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SPINET tried to prove that the somatostatin analogue lanreotide slows lung carcinoid tumours, as it does gut tumours, but recruited too few patients to give a definitive answer; the small comparison favoured the drug and it is used on that basis.
Somatostatin analogues are the first-line treatment for advanced gut and pancreatic neuroendocrine tumours on the strength of the PROMID and CLARINET trials, but their use in lung carcinoids rested on extrapolation. SPINET randomised patients with somatostatin-receptor-positive, well-differentiated typical or atypical lung neuroendocrine tumours to lanreotide autogel 120 mg or placebo, with progression-free survival as the primary endpoint.
Recruitment was slow and the trial closed early with 77 patients, well short of its target. In the reduced population progression-free survival was longer with lanreotide than with placebo, in line with the gut trials, but the trial was underpowered for a formal conclusion. Guidelines still recommend somatostatin analogues for receptor-positive lung carcinoids on this and the gut evidence.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
77 enrolled.
95% CI 11.3 to 21.9; recruitment stopped early
Source| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Progression-free survival on lanreotide across double-blind and open-label phases (adapted primary endpoint)primary | Lanreotide autogel 120 mg + best supportive care | 51 | 16.6 months | - | - | link |
| Progression-free survival, double-blind phase | Lanreotide autogel 120 mg + best supportive care | 51 | 16.6 months | - | - | link |
| Placebo + best supportive care | 26 | 13.6 months | ||||
| Progression-free survival, double-blind phase, typical carcinoids | Lanreotide autogel 120 mg + best supportive care | 29 | 21.9 months | - | - | link |
| Placebo + best supportive care | 16 | 13.9 months |
Shares Somatostatin analogues (octreotide, lanreotide), Lung neuroendocrine tumours (typical and atypical carcinoid), Neuroendocrine tumours.
Shares Somatostatin analogues (octreotide, lanreotide), Ipsen, Lung neuroendocrine tumours (typical and atypical carcinoid), Neuroendocrine tumours.
Shares Somatostatin analogues (octreotide, lanreotide), Ipsen.
Shares Somatostatin analogues (octreotide, lanreotide), Neuroendocrine tumours.
Shares Lung neuroendocrine tumours (typical and atypical carcinoid), Neuroendocrine tumours.
Shares Lung neuroendocrine tumours (typical and atypical carcinoid), Neuroendocrine tumours.
Shares Lung neuroendocrine tumours (typical and atypical carcinoid), Neuroendocrine tumours.
Shares Lung neuroendocrine tumours (typical and atypical carcinoid), Neuroendocrine tumours.