastrointestinal neuroendocrine tumors (GI NETs)","volume":"36","author":"Cai","year":"2018","journal-title":"J Clin Oncol"},{"key":"2021122508024769700_onco12944-bib-0018","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1111\/j.1365-2036.2011.04693.x","article-title":"Long-term results of treatment of malignant carcinoid syndrome with prolonged release Lanreotide (Somatuline Autogel)","volume":"34","author":"Khan","year":"2011","journal-title":"Aliment Pharmacol Ther"},{"issue":"suppl","key":"2021122508024769700_onco12944-bib-0019","first-page":"268a","article-title":"ELECT: A phase III study of efficacy and safety of lanreotide autogel\/depot (LAN) treatment for carcinoid syndrome in patients with neuroendocrine tumors (NETs)","volume":"32","author":"Vinik","journal-title":"J Clin Oncol"},{"key":"2021122508024769700_onco12944-bib-0020","doi-asserted-by":"crossref","first-page":"6128","DOI":"10.3748\/wjg.v23.i33.6128","article-title":"Real-world treatment patterns of gastrointestinal neuroendocrine tumors: A claims database analysis","volume":"23","author":"Benson","year":"2017","journal-title":"World J Gastroenterol"},{"key":"2021122508024769700_onco12944-bib-0021","author":"Klink"}],"container-title":["The Oncologist"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1634\/theoncologist.2018-0798","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1634\/theoncologist.2018-0798","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/oncolo\/article-pdf\/24\/10\/1331\/41917977\/oncolo_24_10_1331.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/oncolo\/article-pdf\/24\/10\/1331\/41917977\/oncolo_24_10_1331.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,25]],"date-time":"2021-12-25T08:03:26Z","timestamp":1640419406000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/oncolo\/article\/24\/10\/1331\/6439421"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,4,23]]},"references-count":21,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2019,4,23]]},"published-print":{"date-parts":[[2019,10,1]]}},"URL":"https:\/\/doi.org\/10.1634\/theoncologist.2018-0798","relation":{},"ISSN":["1083-7159","1549-490X"],"issn-type":[{"value":"1083-7159","type":"print"},{"value":"1549-490X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2019,10,1]]},"published":{"date-parts":[[2019,4,23]]}}}