Beyond Standard Dosing: Clinical Data Supports Higher SSA Doses for Progressive NETs

In an interview at the 2025 North American Neuroendocrine Tumor Society (NANETS) Symposium, Jennifer Chan, MD, MPH, NANETS president and associate professor of medicine at Harvard Medical School, discussed dose escalation in neuroendocrine tumors and the relationships between NANETS, ENETS, and research groups.

Somatostatin analogs (SSAs) like octreotide LAR and lanreotide are essential in managing NETs. Standard practice involves dose adjustments, particularly increasing the dose, to address uncontrolled symptoms and potentially achieve better disease control.

The standard dose of octreotide LAR is 30 mg. However, the dose is often increased to 40 mg or 60 mg to help minimize symptoms of carcinoid syndrome, such as flushing and diarrhea. Data from the control arms of clinical trials, including NETTER-1 and NETTER-2, suggest that escalating the octreotide LAR dose from 30 mg to 60 mg may offer a period of disease control even in patients with higher-grade disease or those who have progressed on the standard dose.

The ongoing SORENTO trial (NCT05050942) is exploring the impact of dose and bioavailability using a novel, highly bioavailable, self-administered formulation of octreotide. This trial is comparing CAM2029 against standard octreotide or lanreotide to determine if this new formulation offers superior efficacy due to its enhanced bioavailability. The results of SORENTO are awaited to better understand if improved bioavailability translates to better outcomes.