Clinical impact of unsuccessful subcutaneous administration of octreotide LAR instead of intramuscular administration in patients with metastatic gastroenteropancreatic neuroendocrine tumors

• DOI: 10.1111/jne.13360
• Publication Date: 2023-12-13T09:50:37Z
• Authors: Tharani Krishnan; Maria Safro; Daniel Moreira Fu...; Sharlene Gill; Joao Paulo Solar ...; Heather C. Stuart; Patrick Martineau; Jonathan M. Loree
• Keywords: Pancreatic Neoplasms; Neuroendocrine Tumors; Stomach Neoplasms; Humans; Female; Octreotide; Somatostatin

Abstract Octreotide LAR is a long‐acting somatostatin analogue (SSA) used in the management of metastatic gastroenteropancreatic neuroendocrine tumors (GEP NETs). It requires intramuscular (IM) injection. Missed IM injections cause subcutaneous nodules (SCNs) on radiologic images. We reviewed rates SCNs real‐world cohort GEP NETs receiving octreotide and explored treatment outcomes. Patients commencing between August 5, 2010 March 8, 2018 at single cancer center Canada were identified from pharmacy records. included if they had computed tomography (CT) scan performed time progression preceding CT with pelvis to enable assessment for presence nodules. Fisher's exact test was examine predictors SCNs, Kaplan–Meier curves summarized differences free (PFS) overall survival (OS) that compared log‐rank tests. Of 243 patients LAR, 45 all required images available central review. found 20/45 (44%) last showing stable disease before numerically but not statistically more likely females (OR: 2.36, 95% CI: 0.66–8.29, p = .23). There an increased risk skin‐to‐muscle distance >38 mm (the length needle) 5.09, 1.39–16.6, .018) trend toward obese 5.71, 1.26–23.4, .061). PFS (HR: 1.01, 0.56–1.78, .98) OS 0.86, 0.41–1.8, .70) similar those with/without SCNs. In conclusion, almost half SCNs; however, missed administration SSA did appear result worse this small study. Factors such as sex, younger age distance, obesity may affect SCN development should be considered when choosing SSA.