Acromegaly

Treatment Phase: Initial treatment

Treatment criteria:

• Must be treated by a specialist practicing in a hospital who is either: (i) an endocrinologist, (ii) an oncologist; OR

• Must be treated by a medical practitioner working under the direct supervision of one of the above mentioned specialist types within a hospital setting.

Clinical criteria:

• The condition must be active,

AND

• Patient must have persistent elevation of mean growth hormone levels of greater than 2.5 micrograms per litre,

AND

• The treatment must be after failure of other therapy including dopamine agonists; OR

• The treatment must be as interim treatment while awaiting the effects of radiotherapy and where treatment with dopamine agonists has failed; OR

• The treatment must be in a patient who is unfit for or unwilling to undergo surgery and where radiotherapy is contraindicated,

AND

• The treatment must cease in a patient treated with radiotherapy if there is biochemical evidence of remission (normal IGF1) after lanreotide has been withdrawn for at least 4 weeks (8 weeks after the last dose),

AND

• The treatment must cease if IGF1 is not lower after 3 months of treatment,

AND

• The treatment must not be given concomitantly with PBS-subsidised pegvisomant.

In a patient treated with radiotherapy, lanreotide should be withdrawn every 2 years in the 10 years after radiotherapy for assessment of remission.

Acromegaly

Treatment Phase: Continuing treatment

Clinical criteria:

• Patient must have previously received PBS-subsidised treatment with this drug for this condition,

AND

• The condition must be active,

AND

• Patient must have persistent elevation of mean growth hormone levels of greater than 2.5 micrograms per litre,

AND

• The treatment must be after failure of other therapy including dopamine agonists; OR

• The treatment must be as interim treatment while awaiting the effects of radiotherapy and where treatment with dopamine agonists has failed; OR

• The treatment must be in a patient who is unfit for or unwilling to undergo surgery and where radiotherapy is contraindicated,

AND

• The treatment must cease in a patient treated with radiotherapy if there is biochemical evidence of remission (normal IGF1) after lanreotide has been withdrawn for at least 4 weeks (8 weeks after the last dose),

AND

• The treatment must cease if IGF1 is not lower after 3 months of treatment,

AND

• The treatment must not be given concomitantly with PBS-subsidised pegvisomant.

In a patient treated with radiotherapy, lanreotide should be withdrawn every 2 years in the 10 years after radiotherapy for assessment of remission.

Functional carcinoid tumour

Treatment Phase: Initial treatment

Treatment criteria:

• Must be treated by a specialist practicing in a hospital who is either: (i) an endocrinologist, (ii) an oncologist; OR

• Must be treated by a medical practitioner working under the direct supervision of one of the above mentioned specialist types within a hospital setting.

Clinical criteria:

• The condition must be causing intractable symptoms,

AND

• Patient must have experienced on average over 1 week, 3 or more episodes per day of diarrhoea and/or flushing, which persisted despite the use of anti-histamines, anti-serotonin agents and anti-diarrhoea agents,

AND

• Patient must be one in whom surgery or antineoplastic therapy has failed or is inappropriate,

AND

• The treatment must cease if there is failure to produce a clinically significant reduction in the frequency and severity of symptoms after 3 months' therapy at a dose of 120 mg every 28 days.

Dosage and tolerance to the drug should be assessed regularly and the dosage should be titrated slowly downwards to determine the minimum effective dose.

Functional carcinoid tumour

Treatment Phase: Continuing treatment

Clinical criteria:

• Patient must have previously received PBS-subsidised treatment with this drug for this condition,

AND

• The condition must be causing intractable symptoms,

AND

• Patient must have experienced on average over 1 week, 3 or more episodes per day of diarrhoea and/or flushing, which persisted despite the use of anti-histamines, anti-serotonin agents and anti-diarrhoea agents,

AND

• Patient must be one in whom surgery or antineoplastic therapy has failed or is inappropriate,

AND

• The treatment must cease if there is failure to produce a clinically significant reduction in the frequency and severity of symptoms after 3 months' therapy at a dose of 120 mg every 28 days.

Dosage and tolerance to the drug should be assessed regularly and the dosage should be titrated slowly downwards to determine the minimum effective dose.