Efficacy of Telotristat Ethyl in Patients with Progressive NET Disease: Real-World Clinical Practice Experience

2020 Year in Review - Neuroendocrine Tumors

Real-world clinical practice data indicate that telotristat ethyl (TE) use in patients with progressive neuroendocrine tumors (NETs) may provide clinical benefit in terms of improvements in carcinoid syndrome (CS) symptoms, functional status, and weight.

Real-world clinical practice data with TE use in terms of worsening tumor status were reported at the 2020 North American Neuroendocrine Tumor Society Annual Symposium. This analysis was conducted in a subgroup of patients enrolled in the TELEACE study, a retrospective, single-arm, pre–post physician panel–based chart review of patients who received TE for at least 6 months in US clinical practice.

In the retrospective TELEACE study, eligible patients were aged ≥18 years at TE initiation, had confirmed diagnosis of advanced NETs and documented CS; TE treatment for ≥6 months following diagnosis; ≥2 radiologic scans in the 12 months prior to TE initiation and ≥1 scans after TE initiation; and NET and CS treatment information until death or for ≥6 months after TE initiation. The present analysis focused on a subgroup of patients in the TELEACE study with worsening tumor status at the time of TE initiation based on radiologic reports.

Of the 200 patients enrolled in the TELEACE study, 33 (17%) patients had worsened tumor status at the time of TE initiation and were included in the present analysis. The mean age of the 33 patients was 60 years; 58% were female and 67% had intermediate-grade tumor. Twenty (61%) patients had received somatostatin analog treatment prior to TE initiation; of these, 14 had received octreotide long-acting release (depot or infusion) and 6 had received lanreotide. Eleven patients received another NET treatment, including liver-directed therapy, surgery, chemotherapy, targeted therapy, and peptide receptor radionuclide therapy. The mean duration of TE treatment was 14 (standard deviation, 10.5) months. All patients exhibited stabilization or improvement in ≥1 physician-assessed post-TE CS symptoms from baseline. Significant improvements were noted in nearly all patients in terms of CS diarrhea, abdominal pain, flushing episodes, weight, and Eastern Cooperative Oncology Group performance status.

These results from a real-world study indicate use of TE in patients with progressive NET may provide clinical benefit in terms of improvements in CS symptoms, functional status, and weight.

Source: Lui E, et al. North American Neuroendocrine Tumor Society 2020 Annual Symposium; October 1-3, 2020. Abstract C5.

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