Lanreotide

Overview

Somatostatin is an endogenous inhibitory hormone with a very short half-life. Lanreotide is a stabilized octapeptide analog with high affinity for somatostatin receptor subtypes 2 and 5, delivered as a supersaturated aqueous depot that provides sustained release over about four weeks.

In acromegaly, lanreotide suppresses excess growth hormone and IGF-1, normalizing hormone levels in a substantial fraction of patients. In neuroendocrine tumors (NETs), the landmark CLARINET trial showed that lanreotide Autogel 120 mg every 4 weeks significantly prolonged progression-free survival versus placebo in metastatic grade 1/2 enteropancreatic NETs, establishing an antiproliferative role in addition to symptom control (e.g., of carcinoid syndrome diarrhea and flushing).

Common adverse effects include gastrointestinal upset, gallstones (from reduced gallbladder motility), and injection-site reactions; it can also alter glucose regulation.

Mechanism of Action

By mimicking somatostatin at SSTR2/SSTR5, lanreotide reduces hormone hypersecretion (lowering GH/IGF-1 in acromegaly and controlling carcinoid symptoms) and slows tumor growth through antiproliferative signaling and inhibition of angiogenic and trophic factors. Its long-acting depot formulation maintains receptor blockade across a monthly interval, and its inhibition of gallbladder contractility explains the elevated risk of cholelithiasis.

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