Lowell B. Anthony, MD, professor of Medicine, University of Kentucky, discusses patient exit interviews from the phase III placebo-controlled TELESTAR trial, which evaluated telotristate epitrate in patients with inadequately controlled carcinoid syndrome.

The prospective, randomized, placebo-controlled trial enrolled more than 100 patients, 35 of which participated in exit interviews from the randomized treatment portion of TELESTAR prior to going on the open-label study.

Patients reported symptoms mainly consisting of diarrhea and the frequency of it, physical function, and impact these symptoms had on their quality of life. A total of 33 of the 35 patients participated in interviews, one-third of which were on placebo. Fourtee patients did not report any signs of improvement, 7 patients had somewhat improvement, and 12 had definite improvement. The reduction in diarrhea allowed for better quality of life, Anthony adds.

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Dr. Anthony on Treatment Benefit With Telotristat Epitrate in Patients With Carcinoid Syndrome

Lowell B. Anthony, MD, professor of Medicine at the University of Kentucky Markey Cancer Center in Lexington, discusses the importance of preventing and managing the diarrhea that can be associated with common molecularly targeted therapies.

	Chemotherapy-induced diarrhea accompanying molecularly targeted agents can be controlled by using loperamide and other drugs that slow gut motility. Physicians must be aware of the incidence of side effects.

	Molecularly targeted agents such as sorafenib, sunitinib, dasatinib, and even monoclonal antibodies such as cetuximab and ponatinib, will have grade 1 or grade 2 toxicity, especially when administered with other drugs. For example, when adding lapatinib to capecitabine, there will be an increased toxicity.

	Anthony says physicians should understand that diarrhea is not a deal breaker. Through prevention, education and communication, physicians can keep patients from going to grade 1 or grade 2 diarrhea, or even grade 3 or 4 diarrhea that would require hospitalization. He adds that no physician wants his/her patient in the hospital for symptoms that could have been avoided. Anthony concluded by stressing the importance of working with patients on dealing with the side effects of chemotherapy and molecularly targeted agents.

Dr. Lowell Anthony from the University of Kentucky Markey Cancer Center on Targeted Therapy Associated Diarrhea.

Lowell B. Anthony, MD

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Dr. Anthony on Treatment Benefit With Telotristat Epitrate in Patients With Carcinoid Syndrome

Dr. Anthony on Targeted Therapy Associated Diarrhea