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Title: Telotristat etiprate: a new option for the management of carcinoid syndrome
Authors: Angela Lamarca1,*, Jorge Barriuso1,2, Mairéad G McNamara1,3, Richard A Hubner1, Juan W Valle1,3
1 Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom.
2 Faculty of Medical, Biological and Human Sciences, University of Manchester, Manchester, United Kingdom.
3 Institute of Cancer Sciences, University of Manchester, Manchester, United Kingdom.
*Part-funded by SEOM (Spanish Society of Medical Oncology) Translational Fellowship Program.
Corresponding author:
Professor Juan W Valle, Department of Medical Oncology, The Christie NHS Foundation Trust, Wilmslow Road, Manchester, M20 4BX, UK. Phone: +44 161-446-8106; Fax +44 161-446-3468
Conflict of Interest
• Authors have no conflict of interest related to this manuscript. A Lamarca and J Barriuso are part-funded by SEOM (Spanish Society of Medical Oncology) Translational Fellowship Grants.
• JW Valle has received Honoraria and a Travel Grant from Ipsen.
Keywords:
Bowel movement, Carcinoid syndrome, diarrhoea, flushing, LX1606, neuroendocrine tumours, serotonin synthesis inhibitor, telotristat ethyl, tryptophan hydroxylase 1 (Tph1)
Abstract
Introduction: Many patients with neuroendocrine tumour-related carcinoid syndrome treated with somatostatin analogues (SSA) won’t achieve adequate symptom relief with the SSA alone; new treatment options are required. Telotristat ethyl is a tryptophan hydroxylase inhibitor, developed for the treatment of carcinoid syndrome.
Areas covered: This review summarises the evidence supporting the role of telotristat ethyl in the management of carcinoid syndrome. Rationale, pharmacodynamics, pharmacokinetics, metabolism, clinical experience, efficacy and toxicity profiles are covered.
Expert opinion: The efficacy of telotristat ethyl in producing a statistically-significant and clinically-meaningful reduction in daily bowel movements has been confirmed in phase III clinical trials. Two pivotal trials, TELESTAR and TELECAST, explored the role of telotristat ethyl in the management of patients with carcinoid syndrome refractory to SSAs focusing on patients with ≥4 and ................
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