Long-term Treatment with Telotristat Ethyl in Patients with Carcinoid Syndrome Symptoms: Results from the TELEPATH Study

Dieter Hörsch, Lowell B. Anthony, David J. Gross, Juan Valle, Staffan Welin, Marta Benavent, Martyn E Caplin, Marianne Pavel , Emily Bergsland, Kjell Öberg, Kenneth B. Kassler-Taub, Polina Binder, Phillip Banks, Pablo Lapuerta, Matthew H Kulke

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction
Telotristat ethyl is indicated for use in combination with somatostatin analogs (SSAs) to treat carcinoid syndrome (CS) diarrhea uncontrolled by SSAs alone in adults, but long-term safety and efficacy data beyond 48 weeks are needed.

Objective
Evaluate the long-term safety and tolerability of telotristat ethyl and its effect on quality of life (QOL) in patients with CS.

Methods
In this phase 3, nonrandomized, multicenter, open-label, long-term extension study (TELEPATH), patients who participated in phase 2 or 3 trials of telotristat ethyl continued treatment at their present dose level (250 or 500 mg thrice daily) for 84 weeks. Safety and tolerability, the primary endpoint, were assessed by monitoring adverse events (AEs), serious adverse events (SAEs), adverse events of special interest (AESIs, including liver-related AEs, depression, and gastrointestinal AEs), and deaths. The secondary objective was to evaluate changes in patients’ QOL using validated cancer questionnaires and a subjective global assessment of CS symptoms.

Results
In 124 patients exposed to telotristat ethyl for a mean of 102.6 ± 53.2 weeks, the type and frequency of AEs were consistent with those reported in previous trials. The occurrence of AESIs was not related to dosage or duration of therapy. Most AEs were mild to moderate in severity, and no deaths were related to telotristat ethyl. QOL scores remained stable and the majority of patients reported adequate symptom relief throughout the study.

Conclusions
Safety results of TELEPATH support the long-term use of telotristat ethyl in patients with CS diarrhea. Telotristat ethyl was well tolerated and associated with sustained improvement in QOL scores (NCT02026063).
Original languageEnglish
JournalNeuroendocrinology
Publication statusAccepted/In press - 27 Apr 2021

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