Endocrine Abstracts

Background: LA-SSA therapy, including octreotide long-acting release (LAR) and lanreotide depot (LAN), is recommended as first-line therapy for treatment of unresectable or metastatic NETs. Understanding treatment sequencing and dosing patterns of LA-SSAs is essential for clinical decision-making to provide value-based management of NET for both the patients and healthcare system. This study describes treatment patterns of LA-SSA therapy among privately insured patients with NET in the US.

Methods: Claims data for patients with NET who were newly treated with LA-SSAs for ≥3 months were extracted from MarketScan Commercial and Medicare databases between 1/1/2015-10/31/2021 (earliest LA-SSA treatment = index date). Treatment patterns were reported during index LA-SSA treatment, including treatment duration, dose, up to 2 dose escalations, use of rescue therapy with short-acting octreotide at any time during treatment, and transition to other LA-SSA. Doses were reported as 28-day doses based on days’ supply/drug quantity (for outpatient pharmacy claims) or units of service (for outpatient medical claims). Dose escalation was defined as an increase in quantity administered or frequency of injections (28-day to 21-day cycles). Chi-square tests, two sample t-tests, and log-rank test were used for binary variables, continuous variables, and treatment duration estimated using the Kaplan-Meier approach, respectively.

Results: A total of 762 patients with NET treated with LA-SSAs were identified (241 started on LAN and 521 started on octreotide LAR). Treatment duration was longer for LAN than octreotide LAR (median 3.4 vs. 2.2 years, P-value=0.004). Compared to octreotide LAR, fewer LAN patients experienced a first and second dose escalation (first dose escalation: 6% vs. 27%; second dose escalation: 1% vs. 5%; all P-values <0.05). Additionally, fewer LAN patients used rescue treatment (8% vs. 14%, P-value=0.011). Doses based on days’ supply/drug quantity or units of service were reported for most patients, and 2% of LAN patients received an above label 28-day dose (>120 mg) compared to 14% of octreotide LAR patients (>30 mg; P-value <0.05). Amongst patients whose initial treatment ended during follow-up (90 LAN and 274 octreotide LAR patients), fewer LAN patients transitioned to the other LA-SSA compared to octreotide LAR (19% (n=17) vs. 34% (n=92), P-value=0.008).

Conclusions: Compared with octreotide LAR patients, LAN patients were more likely to remain on their initial LA-SSA treatment longer as well as on their starting dose without dose escalation, and less likely to use rescue treatment.

Abstract ID 21424