# CLARINET: lanreotide in metastatic enteropancreatic neuroendocrine tumours

Source: https://onco.cc/key-papers/paper-clarinet-lanreotide-nejm-2014/  
OnCo record `paper-clarinet-lanreotide-nejm-2014` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The long-acting somatostatin analogue lanreotide roughly halved the risk of progression in non-functioning gut and pancreatic neuroendocrine tumours, extending the use of these drugs from symptom control to slowing tumour growth.

## Summary

Phase 3 placebo-controlled trial of 204 patients with advanced, well- or moderately differentiated, non-functioning, somatostatin receptor-positive enteropancreatic neuroendocrine tumours (Ki-67 under 10 percent) randomised to lanreotide autogel 120 mg monthly or placebo.

Median progression-free survival was not reached with lanreotide against 18.0 months with placebo (hazard ratio 0.47), with benefit in pancreatic and midgut tumours and in patients with high hepatic tumour load.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: New England Journal of Medicine
- Year: 2014
- DOI: 10.1056/NEJMoa1316158
- Authors: Caplin ME, Pavel M, Ćwikła JB, et al.
- Findings: Progression-free survival hazard ratio 0.47.; 24-month progression-free survival 65.1 percent vs 33.0 percent.
- What it means: Somatostatin analogues are the standard first-line antiproliferative treatment for grade 1 to 2 gastroenteropancreatic neuroendocrine tumours whether or not they cause a hormone syndrome.
- Caveats: Most patients had stable disease at entry, so the natural history was slow.; No overall survival benefit shown.

## Sources

- N Engl J Med 2014: https://doi.org/10.1056/NEJMoa1316158
- PubMed: https://pubmed.ncbi.nlm.nih.gov/25014687/

## Connected records

- cancers: [Pancreatic neuroendocrine tumours](https://onco.cc/cancers/pancreatic-net/), [Small intestinal neuroendocrine tumours](https://onco.cc/cancers/small-intestinal-net/)
- trials: [CLARINET](https://onco.cc/trials/clarinet/)
- journals: [New England Journal of Medicine](https://onco.cc/journals/nejm/)

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