Antiproliferative Effects of Telotristat Ethyl in Patients with Neuroendocrine Tumors: The TELEACE Real-World Chart Review Study
Received 6 May 2020
Accepted for publication 13 July 2020
Published 30 July 2020 Volume 2020:12 Pages 6607—6614
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 3
Editor who approved publication: Dr Yong Teng
Michael A Morse,1 Eric Liu,2 Vijay N Joish,3 Lynn Huynh,4 Mu Cheng,4 Mei Sheng Duh,4 Kiernan Seth,3 Pablo Lapuerta,3 David C Metz5
1Duke Cancer Institute, School of Medicine, Duke University, Durham, NC, USA; 2The Neuroendocrine Institute at Rocky Mountain Cancer Centers, Denver, CO, USA; 3Lexicon Pharmaceuticals, Inc., The Woodlands, TX, USA; 4Analysis Group, Boston, MA, USA; 5Neuroendocrine Tumor Program at Penn Medicine, Philadelphia, PA, USA
Correspondence: Michael A Morse, 10 Bryan Searle Drive, Box 3233, Durham, NC 27710, USA
Tel +1 919 681– 3480
Purpose: Neuroendocrine tumors (NETs) associated with carcinoid syndrome (CS) overproduce serotonin, mediated by tryptophan hydroxylase-1 (TPH1). The TPH inhibitor telotristat ethyl (TE) reduces peripheral serotonin and relieves CS symptoms. We conducted a real-world clinical practice study to explore the effects of TE on tumor growth in patients with NETs and CS.
Patients and Methods: Single-arm, pre/post chart review study of patients with advanced NETs who received TE for ≥ 6 months and had ≥ 2 radiological scans within 12 months before and ≥ 1 scan after TE initiation. Linear regression and longitudinal analyses assessed changes in tumor size controlling for background NET treatment.
Results: Two hundred patients were enrolled, most (61%) had well-differentiated gastrointestinal NETs (61%) and received TE for an average of 12 months (SD, 7.3). Mean reduction in tumor size after TE initiation was 0.59 cm (p=0.006). Longitudinal analysis showed an 8.5% reduction in tumor size (p=0.045) from pre- to post-TE periods. Documented NET treatment prior to initiating TE and time between scans were not significant predictors of changes in tumor size. Results were consistent in a subgroup of patients with the same documented NET treatment before and after initiating TE.
Conclusion: TE may have antitumor effects consistent with serotonin overproduction in tumor growth.
Keywords: neuroendocrine tumors, carcinoid tumor, malignant carcinoid syndrome, telotristat ethyl, octreotide, lanreotide
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF] View Full Text [HTML][Machine readable]