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Carcinoid SyndromePhase 2NCT00853047

Study of Telotristat Etiprate (LX1606) in Participants With Symptomatic Carcinoid Syndrome Not Managed by Stable-Dose Octreotide Therapy

A Phase 2 study testing Telotristat etiprate and Octreotide LAR Depot in people with Carcinoid Syndrome, run by Lexicon Pharmaceuticals at 9 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this study is to evaluate the safety and tolerability of telotristat etiprate (LX1606) versus a placebo control in participants with symptomatic carcinoid syndrome not managed by stable-dose long-acting octreotide therapy. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Carcinoid Syndrome
What is being tested?
Telotristat etiprate and Octreotide LAR Depot
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
23 participants
Where
9 sitesUnited States
Study dates
Mar 2009to Jun 2014
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Males and females, aged 18 and older
  • Biopsy-proven metastatic carcinoid tumor of the gastrointestinal (GI) tract with disease extent confirmed by computed tomography (CT), magnetic resonance imaging (MRI), or radionuclide imaging
  • Symptoms not managed by stable-dose long-acting octreotide therapy (≥4 bowel movements per day)
  • Ability to provide written informed consent

Who cannot join

  • ≥12 high volume, watery bowel movements per day associated with a clinical syndrome of volume contraction, dehydration, or hypotension compatible with a "pancreatic cholera"-type clinical syndrome
  • Sponsor-unacceptable clinical laboratory values for hematology and liver function tests at screening
  • Karnofsky status ≤70% - unable to care for self
  • Surgery within 60 days prior to screening
  • A history of short bowel syndrome
  • Life expectancy <12 months
Show all 9Show fewer
  • History of substance or alcohol abuse within 2 years prior to screening
  • Previous exposure to a tryptophan hydroxylase (TPH) inhibitor
  • Administration of any investigational drug within 30 days of screening or any therapeutic protein or antibody within 90 days of screening

Trial locations and contacts

9 sites in 1 country.

9 sites in 1 country

United States9 sites
  • Dana Farber Cancer Institute

    Boston, Massachusetts, 02115

  • UT M.D. Anderson Cancer Center

    Houston, Texas, 77030

  • St. Francis Medical Group Oncology and Hematology Specialists

    Indianapolis, Indiana, 46237

  • University of Iowa

    Iowa City, Iowa, 52242

  • Hematology Oncology Services of Arkansas

    Little Rock, Arkansas, 72205

  • Texas Oncology - McAllen

    McAllen, Texas, 78503

  • Nebraska Methodist Hospital

    Omaha, Nebraska, 68114

  • UCSF Helen Diller Family Comprehensive Cancer Center

    San Francisco, California, 94115

  • Texas Oncology - Weslaco

    Weslaco, Texas, 78596

Other trials in United States

About this study

Official title: A Phase 2, Multicenter, Randomized, Double-blind, Placebo-controlled, Ascending, Multidose Study To Determine Safety and Tolerability of Orally Administered LX1606 in Subjects With Symptomatic Carcinoid Syndrome Refractory to Stable-Dose Octreotide Long-Acting Release Depot Therapy

The purpose of this study is to evaluate the safety and tolerability of telotristat etiprate (LX1606) versus a placebo control in participants with symptomatic carcinoid syndrome not managed by stable-dose long-acting octreotide therapy. Following determination of the maximally tolerated or effective dose, cohort expansion will occur to confirm effect on symptoms and safety profile.

Being tested
Telotristat etiprate, Octreotide LAR Depot, Placebo
Medical subject headings
Serotonin Syndrome

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Telotristat etiprateDrug

    Also called LX1606

    Telotristat etiprate capsules; orally 3 times daily.

  • Octreotide LAR DepotDrug

    A stable-dose octreotide LAR depot therapy; administered subcutaneously once per month.

  • PlaceboDrug

    Placebo-matching telotristat etiprate capsules; orally 3 times daily.

Study groups in NCT00853047
Study groupRoleWhat they receive
Telotristat Etiprate 150 mg Core PhaseExperimentalTelotristat etiprate capsules,150 mg orally 3 times daily for 28 days in the double-blind treatment period (core phase) in combination with stable-dose octreotide long-acting release (LAR) depot therapy given once per month. Upon completion of 28-days of treatment, participants were eligible to enter the optional open-label extension period.
Receives: Drug: Telotristat etiprate; Drug: Octreotide LAR Depot
Telotristat Etiprate 250 mg Core PhaseExperimentalTelotristat etiprate capsules, 250 mg orally 3 times daily for 28 days in the double-blind treatment period in combination with stable-dose octreotide LAR depot therapy given once per month. Upon completion of 28-days of treatment, participants were eligible to enter the optional open-label extension period.
Receives: Drug: Telotristat etiprate; Drug: Octreotide LAR Depot
Telotristat Etiprate 350 mg Core PhaseExperimentalTelotristat etiprate capsules, 350 mg orally 3 times daily for 28 days in the double-blind treatment period in combination with stable-dose octreotide LAR depot therapy given once per month. Upon completion of 28-days of treatment, participants were eligible to enter the optional open-label extension period.
Receives: Drug: Telotristat etiprate; Drug: Octreotide LAR Depot
Telotristat Etiprate 500 mg Core PhaseExperimentalTelotristat etiprate capsules, 500 mg orally 3 times daily for 28 days in the double-blind treatment period in combination with a stable-dose octreotide LAR depot therapy given once per month. Upon completion of 28-days of treatment, participants were eligible to enter the optional open-label extension period.
Receives: Drug: Telotristat etiprate; Drug: Octreotide LAR Depot
Placebo Core PhaseExperimentalPlacebo-matching telotristat etiprate capsules, orally 3 times daily for 28 days in the double-blind treatment period in combination with stable-dose octreotide LAR depot therapy given once per month. Upon completion of 28-days of treatment, participants were eligible to receive telotristat etiprate in the optional open-label extension period.
Receives: Drug: Octreotide LAR Depot; Drug: Placebo
Telotristat Etiprate Open-Label Extension PhaseExperimentalTelotristat etiprate at assigned dose level for 8 weeks in combination with stable-dose octreotide LAR depot therapy given once per month in the open-label extension period. Upon completion of the 8-week period, participants could enter an additional extension period of 172 weeks, receiving telotristat etiprate at the assigned dose or maximum tolerated dose (500 mg 3 times daily).
Receives: Drug: Telotristat etiprate; Drug: Octreotide LAR Depot

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of Participants With Any Treatment-emergent Adverse Event (TEAE) and Any Drug-related TEAE in the Core Phase

    An adverse event (AE) was defined as any untoward medical occurrence associated with the use of a drug in humans, whether or not considered drug-related. A TEAE was an AE reported after the first dose of randomized treatment on Day 1.

    Measured: Up to 4 Weeks Core Phase

  2. Number of Participants With Any TEAE in the Open-Label Extension Phase

    An AE was defined as any untoward medical occurrence associated with the use of a drug in humans, whether or not considered drug related. A TEAE was an AE reported after receiving treatment.

    Measured: Up to 180 weeks in the open-label extension phase

Secondary outcomes (11)
  1. Change From Baseline in Mean Number of Bowel Movements (BMs) Per Day

    Participants recorded the number of BMs per day in a daily diary. The total number of BMs per day were averaged over the 4-week period. A negative change from Baseline indicates improvement.

    Measured: Baseline to Week 4

  2. Change From Baseline in Weekly Mean Stool Form

    Participants recorded stool form in a daily diary using a 6-point scale (0-none,1-hard, 2-firm, 3-soft, 4-loose, 5-watery). A negative change from Baseline indicates improvement.

    Measured: Baseline to Week 4

  3. Change From Baseline in Percentage of Days Per Week Experiencing a Sensation of Urgency to Defecate

    Participants recorded the sensation of urgency to defecate (Yes or No) in a daily diary. A negative change from Baseline indicates improvement.

    Measured: Baseline to Week 4

  4. Change From Baseline in Number of Cutaneous Flushing Episodes

    Participants recorded the number of daily flushing episodes per day in a daily diary. The total number of flushing episodes per day were averaged over the 4-week period. A negative change from Baseline indicates improvement.

    Measured: Baseline to Week 4

  5. Change From Baseline in Severity of Abdominal Pain or Discomfort

    Participants recorded the severity of abdominal pain or discomfort in a daily diary assessed using a 4-point scale (0-none, 1-mild, 2-moderate, 3-severe). A negative change from Baseline indicates improvement.

    Measured: Baseline to Week 4

  6. Change From Baseline in Urinary 5-hydroxyindoleacetic Acid (u5-HIAA)

    u5-HIAA is a standard test used in clinical practice to assess the neuroendocrine tumor (NET) activity and is collected as a 24-hour urine specimen. A negative change from Baseline indicates improvement.

    Measured: Baseline to Week 4

  7. Change From Baseline in Chromogranin A

    Blood samples were collected for assessment of Chromogranin A level. A negative change from Baseline indicates improvement.

    Measured: Baseline to Week 4

  8. Number of Participants Reporting Improvement in the Subjective Global Assessment of Symptoms Associated With Carcinoid Syndrome

    Participants were asked to answer the following question: "In the past 7 days, have you had adequate relief of your carcinoid syndrome bowel complaints such as diarrhea, urgent need to have a bowel movement, abdominal pain, or discomfort?". The number of participants who answered Yes are reported.

    Measured: Week 4

  9. Change From Baseline in Frequency of Rescue for Short-acting Octreotide Use/Day

    Participants recorded details (location and frequency of injection) of subcutaneous injections of rescue, short-acting octreotide, if taken, in the daily diary. A negative change from Baseline indicates improvement.

    Measured: Baseline to Week 4

  10. Time to First Rescue, Short-acting Octreotide

    Time to the first subcutaneous injections of rescue, short-acting octreotide was determined from the participant's daily diary.

    Measured: Baseline to Week 4

  11. Number of Participants Experiencing Complete Response at Week 4

    Complete Response to treatment was defined as one of the following: 1. Less than 4 bowel movements per day; or 2. A decrease in daily bowel movements that is ≥ 50% from baseline; or 3. A positive response to the global assessment question ("In the past 7 days, have you had adequate relief of your carcinoid syndrome bowel complaints such as diarrhea, urgent need to have a bowel movement, abdominal pain or discomfort?") for each of the last 2 weeks of the Treatment Period.

    Measured: Baseline to Week 4

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted27 Feb 2009 (estimated)
  2. Study startMar 2009
  3. Primary completionJun 2014
  4. Study completionJun 2014

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Investigator, Outcomes assessor
Enrolment
23 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00853047
Sponsor's protocol ID
LX1606.1-202-CS
Other IDs
LX1606.202
Status last verified
Oct 2018
First submitted
25 Feb 2009
Last updated
26 Dec 2018
Data monitoring committee
No

Publications

  • Gelhorn HL, Kulke MH, O'Dorisio T, Yang QM, Jackson J, Jackson S, Boehm KA, Law L, Kostelec J, Auguste P, Lapuerta P. Patient-reported Symptom Experiences in Patients With Carcinoid Syndrome After Participation in a Study of Telotristat Etiprate: A Qualitative Interview Approach. Clin Ther. 2016 Apr;38(4):759-68. doi: 10.1016/j.clinthera.2016.03.002. Epub 2016 Mar 31.

    PubMed 27041406
  • Kulke MH, O'Dorisio T, Phan A, Bergsland E, Law L, Banks P, Freiman J, Frazier K, Jackson J, Yao JC, Kvols L, Lapuerta P, Zambrowicz B, Fleming D, Sands A. Telotristat etiprate, a novel serotonin synthesis inhibitor, in patients with carcinoid syndrome and diarrhea not adequately controlled by octreotide. Endocr Relat Cancer. 2014 Oct;21(5):705-14. doi: 10.1530/ERC-14-0173. Epub 2014 Jul 10.

    PubMed 25012985

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Telotristat etiprate and Octreotide LAR Depot in people with Carcinoid Syndrome, run by Lexicon Pharmaceuticals at 9 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 26 Dec 2018. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 9 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 26 Dec 2018). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of Participants With Any Treatment-emergent Adverse Event (TEAE) and Any Drug-related TEAE in the Core Phase (time frame: Up to 4 Weeks Core Phase). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00853047, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 26 Dec 2018.

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