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Octreotide LAR is a long‐acting somatostatin analogue (SSA) used in the management of metastatic gastroenteropancreatic neuroendocrine tumors (GEP NETs). It requires intramuscular (IM) injection. Missed IM injections cause subcutaneous nodules (SCNs) on radiologic images. We reviewed the rates of SCNs in a real‐world cohort of GEP NETs receiving octreotide LAR and explored treatment outcomes. Patients commencing octreotide LAR between August 5, 2010 and March 8, 2018 at a single cancer center in Canada were identified from pharmacy records. Patients were included if they had a computed tomography (CT) scan performed at the time of progression and a preceding CT with pelvis included to enable assessment for the presence of nodules. Fisher's exact test was used to examine predictors of SCNs, and Kaplan–Meier curves summarized differences in progression free (PFS) and overall survival (OS) that were compared with log‐rank tests. Of 243 patients receiving octreotide LAR, 45 had all required CT images available for central review. SCNs were found in 20/45 (44%) of patients on the last scan showing stable disease before progression and were numerically but not statistically more likely in females (OR: 2.36, 95% CI: 0.66–8.29, p =.23). There was an increased risk of SCNs in patients with a skin‐to‐muscle distance >38 mm (the length of an octreotide LAR needle) on CT (OR: 5.09, 95% CI: 1.39–16.6, p =.018) and a trend toward increased risk in obese patients (OR: 5.71, 95% CI: 1.26–23.4, p =.061). PFS (HR: 1.01, 95% CI: 0.56–1.78, p =.98) and OS (HR: 0.86, 95% CI: 0.41–1.8, p =.70) was similar between those with/without SCNs. In conclusion, almost half of patients receiving octreotide LAR had SCNs; however, missed administration of SSA did not appear to result in worse survival in this small study. Factors such as sex, younger age skin‐to‐muscle distance, and obesity may affect SCN development and should be considered when choosing an SSA. [ABSTRACT FROM AUTHOR]

Abstract: The reconstruction of the paleocontinental configuration involving ancestral North America (Laurentia) at the Paleoproterozoic–Mesoproterozoic boundary has been developed in the last 30 years with different scenarios being proposed and different combinations of landmasses assembled together. However, the lack of information for the northwestern side of the North American craton has so far been an obstacle for the complete paleocontinental reconstruction and its tectonic history. Here we provide new age determinations on rocks of the Wernecke Supergroup and of the Wernecke Breccia of the Wernecke Mountains in Yukon to provide a more complete picture of the entire North American craton and its possible conterminous at 1600Ma. The six youngest U–Pb ages of the detrital zircon from quartz sandstones of the Wernecke Supergroup suggest that the sedimentary succession is as old as 1640Ma. Lu–Hf garnet ages on garnet bearing schists of the Fairchild Lake Group (lower Wernecke Supergroup) give a bimodal population of ages of approximately 1600Ma and 1370Ma: the first age is related to the Racklan Orogeny, and the younger event is likely attributable to a reheating episode (Hart River Sills emplacement). The younger age of the Wernecke Supergroup puts into question the previous model concerning the emplacement of the Bonnet Plume River Intrusions, and requires the development of a new tectonic model for the northwestern margin of Laurentia. This new model involves obduction of an exotic terrane on top of the Wernecke Supergroup during the latest phases of the Racklan Orogeny (ca. 1600Ma). This exotic terrane, herein called Bonnetia, contains rocks of the Bonnet Plume River intrusions and of the Slab volcanics. During the hydrothermal event that led to the emplacement of the Wernecke Breccia, clasts and megaclasts of the overlying Bonnetia foundered down to the breccia pipes to the level of the Wernecke Supergroup, and this dynamic explains the existence of older rocks engulfed within a younger sedimentary succession. The Racklan Orogeny is now interpreted as a northwestern expression of the Mazatzal Orogeny of southwestern United States, and of the Labradorian Orogeny of eastern Canada which was in turn connected with the Gothian Orogeny of Scandinavia. The connection among these orogenic events makes plausible the hypothesis of a circum-Laurentian orogenic belt with possible extensions in other landmasses (Australia, Antarctica, Siberia, or China) where coeval deformation belts are present. [Copyright &y& Elsevier]