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CLARINET SSA Antiproliferative — SCE Medical Oncology MCQ

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ModerateGI CancersCLARINET SSA AntiproliferativeSCE Medical Oncology

A 60-year-old man with well-differentiated pancreatic neuroendocrine tumour (Ki-67 8%, G2) has non-functional liver metastases growing slowly. He is asymptomatic. Somatostatin analogue therapy is being considered. What does the CLARINET trial show?

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Correct answer: D — The CLARINET trial demonstrated that lanreotide 120 mg depot monthly significantly prolonged PFS compared with placebo in non-functional GEP-NETs (median PFS not reached vs 18 months; HR 0.47) — SSAs have antiproliferative activity independent of hormone control

The CLARINET trial (Caplin et al NEJM 2014) established lanreotide depot as antiproliferative therapy for advanced well/moderately-differentiated non-functional GEP-NETs (Ki-67 <10%, G1-G2). PFS was significantly prolonged (HR 0.47). This complemented the PROMID trial showing similar antiproliferative benefit for octreotide in midgut NETs. SSAs are now first-line systemic therapy for well-differentiated GEP-NETs regardless of functional status, based on their dual antiproliferative and antisecretory properties.

Reference: NICE; CLARINET Caplin et al NEJM 2014; PROMID; ESMO 2024 NET