Lanreotide

CPT Code: 80299

Clinical Significance:
Lanreotide (Somatuline Depot®, Tercica) is used for the control of symptoms associated with functional neuroendocrine tumors. Frequent measurement of the lanreotide levels may be useful in guiding therapy in patients with poorly controlled symptoms or those patients experiencing tumor growth. Lanreotide levels in blood need to be in a specific range to be effective. Measuring lanreotide immediately prior to the monthly injection will determine trough levels of the drug in your blood.

Reference Range:
Mean lanreotide levels +/- 2SD for patients on Somatuline Depot® injections for 4 or more months (steady-state). The following values represent trough levels of lanreotide measured immediately before a patient’s next injection of Somatuline Depot.
Lanreotide administered as Somatuline® Depot:
480 mg/month: 20,000 pg/mL ± 2,000 pg/mL
240 mg/month: 10,000 pg/mL ± 2,000 pg/mL
120 mg/month: 5,000 pg/mL ± 1,000 pg/mL
90 mg/month: 2,500 pg/mL ± 500 pg/mL

Procedure:
Lanreotide is measured by direct radioimmunoassay.

Expected Turnaround Time: 10-14 Business Days

Turnaround time is defined as the usual number of days from the date of receipt of a specimen for testing to when the result is released to the ordering facility.

Report: Sample Report

Patient Preparation:
This test is only useful for those patients being treated with Lanreotide. No special preparation is necessary since Lanreotide is not a naturally occurring substance. For optimal results, specimen should be collected immediately before the next injection of Lanreotide (trough levels) and after having been on the medication at least four months. Additional Lanreotide levels should be drawn in patients with evidence of tumor progression or loss of symptom control.

Specimen Collection:
Collect 3 mL serum or EDTA plasma and separate as soon as possible. Specimens collected for Lanreotide are stable at room temperature for 3 days. Specimens can be stored at room temperature, refrigerated, or frozen in dry ice. Minimum specimen size is 1 mL.

Shipping Instructions:
Specimens can be shipped at ambient temperature, refrigerated, or frozen in dry ice.

References:

1. Colao A, Pivonello R, Auriemma R, Briganti F, et al. Predictor of Tumor Shrinkage after Primary Therapy with Somatostatin Analogs in Acromegaly: A Prospective Study in 99 Patients. J Clin Endocrinology and Metabolism.  2006; 91(6) 2112-2118.

2. Woltering, E. et al. (2015) ‘Effect of sex, weight, and body mass index on plasma lanreotide levels.’, Journal of Clinical Oncology, 33(15_suppl). doi:10.1200/jco.2015.33.15_suppl.e15189.

3. Fisher, G.A. et al. (2018) ‘Lanreotide therapy in carcinoid syndrome: Prospective analysis of patient-reported symptoms in patients responsive to prior octreotide therapy and patients naïve to somatostatin analogue therapy in the elect phase 3 study’, Endocrine Practice, 24(3), pp. 243–255. doi:10.4158/ep172000.or.

4. Anthony, L.B. and O’Dorisio, T.M. (2021) ‘Opportunities to improve symptom control with somatostatin congeners in GEP-Nets: A Review of Key Issues’, The Oncologist, 26(7). doi:10.1002/onco.13847.