Proportion of Subjects Experiencing Diarrhoea of Grade 2 and Above (up to 24 Weeks)
| Group | Value (Participants) |
|---|---|
| Octreotide Treatment | 7 |
| No Octreotide Treatment | 9 |
Trial · Interventional
TerminatedPhase 2Results postedRegistry dataThis trial was stopped early.
The registry gives no reason.
Results were posted for this trial.
Czechia, Israel, Poland, Russia, United Kingdom
1 trial · 1 stopped early · 1 with posted results
Study of Prophylactic Octreotide to Prevent or Reduce the Frequency and Severity of Diarrhoea in Subjects Receiving Lapatinib With Capecitabine for the Treatment of Metastatic Breast Cancer
NCT0229478617 Dec 2014 to 19 Oct 2017
Text and fields below are the sponsor's entries at ClinicalTrials.gov, shown as posted.
Diarrhoea is the most commonly reported adverse event (AE) associated with Lapatinib treatment, and is also commonly associated with Capecitabine treatment. Although these events are generally mild to moderate in severity, diarrhoea adversely affects the tolerability of cancer treatment, and in severe cases diarrhoea has the potential to affect the efficacy of treatment due to poor compliance, or treatment interruption or withdrawal. The efficacy of Octreotide in the management of cancer treatment-associated diarrhoea has not been extensively evaluated in large, well-controlled studies. This is a randomised, multi-centre, open-label Phase II study in subjects with Human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer which has progressed following prior therapy, which must have included anthracyclines and taxanes and therapy with Trastuzumab in the metastatic setting. This study is not placebo controlled, and there is no active comparator. The study evaluates whether the prophylactic use of Octreotide Long Acting Release (LAR) offers a clinically meaningful benefit by reducing the frequency and severity of diarrhoea associated with treatment with Lapatinib and Capecitabine. Study completion for a subject is defined as the completion of 24 weeks of treatment with Lapatinib and Capecitabine, or progression of cancer or the death of the subject during treatment, whichever occurs first. Approximately 140 subjects were planned to be randomized out of which 70 were planned to receive octreotide and 70 were planned to receive no Octreotide.
Experimental
Octreotide treatment
Subjects randomised to receive Octreotide were administered with Octreotide (Sandostatin LAR™) 40mg 7 days before the start of treatment with Lapatinib and Capecitabine and again 28 days later. All subjects received treatment with Lapatinib 1250milligram (mg) once daily and Capecitabine 1000 milligram/square meter (mg/m\^2) twice daily until disease progression. Lapatinib was given every day; Capecitabine was given in 3 week cycles of two weeks treatment followed by one week off treatment. SANDOSTATIN™ is a trademark of Novartis.
Experimental
No Octreotide treatment
Subjects randomised to receive no octreotide, treatment with Lapatinib and Capecitabine was initiated immediately following enrolment. All subjects received treatment with Lapatinib 1250mg once daily and Capecitabine 1000mg/m\^2 twice daily until disease progression. Lapatinib was given every day; Capecitabine was given in 3 week cycles of two weeks treatment followed by one week off treatment
Outcomes the sponsor listed as primary.
Proportion of Subjects Experiencing Diarrhoea of Grade 2 and Above (up to 24 Weeks)
Time frame · Up to 24 weeks
Proportion of subjects experiencing at least one episode of diarrhoea with a severity of Grade 2 and above, as defined by the National Cancer Institute common terminology criteria for adverse events (NCI CTCAE) version 4.03, recorded as AEs in the Electronic case report form (eCRF)
Proportion of Subjects Experiencing Diarrhoea of Grade 3 and Above (up to 24 Weeks)
Time frame · Up to 24 weeks
Proportion of subjects experiencing diarrhoea with a severity of Grade 3 and above, as defined by the NCI CTCAE, version 4.03 and recorded as AEs in the eCRF
Proportion of Subjects Experiencing Diarrhoea of Any Grade of Severity (up to 24 Weeks)
Time frame · Up to 24 weeks
Proportion of subjects experiencing diarrhoea of any grade of severity as defined by the NCI CTCAE, version 4.03 and recorded as AEs in the eCRF
Duration of Diarrhoea of Any Grade of Severity
Time frame · Up to 24 weeks
Duration of diarrhoea of any grade of severity, recorded as AEs in the eCRF
Time to Onset of the First Episode of Diarrhoea of Any Grade of Severity
Time frame · Up to 24 weeks
Time to onset of the first episode of diarrhoea of any grade of severity, recorded as an AE in the eCRF. Subject are censored if there was no event. Median time and 95% confidence intervals were calculated using Kaplan-Meier estimates.
Proportion of Subjects Taking Anti-diarrhoeal Medication
Time frame · Up to 24 weeks
Proportion of subjects taking anti-diarrhoeal medication as recorded in the eCRF
Proportion of Subjects Who Had Unscheduled Visits to Healthcare Professionals Due to Diarrhoea
Time frame · Up to 24 weeks
Proportion of subjects making diarrhoea related unscheduled visits to healthcare professionals as recorded in the eCRF
Proportion of Subjects Requiring Dose Reduction in Lapatinib and Capecitabine
Time frame · Up to 24 weeks
Proportion of subjects requiring diarrhoea related Lapatinib and Capecitabine dose reduction as recorded in the eCRF
Proportion of Subjects Requiring Dose Delay in Lapatinib and Capecitabine
Time frame · Up to 24 weeks
Proportion of subjects requiring diarrhoea related Lapatinib and Capecitabine dose delay as recorded in the eCRF
Proportion of Subjects Requiring Treatment Withdrawal in Lapatinib and Capecitabine
Time frame · Up to 24 weeks
Proportion of subjects requiring diarrhoea related Lapatinib and Capecitabine treatment withdrawal as recorded in the eCRF
Proportion of Subjects Requiring Use of Diarrhoea-related Intravenous Fluids
Time frame · Up to 24 weeks
Proportion of subjects requiring use of diarrhoea-related intravenous fluids for rehydration as recorded in the eCRF
Number of Lapatinib and Capecitabine Tablets Dispensed and Returned
Time frame · Up to 24 weeks
Number of Lapatinib and Capecitabine tablets dispensed and returned as recorded in the eCRF
Overall Response Rate (up to 24 Weeks)
Time frame · Up to 24 weeks
Overall response rate as measured in accordance with the Response Evaluation Criteria In Solid Tumours (RECIST) version 1.1. Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions; Progressive Disease (PD) \>=20% and \>= 5mm increase in the sum of diameters of target lesions; Stable Disease (SD), Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD.
Clinical Benefit Response (up to 24 Weeks)
Time frame · Up to 24 weeks
Clinical benefit response as measured in accordance with the Response Evaluation Criteria In Solid Tumours (RECIST) version 1.1. Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions; Stable Disease (SD), Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD. Clinical Benefit Response rate (CBR) is defined as the percentage of subjects with a CR, PR or SD at week 24.
Proportion of Subjects Reporting Changes in Bowel Movements From Baseline (Frequency and/or Consistency) as Recorded in the Diarrhoea Management Diary (DMD)
Time frame · Up to 24 weeks
All subjects completed the baseline DMD during the 3 days prior to randomisation, before any study-related treatment is administered. Subjects randomised to receive Octreotide completed a second baseline DMD before starting the first cycle of treatment with Lapatinib and Capecitabine. The baseline DMD comprised of 3 questions to record stool form and consistency. The DMD to be completed throughout the rest of the study comprised of 3 questions in the baseline DMD and a further 5 questions and 6 sub-questions to evaluate the consequences and management of diarrhoea.
Time to the First Subject Reported Change in Frequency and/or Consistency of Bowel Movements From Baseline as Recorded in the DMD
Time frame · Up to 24 weeks
Event is defined as Subjects reporting change in frequency and/or consistency of bowel movements from baseline at least once in DMD. Subject are censored if there is no change in bowel movement frequency/consistency as compared to baseline. Median time and 95% confidence intervals were calculated using Kaplan-Meier estimates.
Proportion of Subjects Taking Anti-diarrhoeal Medication as Recorded in the DMD
Time frame · Up to 24 weeks
The proportion of subjects taking medication at least once as a result of diarrhoea are summarised
Proportion of Subjects Making Dietary Changes Due to Diarrhoea as Recorded in the DMD
Time frame · Up to 24 weeks
The proportion of subjects making dietary changes to help with the diarrhoea are summarised
Proportion of Subjects Contacting Other Non-hospital Healthcare Professionals to Discuss Diarrhoea as Recorded in the DMD
Time frame · Up to 24 weeks
The proportion of subjects contacting a health care professional other than the hospital doctors/nurses to discuss diarrhoea are summarised
Proportion of Subjects Reporting Stopping Completely or Missing Doses of Anti-cancer Tablets Due to Diarrhoea as Recorded in the DMD
Time frame · Up to 24 weeks
The proportion of subjects reducing or completely stopping the number of anti-cancer tablets to help with diarrhoea are summarised
Values are shown as posted at ClinicalTrials.gov, with their units. PepBank has not converted, pooled or compared them.
| Group | Value (Participants) |
|---|---|
| Octreotide Treatment | 7 |
| No Octreotide Treatment | 9 |
| Group | Value (Participants) |
|---|---|
| Octreotide Treatment | 2 |
| No Octreotide Treatment | 0 |
| Group | Value (Participants) |
|---|---|
| Octreotide Treatment | 18 |
| No Octreotide Treatment | 14 |
| Group | Value (days) | Spread |
|---|---|---|
| Octreotide Treatment | 8.7 | 11.15 |
| No Octreotide Treatment | 36.8 | 48.59 |
| Group | Value (Days) |
|---|---|
| Octreotide Treatment | NA |
| No Octreotide Treatment | 170 |
| Group | Value (Participants) |
|---|---|
| Octreotide Treatment | 7 |
| No Octreotide Treatment | 11 |
| Group | Value |
|---|---|
| Octreotide Treatment | not posted |
| No Octreotide Treatment | not posted |
| Group | Value (Participants) |
|---|---|
| Octreotide Treatment | 1 |
| No Octreotide Treatment | 0 |
| Group | Deaths | Serious events | Other events |
|---|---|---|---|
| Octreotide TreatmentOctreotide+Lap+Cap | 1 / 29 | 5 / 29 | 26 / 29 |
| No Octreotide TreatmentLap+Cap | 0 / 33 | 3 / 33 | 27 / 33 |
| All PatientsAll Patients | 1 / 62 | 8 / 62 | 53 / 62 |
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