FREQUENT, AND WATERY STOOLS
Functioning neuroendocrine tumors (NETs) can lead to a constellation of symptoms known as carcinoid syndrome (CS)1-4
CSD is the most common manifestation of CS and is caused primarily by serotonin overproduction from functioning NETs.1
Serotonin normally plays a role in mediating secretion and motility of the gastrointestinal tract, but excessive serotonin in the body can have significant physiologic consequences in multiple systems, including1-4:
- Flushing of the skin
- Bronchial constriction
- Tissue fibrosis and heart valve damage, potentially leading to carcinoid heart disease
Long-term SSA therapy alone can be ineffective in a majority of patients3,5-9
- Over time, tachyphylaxis and other mechanisms of resistance can lead to a diminished response to SSA therapies, and subsequent release of serotonin5
- This means that many patients can continue to experience debilitating diarrhea3,10,11
The combination of XERMELO + SSA offers 2 distinct pathways to reduce excess serotonin by addressing the underlying pathology3,10
- XERMELO inhibits the enzyme tryptophan hydroxylase, which reduces the production of serotonin3,10
- Together, XERMELO + SSA mediate serotonin overproduction by modifying its production AND release6,10
Request a XERMELO representative
A representative can give you more information about XERMELO and provide resources to support your patients.Request a rep
See study results of XERMELO + SSA treatment versus SSA treatment alone.
Support for your patients
Get support and resources to help your patients on their treatment journey.
Download practice resources
Download patient brochures, enrollment forms, sample prior authorization letters, checklists, and more.
- Naraev B, Halland M, Halperin DM, Purvis AJ, O’Dorisio TM, Halfdanarson TR. Management of diarrhea in patients with carcinoid syndrome. Pancreas. 2019;48(8):961-972.
- Clement D, Ramage J, Srirajaskanthan R. Update on pathophysiology, treatment, and complications of carcinoid syndrome. J Oncol. 2020;2020:1-11.
- Molina-Cerrillo J, Alonso-Gordoa T, Martínez-Sáez O, Grande E. Inhibition of peripheral synthesis of serotonin as a new target in neuroendocrine tumors. Oncologist. 2016;21(6):701-707.
- Møller JE, Connolly HM, Rubin J, Seward JB, Modesto K, Pellikka PA. Factors associated with progression of carcinoid heart disease. N Engl J Med. 2003;348(11):1005-1015.
- Kulke MH, O’Dorisio T, Phan A, et al. Telotristat etiprate, a novel serotonin synthesis inhibitor, in patients with carcinoid syndrome and diarrhea not adequately controlled by octreotide. Endocr Relat Cancer. 2014;21(5):705-714.
- SANDOSTATIN® LAR DEPOT (octreotide acetate) Prescribing Information. Novartis Pharmaceuticals Corporation.
- Janson ET, Öberg K. Long-term management of the carcinoid syndrome treatment with octreotide alone and in combination with alpha-interferon. Acta Oncologica. 1993;32(2):225-229.
- Toumpanakis C, Garland J, Marelli L, et al. Long-term results of patients with malignant carcinoid syndrome receiving octreotide LAR. Aliment Pharmacol Ther. 2009;30(7):733-740.
- Khan MS, El-Khouly F, Davies P, Toumpanakis C, Caplin ME. Long-term results of treatment of malignant carcinoid syndrome with prolonged release lanreotide (somatuline autogel). Aliment Pharmacol Ther. 2011;34(2):235-242.
- XERMELO® (telotristat ethyl) Prescribing Information. TerSera Therapeutics LLC.
- Kvols LK, Oberg KE, O’Dorisio TM, et al. Pasireotide (SOM230) shows efficacy and tolerability in the treatment of patients with advanced neuroendocrine tumors refractory or resistant to octreotide LAR: results from a phase II study. Endocr Relat Cancer. 2012;19(5):657-666.