Five-year survival for patients with malignant carcinoid syndrome rose from 18% in the pre-somatostatin era to 67% by 1996. The long-acting release formulation of octreotide (Sandostatin LAR®, Novartis), a somatostatin analogue, was approved by the US FDA for patients with carcinoid syndrome in 1998. The subcutaneous formulation (approved in 1989), while effective, had a very short half-life, requiring frequent (3x daily) self-administration. This led to wide peak-to-trough serum-level fluctuations and subsequently increased side effects. New surveys suggest that higher doses of long-acting release octreotide are being used safely for symptom control.
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