Lanreotide

drugbox
IUPAC_name = (4"S",7"S",10"S",13"R",16"S",19"S")-10-(4-aminobutyl)-19-
[(2"R")-2-amino-3-naphthalen-2-yl-propanoyl] amino] -
"N"- [(1"S",2"R")-1-carbamoyl-2-hydroxy-propyl] -16-
[(4-hydroxyphenyl)methyl] -13-(1"H"-indol-3-ylmethyl)-
6,9,12,15,18-pentaoxo-7-propan-2-yl-1,2-dithia-5,8,
11,14,17-pentazacycloicosane-4-carboxamide

---

CAS_number = 108736-35-2
CAS_supplemental = CAS|127984-74-1
ATC_prefix = H01
ATC_suffix = CB03
PubChem = 71349
DrugBank =
C=54|H=69|N=11|O=10|S=2
molecular_weight = 1096.33 g/mol
1156.380 g/mol (acetate)
bioavailability = Approximately 80%fr icon cite web | url = http://www.biam2.org/www/Sub5041.html | title = Lanreotide Acetate | date = March 5, 2001 | accessdate = 2007-03-02 | publisher = BIAM]
protein_bound = 78%
metabolism = In GI tract
elimination_half-life = 2 hours (immediate release)
5 days (sustained release)
excretion = Mostly biliary
licence_US = Lanreotide
pregnancy_AU = C
pregnancy_US = C
legal_AU =
legal_UK = POM
legal_US = Rx-only
routes_of_administration = Intramuscular, subcutaneous

Lanreotide (INN) is a medication used in the management of acromegaly and symptoms caused by neuroendocrine tumors, most notably carcinoid syndrome. It is a long-acting analogue of somatostatin, like octreotide.

Lanreotide (as lanreotide acetate) is manufactured by Ipsen, and marketed under the trade name Somatuline. It is available in several countries, including the United Kingdom, Australia and Canada, and was approved for sale in the United States by the Food and Drug Administration (FDA) on August 30 2007. [cite press release | url = http://www.fda.gov/bbs/topics/NEWS/2007/NEW01692.html | title = FDA Approves New Drug to Treat Rare Disease, Acromegaly | date = August 30 2007 | accessdate = 2007-09-06 | publisher = U.S. Food and Drug Administration]

Pharmacology

Lanreotide is a synthetic analogue of somatostatin, a naturally occurring inhibitory hormone which blocks the release of several other hormones, including growth hormone, thyroid-stimulating hormone (TSH), insulin and glucagon. Lanreotide binds to the same receptors as somatostatin, although with higher affinity to peripheral receptors, and has similar activity. However, while somatostatin is quickly broken down in the body (within minutes), [cite journal |author=Rens-Domiano S, Reisine T |title=Biochemical and functional properties of somatostatin receptors |journal=J Neurochem |volume=58 |issue=6 |pages=1987–96 |year=1992 |pmid=1315373 |doi=10.1111/j.1471-4159.1992.tb10938.x] lanreotide has a much longer half-life, and produces far more prolonged effects.

The efficacy of lanreotide has not been extensively studied, and results differ greatly between trials and formulations.

Indications

Lanreotide is used in the treatment of acromegaly, due to both pituitary and non-pituitary growth hormone-secreting tumors, and the management of symptoms caused by neuroendocrine tumors, particularly carcinoid tumors and VIPomas. In the United Kingdom, it is also indicated in the treatment of thyrotrophic adenoma,cite web | url = http://emc.medicines.org.uk/emc/assets/c/html/displaydoc.asp?documentid=877 | title = Somatuline LA | date = September 17, 2003 | accessdate = 2007-03-02 | publisher = electronic Medicines Compendium] a rare tumor of the pituitary gland which secretes TSH.

Interestingly, lanreotide also shows activity against non-endocrine tumors, and, along with other somatostatin analogues, is being studied as a possible general antitumor agent. [cite journal |author=Kvols L, Woltering E |title=Role of somatostatin analogs in the clinical management of non-neuroendocrine solid tumors |journal=Anticancer Drugs |volume=17 |issue=6 |pages=601–8 |year=2006 |pmid=16917205 |doi=10.1097/01.cad.0000210335.95828.ed] [cite journal |author=Susini C, Buscail L |title=Rationale for the use of somatostatin analogs as antitumor agents |journal=Ann Oncol |volume=17 |issue=12 |pages=1733–42 |year=2006 |pmid=16801334 |doi=10.1093/annonc/mdl105]

ide effects

The main side effects of lanreotide treatment are mild to moderate pain at the injection site and gastrointestinal disturbances, such as diarrhea, nausea and vomiting. Isolated cases of gallstone formation have been associated with use of lanreotide, particularly over long periods of time.

Formulations

Lanreotide is available in two formulations: a sustained release formulation (sold under the trade name Somatuline LA), which is injected intramuscularly every ten or fourteen days, and an extended release formulation (UK trade name Somatuline Autogel, or Somatuline Depot in the U.S.), which is administered subcutaneously once a month. [cite web | url = http://emc.medicines.org.uk/emc/assets/c/html/displaydoc.asp?documentid=8203 | title = Somatuline Autogel | date = April 12, 2007 | accessdate = 2007-04-19 | publisher = electronic Medicines Compendium]

References