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Antiproliferative Effects of Telotristat Ethyl in Patients with Neuroendocrine Tumors: The TELEACE Real-World Chart
Michael A Morse1, Eric Liu2, Vijay N Joish3
1Duke Cancer Institute, School of Medicine, Duke University, Durham, NC, USA.
Purpose:
Neuroendocrine tumors (NETs) associated with carcinoid syndrome (CS) overproduce serotonin, mediated by tryptophan hydroxylase-1 (TPH1). The TPH inhibitor telotristat ethyl (TE) reduces peripheral serotonin and relieves CS symptoms. We conducted a real-world clinical practice study to explore the effects of TE on tumor growth in patients with NETs and CS.
Patients And Methods:
Single-arm, pre/post chart review study of patients with advanced NETs who received TE for ≥6 months and had ≥2 radiological scans within 12 months before and ≥1 scan after TE initiation. Linear regression and longitudinal analyses assessed changes in tumor size controlling for background NET treatment.
Results:
Two hundred patients were enrolled, most (61%) had well-differentiated gastrointestinal NETs (61%) and received TE for an average of 12 months (SD, 7.3). Mean reduction in tumor size after TE initiation was 0.59 cm (p=0.006). Longitudinal analysis showed an 8.5% reduction in tumor size (p=0.045) from pre- to post-TE periods. Documented NET treatment prior to initiating TE and time between scans were not significant predictors of changes in tumor size. Results were consistent in a subgroup of patients with the same documented NET treatment before and after initiating TE.
Conclusion:
TE may have antitumor effects consistent with serotonin overproduction in tumor growth.
Insights
Telotristat ethyl (TE) may slow tumor growth in neuroendocrine tumors (NETs) with carcinoid syndrome (CS). This study found TE reduced tumor size, suggesting potential antitumor effects linked to serotonin overproduction.
Area of Science:
- Oncology
- Endocrinology
- Pharmacology
Background:
- Neuroendocrine tumors (NETs) with carcinoid syndrome (CS) overproduce serotonin, driven by tryptophan hydroxylase-1 (TPH1).
- Telotristat ethyl (TE) is a TPH inhibitor that reduces peripheral serotonin and alleviates CS symptoms.
Purpose of the Study:
- To investigate the real-world effects of telotristat ethyl (TE) on tumor growth in patients with NETs and CS.
- To explore the potential antitumor properties of TE in this patient population.
Main Methods:
- A single-arm, pre/post chart review of 200 patients with advanced NETs who received TE for at least 6 months.
- Tumor size changes were assessed using radiological scans before and after TE initiation.
- Linear regression and longitudinal analyses were employed, controlling for background NET treatments.
Main Results:
- A mean reduction in tumor size of 0.59 cm was observed after TE initiation (p=0.006).
- Longitudinal analysis revealed an 8.5% reduction in tumor size from pre- to post-TE periods (p=0.045).
- Background NET treatments and time between scans did not significantly predict tumor size changes.
Conclusions:
- Telotristat ethyl (TE) may possess antitumor effects in NETs with CS.
- These findings align with the role of serotonin overproduction in tumor growth.
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