Lanreotide is an eight-
amino acid peptide, which is an analog of the native
somatostatin peptide, physiological inhibitor of
growth hormone (GH). The
drug shows high binding affinity for
somatostatin receptors, SSTR2 and SSTR5, which is the primary mechanism considered to be responsible for decreasing GH secretion and GH cell proliferation in
acromegaly. Two different formulations of
lanreotide are currently available:
lanreotide slow release, which requires
intramuscular injection every 7-14 days, and
lanreotide autogel, which requires deep
subcutaneous injection every 4-8 weeks. Several studies have been published to date on the use of
lanreotide in
acromegaly. Antisecretory efficacy has been reported in 35%-70% of cases; this huge variability is probably explained by different indications (eg, primary or adjunctive postsurgical treatment), or the fact that some studies were based on patients known to be responders to
somatostatin analogs. As a primary treatment, antisecretory efficacy was very similar, confirming the possibility of
lanreotide as an option in cases of unsuccessful
surgery, contraindication, or surgery refusal.
Lanreotide also has antitumoral effects as it induces a decrease in
tumor volume of [Symbol: see text]25% in 30%-70% of patients. This could be beneficial before transsphenoidal surgery, as a pretreatment, to decrease
tumor volume and ease surgery; however, to date, advantages in terms of final remission or uncured status remain a matter of debate. Side effects are rare; the most frequent being gastrointestinal discomfort and increased risk of
gallstone formation, and
glucose metabolism modifications. Comparison with the other
somatostatin analog,
octreotide, tends to show identical levels of efficacy between both drugs.
Lanreotide thus seems to be an effective treatment in
acromegaly. To date, however,
lanreotide is still considered as only suspending GH secretion, thus requiring prolonged and costly treatment.