Return to List

Study Summary
No. 2008-0211:.......Endocrine; Gastrointestinal......David Fogelman......Gastrointestinal Medical Oncology
.
Study Summary Title
Study Summary
Number:
2008-0211
Study Title:A multicenter, randomized, blinded efficacy and safety study of pasireotide LAR vs octreotide LAR in patients with metastatic carcinoid tumors whose disease-related symptoms are inadequately controlled by somatostatin analogues (CSOM230C2303)
.
Physician New Patient Referral
Name:David FogelmanPatients Call:800-392-1611 (in U.S.A.) 713-792-6161 (outside U.S.A.)
Dept:Gastrointestinal Medical OncologyReferring MD
Call:
800-392-1611 (in U.S.A.) 713-792-6161 (outside U.S.A.)
Phone:713-792-2828
Contact us about clinical trials
.
General Information
Disease Group:Endocrine
Gastrointestinal
Supported By:Novartis
Phase of Study:Phase IIIReturn
Visit:
For the first 2 months, 3 times each month (D1, D21, D29, D49, D57, D77) .
Once a month thereafter.
Treatment
Agents:
Octreotide
SOM230
Home Care:NA
Treatment Loc:Both at MDACC & outside MDACC at one or more Collaborating Sites or Institutions
Estimated
Length of Stay
in Houston:
NA
Description/
Intervention:
The goal of this clinical research study is to compare pasireotide long-acting
release (LAR) against octreotide LAR. Researchers want to learn which drug may
be more effective at controlling diarrhea and/or skin flushing in patients with
carcinoid tumors that have spread. The safety of these treatments will also be
compared.
.
Study Objectives / Outcomes
Primary objective
Compare the long term efficacy of pasireotide Long Acting Release (LAR) vs. octreotide LAR at month 6 in controlling diarrhea and/or flushing in patients with metastatic carcinoid tumors whose
disease-related symptoms are inadequately controlled by the maximum approved dose of a somatostatin analogue.

Secondary objectives
• Assess the effect of pasireotide LAR vs. octreotide LAR on objective tumor response rate
(complete response (CR) or partial response (PR)) at month 6 based on RECIST criteria .
• Assess the effect of pasireotide LAR vs. octreotide LAR on disease control rate (CR, PR or
stable disease (SD)) at month 6 based on RECIST criteria
• Assess the proportion of patients who achieved at least a 30% reduction in frequency of
bowel movements at month 6
• Assess the effect of pasireotide LAR vs. octreotide LAR on improvement in the individual
components of the primary endpoints (i.e., percent change in daily bowel movement
and/or total number of flushing)
• Assess the effect of pasireotide LAR vs. octreotide LAR on time to symptom response
• Assess the effect of pasireotide LAR vs. octreotide LAR on duration of symptom response
• Assess the effect of pasireotide LAR vs. octreotide LAR on time to symptom progression
• Assess the effect of pasireotide LAR vs octreotide LAR on Quality of Life
• Assess the overall safety and tolerability of pasireotide LAR vs. octreotide LAR

Exploratory objectives
• Assess pasireotide and octreotide plasma exposure (trough levels)
• Examine the effect of pasireotide LAR vs. octreotide LAR on percent change from
baseline of selected biochemical parameters, 5- HIAA and Chromogranin-A
• Explore patient population demographics (e.g. age, BMI, sex) as PK covariates on
pasireotide plasma exposure
• Explore relationship between pasireotide plasma exposure and PD/safety markers
• Explore hsst receptors status in tumor tissue pending tissue availability and correlation
with outcome data
• Examine whether individual variations in genes relating to drug metabolism, carcinoid
tumors, and the drug target pathway confer differential response to pasireotide (optional).
.
Study Status Information
Study Activation / Registration Date:03/17/2009
IRB Review and Approval Date:07/07/2008
Study Type:Phase Iii
Recruitment Status:Closed
Projected Accrual:216
.
Enrollment Eligibility
If you do not meet the enrollment eligibility, there may be other treatment options for you. Please Contact the Referral Office for more information.

Inclusion Criteria:1) Male or female patients aged 18 years or greater.

2) Patients with histopathologically confirmed (from primary or metastatic lesion biopsy) metastatic carcinoid tumors of the digestive system with extent of disease determined by Computer Tomography (CT) scan or Magnetic Resonance Imaging (MRI).

3) Patients must have inadequate control of symptoms (i.e. diarrhea and/or flushing) while receiving treatment with the maximum approved dose of a currently available somatostatin analogue for at least 3 months prior to study entry. Inadequate control is defined by the groups below: 1) Diarrhea and Flushing group (D+F): patients with a daily mean of >/= 4 bowel movements and a total of >/= 5 flushing episodes over a two-week period (14 days) while receiving treatment with the maximum approved dose of a currently available somatostatin analogue for at least a 3 month period prior to study entry.

4) (continuation of # 3) 2) Predominantly Diarrhea group (D): patients with a daily mean of =/> 4 bowel movements and a total number of < 5 flushing episodes over a two-week period (14 days) while receiving treatment with the maximum approved dose of a currently available somatostatin analogue for at least a 3 month period prior to study entry.

5) (continuation of #4) 3) Predominantly Flushing group (F): patients with >/= 14 flushing episodes and a daily mean of < 4 bowel movements over a two-week period (14 days) while receiving treatment with the maximum approved dose of a currently available somatostatin analogue for at least a 3 month period prior to study entry.

6) Patients must observe the following intervals between the last injection of their previous treatment and the first injection of study drug: a) Octreotide LAR = 28 days (4 weeks), b) Octreotide s.c. = 8 hours, c) Lanreotide Autogel = 28 days (4 weeks), d) Lanreotide SR = 14 days (2 weeks).

7) Patients with measurable or evaluable disease per RECIST criteria

8) Karnofsky Performance Status =/> 60 (Requires occasional assistance, but is able to care for most of his personal needs, or better)

9) Patients with a known history of impaired fasting glucose or diabetes mellitus (DM) may be included, however blood glucose and antidiabetic treatment must be monitored closely throughout the trial and adjusted as necessary.

10) Female patients of child bearing potential must have a negative pregnancy test at baseline.

11) Patients for whom written informed consent to participate in the study has been obtained.

12) Baseline lab values for adequate organ function: 1) Absolute neutrophil count >/=1.5 x 10^9/L ) Hemoglobin =/>9 g/dL 3)Platelets >/=100 x 10^9/L 4) Hepatic: Serum bilirubin </= upper limit of normal (ULN), Aspartate aminotransferase and alanine aminotransferase, </=3 x ULN without liver metastases, </= 5 x ULN if documented liver metastases. 5) Renal: Serum creatinine </=1.5 mg/dL, calculated creatinine clearance >/=40 mL/min

Exclusion Criteria:1) Patients who have received a somatostatin analogue higher than the maximum approved dose within 3 months of Visit 1. (This exclusion criteria is not applicable to patients who are receiving short acting formulation.)

2) Patients receiving radiolabeled somatostatin analogue therapy within the 3 months or any cytotoxic chemotherapy or interferon therapy within the 4 weeks prior to recording baseline symptoms.

3) Patients who have undergone major surgery/surgical therapy for any cause within 1 month or surgical therapy of loco-regional metastases within the last 3 months before recording baseline symptoms.

4) Patients with hepatic artery embolization, chemoembolization or radioembolization (yttrium 90 microspheres) within the last 6 months (1 month if there are other sites of measurable disease), or patients who have undergone cryoablation or radiofrequency ablation of hepatic metastasis within the last 2 months before recording baseline symptoms.

5) Patients who have received radiotherapy for any reason within the last 4 weeks and must have recovered from any side effects of radiotherapy before recording baseline symptoms.

6) Patients who are unwilling to follow dietary restrictions within 3 days of urinary 5-HIAA sample collection or require medications that would interfere with urinary 5-HIAA measurement (e.g. Reserpine, mephenesin carbamate, Lugol's solution).

7) Patients with known malabsorption syndrome, short bowel or chologenic diarrhea not controlled by specific therapeutic means.

8) Patients who are not biochemically euthyroid. Diabetic patients on antidiabetic medications whose fasting blood glucose is poorly controlled as indicated by HbA1C > 8%.

9) Patients with symptomatic cholelithiasis.

10) Any of the following cardiac abnormalities:1) QTcF at screening > 450 msec 2) History of syncope or family history of idiopathic sudden death 3) Sustained or clinically significant cardiac arrhythmias 4) Risk factors for Torsades de Pointes such as hypokalemia, hypomagnesemia, cardiac failure, clinically significant/symptomatic bradycardia, or high-grade AV block 5) Concomitant disease(s) that could prolong QT such as autonomic neuropathy (caused by diabetes, or Parkinson's disease), HIV, cirrhosis, uncontrolled hypothyroidism or cardiac failure.

11) (continuation of # 10) 6) Concomitant medication(s) known to increase the QT interval.

12) Patients with additional active malignant disease within the last five years (with the exception of basal cell carcinoma or carcinoma in situ of the cervix).

13) Patients with the presence of active or suspected acute or chronic uncontrolled infection or with a history of immunocompromise, including a positive HIV test result (ELISA and Western blot). A HIV test will not be required; however, previous medical history will be reviewed.

14) Patients with abnormal coagulation [prothrombin time (PT) or activated thromboplastin time (APTT) elevated by 30% above normal limits.]

15) Patients who have any current or prior medical condition that may interfere with the conduct of the study or the evaluation of its results in the opinion of the Investigator or the Sponsor's Study Physician.

16) Female patients who are pregnant or lactating, or are of childbearing potential and not practicing a medically acceptable method of birth control. Female patients must use barrier contraception with condoms. If oral contraception is used in addition to condoms, the patient must have been practicing this method for at least two months prior to enrollment and must agree to continue the oral contraceptive throughout the course of the study, and for three months after the study has ended.

17) (Continuation of # 18) Male patients who are sexually active are required to use condoms during the study and for three months afterwards as a precautionary measure (available data do not suggest any increased reproductive risk with the study drugs). Female partners of these male patients must use a secondary barrier contraception.

18) Patients who are currently part of or have participated in any clinical investigation with an investigational drug within 1 month prior to dosing.

19) Known hypersensitivity to somatostatin analogues or any component of the pasireotide or octreotide LAR or s.c. formulations.

20) Patients with a history of non-compliance to medical regimens or who are considered potentially unreliable or will not be able to complete the entire study.

21) Patients who have been previously treated with Pasireotide.

.
Links
Registration Number: NCT00690430
Study Information on Clinical Trials Registry (clinicaltrials.gov)

Other Links:
.
Results


Return to Clinical Trials at M.D. Anderson Cancer Center