Dr. Yao on Octreotide in Elderly Patients with NET

James C. Yao, MD, Associate Professor, Department of Gastrointestinal Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, discusses an analysis of the linked SEER-Medicare database that examined the benefits and utilization of octreotide LAR as a treatment for patients with carcinoid syndrome associated with neuroendocrine tumors (NET).

Each database has its own advantages, Yao says. The advantage of the SEER database is that it is a rigorous with diagnoses confirmed by pathology and the Medicare database provides access to comorbidity and treatment data.

This study analyzed patients over age 65 who had at least two claims of carcinoid syndrome (flushing, diarrhea, or malignant islet cell neoplasm) within the first year of diagnosis with NET. Patients' first claim also occurred within six months of diagnosis. The population-based analysis looked at whether or not treatment with octreotide was being fully utilized and was beneficial in these patients.

Data showed that a significant portion of the elderly population of patients with carcinoid syndrome, though indicated to be treated with octreotide, were not necessarily getting treated. The study also demonstrated that the patients who received treatment with octreotide had a longer and better five-year survival rate than those who did not. Overall, the five-year survival benefit for distant stage patients was higher with octreotide (hazard ratio [HR] = .80; P = .047) compared with local/regional stage patients (HR = .97,P = .89), suggesting a more appropriate population for treatment.