Background: Based on SEER database, gastroenteropancreatic neuroendocrine tumor (GEPNET) incidence has increased 6-fold from 1 in 100,000 cases to about 6 in 100,000 cases over past 3 decades. North American Neuroendocrine Tumor Society estimates that over 100,000 GEPNET patients are currently living in the United States. One of the common quality of life limiting symptom seen in GEPNET patient is diarrhea. Diarrhea in these patients could be due to excessive serotonin production, secondary to post-operative short gut syndrome, steatorrhea from somatostatin analogs, bile acid colitis or intestinal bacterial overgrowth. A novel amino acid based oral rehydration solution (Enterade) is currently being evaluated in a Phase II clinical trial for antidiarrheal effects in post bone marrow transplant patients (NCT02919670). We conducted a pilot study of Enterade in neuroendocrine tumor patients with quality of life limiting diarrhea to evaluate its antidiarrheal efficacy. Methods: Medical records of all the GEPNET patients treated with Enterade for symptomatic diarrhea were evaluated. Patients were treated at Markey cancer center between May 2017-January 2018 Results: Total 35 patients were treated with Enterade. Enterade was administered as 8 Oz bottle BID for 1 a week. Antidiarrheal efficacy data was available on 23 patients at the time of abstract submission. 7 patients had small bowel neuroendocrine tumors (NET), 5 had bronchial NETs, 2 had colorectal NETs, 3 had NETs of unknown primary, 3 had gastric NETS, 2 had pancreatic NETs and one was high grade neuroendocrine carcinoma of prostate.14 patients had history of prior bowel resection either for primary neuroendocrine tumor resection or debulking. 15 patients were on somatostatin analogs at the time of initiation of Enterade. 17 out of 23 patients reported subjective improvement in diarrheal symptoms. 12 out of these 17 responders reported at least 50 percent reduction in diarrhea frequency. 
Conclusions:  73.9% (17/23) neuroendocrine tumor patients reported improvement in diarrhea with Enterade. 52.173% (12/23) reported more than 50% reduction in diarrhea frequency. A prospective Phase II study of Enterade in gastroenteropancreatic neuroendocrine tumor patients with quality of life limiting diarrhea is planned.

17 - THE ANTIDIARRHEAL EFFICACY OF A PROPRIETARY AMINO ACID MIXTURE (ENTERADE) IN NEUROENDOCRINE TUMOR (NET) PATIENTS.