Evidence Grade A — Regulatory approved. 1218 published studies. 106 registered clinical trials.
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Lanreotide (sold as Somatuline Depot) is a monthly injection used to control hormone overproduction in acromegaly (a condition where the pituitary gland makes too much growth hormone) and to slow the growth of certain neuroendocrine tumours — rare cancers that often develop in the digestive system or pancreas. Its prefilled syringe can be given at home, avoiding the need for clinic visits for each dose.
Lanreotide is also known by these brand and alternate names:
1,218 published studies: 924 human, 36 animal, 84 in-vitro, 305 reviews
Lanreotide is marketed as Somatuline Depot (approved 2007 for acromegaly; 2014 for GEP-NETs; 2017 for carcinoid syndrome). The CLARINET trial was a landmark study that demonstrated lanreotide significantly prolonged progression-free survival in patients with GEP-NETs — the risk of disease progression or death was reduced by 53% compared to placebo.
CLARINET was particularly important because it included patients with stable disease, establishing that somatostatin analogues have anti-tumour activity beyond just symptom control. The practical advantage of lanreotide over octreotide LAR is its deep subcutaneous injection (which patients can do at home) compared to octreotide LAR's intramuscular injection (which often requires a clinic visit). Both agents are considered clinically equivalent for acromegaly.
Lanreotide works through the same somatostatin pathway as octreotide — suppressing growth hormone release from the pituitary and reducing hormone secretion from neuroendocrine tumours. It also has direct anti-tumour effects, slowing the growth and proliferation of tumour cells. The formulation is designed as a supersaturated gel that forms a depot under the skin, slowly releasing medication over a full month from a single injection.
The landmark CLARINET trial demonstrated that lanreotide reduced the risk of disease progression or death by 53% in patients with gastroenteropancreatic neuroendocrine tumours, including those with stable disease. This was important because it proved that drugs in this class have genuine anti-tumour effects — not just symptom control. Lanreotide is considered clinically equivalent to the other main somatostatin analogue, octreotide LAR, for acromegaly. The practical difference is that lanreotide's deep subcutaneous injection can be self-administered at home, whereas octreotide LAR requires an intramuscular injection typically given by a healthcare professional. Biosimilar development is underway which could improve access and reduce costs. Current research focuses on combination strategies and identifying which tumour patients are most likely to respond.
PeptideTrace tracks 106 registered clinical trials for Lanreotide sourced from ClinicalTrials.gov.
Analysis of Optimal Treatment Sequencing of Surufatinib and Somatostatin Analogs in Neuroendocrine Tumors: A Retrospective Cohort Study
Carcinoid Syndrome Efficacy Study Featuring an Oral Daily Paltusotine Regimen
Lanreotide Versus Placebo Before Surgery to Prevent a Surgical Complication Called a Pancreatic Fistula
Continuing Somatostatin Analogues Upon Progression in Neuroendocrine Tumour pAtients
Health Canada Market Authorisation
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Lanreotide is a synthetic cyclic octapeptide (8 amino acids) somatostatin analogue with preferential binding to SST2. It is formulated as a supersaturated aqueous solution in a prefilled syringe (Somatuline Depot/Autogel), allowing deep subcutaneous self-administration every 28 days.
Lanreotide activates somatostatin receptor SST2 (with some SST5 affinity), inhibiting GH, glucagon, insulin, and GI hormones. Its antiproliferative effects on neuroendocrine tumor cells occur through both direct (cell cycle arrest, apoptosis) and indirect (anti-angiogenic) mechanisms. The deep SC formulation creates a local depot, providing sustained plasma levels over 28 days.
Lanreotide is marketed as Somatuline Depot (approved August 30, 2007 for acromegaly; December 16, 2014 for GEP-NETs; September 18, 2017 for carcinoid syndrome). The CLARINET trial (N=204; NEJM 2014) demonstrated lanreotide significantly prolonged PFS in GEP-NETs: median PFS not reached versus 18.0 months with placebo (HR 0.47; 95% CI 0.30–0.73; P<0.001). PFS at 24 months was 65.1% versus 33.0%—a 53% risk reduction. The prefilled syringe enables patient or caregiver self-injection.
Linaclotide is marketed as Linzess (approved August 2012). It is taken as a daily oral capsule on an empty stomach, at least 30 minutes before the first meal. The recommended dose is 290 mcg for IBS-C and 72 or 145 mcg for chronic constipation. In clinical trials, approximately 34% of IBS-C patients met the composite improvement endpoint compared to 17% on placebo. Diarrhoea is the most common side effect (approximately 20%) and the leading reason for discontinuation. Linaclotide has a boxed warning against use in children under 6 years due to deaths in young mice, though no such events have been reported in humans. It competes with plecanatide (which targets the same pathway) and other IBS-C treatments.
Elamipretide (Forzinity) was approved by the FDA for Barth syndrome based on the TAZPOWER trial. The randomised crossover phase (12 patients) did not meet its primary endpoints, but the open-label extension (168 weeks) demonstrated durable improvements in walking distance and muscle strength that formed the basis for approval. Barth syndrome affects approximately 1 in 300,000–400,000 births. A larger Phase III trial in primary mitochondrial myopathy (218 patients, MMPOWER-3) did not meet its primary endpoint, and the drug was not approved for that broader indication. Elamipretide remains approved exclusively for Barth syndrome. See also SS-31 (#158) for the research compound context.
Glucagon has been available as an emergency injection since the 1960s and remains the standard rescue treatment for severe hypoglycaemia. Recent innovation has focused on making it easier to administer in emergencies. Baqsimi, approved in 2019, was the first needle-free option as a nasal powder. Gvoke, also approved in 2019, eliminated the need to mix and reconstitute the medication before injection — a significant advance since severe hypoglycaemia often impairs the ability to follow complex preparation steps. Dasiglucagon (Zegalogue), a next-generation stable liquid glucagon approved in 2021, further improved on the convenience of rescue administration. Beyond emergency rescue, glucagon's receptor is now a major research target — dual and triple agonists combining glucagon receptor activity with GLP-1 (such as survodutide and retatrutide) are in advanced clinical trials for obesity and metabolic disease.
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