Diarrhea is a huge subject for NET patients, whether it’s caused by the tumour itself (i.e. a syndrome), due to treatment, knock on effects of treatment, or some other reason, it can dramatically limit qualify of life.  Working out the root cause can be problematic even for medical teams. I wrote about these issues before in my article Neuroendocrine Cancer – the diarrhea jigsaw. So when I saw the data from a trial of something called enterade®, I was immediately drawn to investigate.  I don’t normally write articles on over the counter commercial products but this one is an exception given that it has been classed as a medical food since 2012 and is also used to rehydrate patients undergoing radiotherapy and chemotherapy for cancer (so not just for NETs).

What is enterade® ?

It’s a drink currently produced in 8oz bottles.  It’s a first-in-class, glucose-free medical food i.e. it is intended to be used under the supervision of a healthcare provider.  The solution comprises five critical amino acids – Valine, Aspartic Acid, Serine, Threonine, Tyrosine and electrolytes – potassium and sodium.

What does it do?

It’s designed to help manage debilitating gastrointestinal (GI) side effects. With no sugar to exacerbate the GI tract, enterade® supports the small bowel’s ability to absorb fluids, nutrients, and electrolytes and leads to improved digestive function. By helping to restore normal GI function, enterade® reduces diarrhea and dehydration, leading to a significant improvement in the patient’s overall quality of life and a healthier GI tract.

Is there evidence that it works?

Since May 2017, it’s been trialled by University of Kentucky Markey Cancer Center (MCC) for potential use by NET patients – trial coordinators include the well-known NET specialist Dr Lowell Anthony.  The results so far are very interesting.  The recent  conference reported revised data as follows:

• 33 of 41 patients (80%) reported subjective improvement in diarrheal symptoms.
• 51% (21/41) reported more than 50% reduction in diarrhea frequency.
• click here or on the poster below to see the trial poster data output.

As you will see from the poster, there were a wide range of patient types including (but not limited to) small intestinal NETs, bronchial NETs, NETs of unknown primary, gastric NETS, pancreatic NETs and one high grade neuroendocrine carcinoma of the prostate.

A follow on Phase 2 trial was conducted (no results as of Sep 2022)

1. Up to 30 patients will be recruited.

2. The trial is coordinated by Markey Cancer Centre, Kentucky.

3.  There will be two cohorts, those with carcinoid syndrome and those without.

4.  The trial will run from December 2018 to August 2020 (possibly delayed by the pandemic).

• Click here to see the trial information – important to note the inclusion and exclusion criteria.
• Read the trial start announcement by clicking here.
• Please also note there’s a plan for a follow on trial covering more locations.  I will update further when known.

Can I buy Enterade now?  

The product is available in North America on Amazon.com,  www.enterade.com and 1-855-enterade.  Reimbursements via insurance may be possible – read more here. 

The parent company (Entrinsic Health) recently announced a partnership with global company  Nestlé Health Science to provides worldwide commercial license and supply agreement for enterade®. The announcement is linked here:

NORWOOD, Mass., November 15, 2018 – Entrinsic Health Solutions (EHS), an innovative health sciences company, today announced that they have entered into a partnership with Nestlé Health Science (NHSc), a global innovative leader pioneering premium-quality, science-based nutritional health solutions. The partnership gives NHSc the exclusive rights to market EHS’s enterade® product.

Disclaimer

Please note this is not a recommendation to go out and buy the product.  It is actually described as a ‘medical food’ and is formulated to be consumed or administered under the supervision of a physician.

Further reading:

1. Enterade FAQ – click here

2. A breakthrough for NET Patients. click here.

3. Output from ASCO 2018 – click here. 

4. If you are interested in more information about how enterade® works, check out this short video

5.  Enterade Facebook – click here