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CompletedNCT00075868Updated Nov 17, 2015

Octreotide in Preventing or Reducing Diarrhea in Patients Receiving Chemoradiotherapy for Anal or Rectal Cancer

A Phase 3 interventional study of octreotide acetate and Placebo in Anal Cancer, Colorectal Cancer and Drug/Agent Toxicity by Tissue/Organ, sponsored by Radiation Therapy Oncology Group. Completed at 112 sites in United States. Open to participants aged 18 Years to 120 Years. Per ClinicalTrials.gov, last updated 2015-11-17.

Sponsored by Radiation Therapy Oncology Group · Phase 3, Interventional, and Supportive care

Phase
Phase 3
Study type
Interventional
Enrollment
233
Allocation
Randomized
Ages
18 Years to 120 Years
Sex
All
01

Study summary

RATIONALE: Octreotide may be effective in preventing or controlling diarrhea in patients who are undergoing chemoradiotherapy for anal or rectal cancer. It is not yet known whether octreotide is effective in treating diarrhea.

PURPOSE: This randomized phase III trial is studying octreotide in preventing or reducing diarrhea in patients who are undergoing chemoradiotherapy for anal or rectal cancer.

Read the detailed description

OBJECTIVES:

Primary

  • Determine the ability of octreotide to prevent the incidence of moderate, severe, or life-threatening chemoradiotherapy-induced diarrhea (grades 2-4) in patients with anal or rectal cancer.

Secondary

  • Compare the quality of life of patients treated with this drug vs placebo.
  • Compare the number of hospitalizations and use of antidiarrheal agents (e.g., Imodium®) related to diarrhea (or its complications) in patients treated with these drugs.
  • Compare treatment delays and/or dose reductions (chemotherapy and radiotherapy) in patients treated with these drugs.

OUTLINE: This is a double-blind, placebo-controlled, randomized, multicenter study. Patients are stratified according to radiotherapy dose (\< 50 Gy vs ≥ 50 Gy), chemotherapy dose (bolus vs continuous), and gender. Patients are randomized to 1 of 2 treatment arms.

  • Arm I: Patients receive octreotide* intramuscularly (IM) 4-7 days before the start of chemoradiotherapy and on day 22 (± 3 days) during chemoradiotherapy.
  • Arm II: Patients receive placebo* IM 4-7 days before the start of chemoradiotherapy and on day 22 (± 3 days) during chemoradiotherapy.

NOTE: *Patients receive a total of 2 injections of octreotide or placebo

In both arms, treatment continues in the absence of unacceptable toxicity.

Quality of life is assessed at baseline, at the completion of chemoradiotherapy, and at 3, 6, 9, and 15 months from the start of chemoradiotherapy.

Patients are followed at 3, 6, 9, and 15 months from the start of chemoradiotherapy.

PROJECTED ACCRUAL: A total of 226 patients (113 per treatment arm) will be accrued for this study within 2 years.

02

Conditions studied

  • Anal Cancer
  • Colorectal Cancer
  • Drug/Agent Toxicity by Tissue/Organ
  • Radiation Enteritis

Keywords

  • radiation enteritis
  • drug/agent toxicity by tissue/organ
  • stage I rectal cancer
  • stage II rectal cancer
  • stage III rectal cancer
  • stage IIIA anal cancer
  • stage IIIB anal cancer
  • recurrent anal cancer
  • stage I anal cancer
  • stage II anal cancer
  • recurrent rectal cancer
03

Who can participate

Ages eligible
18 Years to 120 Years
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

DISEASE CHARACTERISTICS:

  • Histologically confirmed primary anal or rectal cancer

    • No metastasis beyond the pelvic regional nodes
  • Must be scheduled to receive chemoradiotherapy

PATIENT CHARACTERISTICS:

Age

  • 18 and over

Performance status

  • Not specified

Life expectancy

  • Not specified

Hematopoietic

  • Not specified

Hepatic

  • Liver function tests \< 3 times upper limit of normal
  • No prior hepatic disease

Renal

  • Not specified

Gastrointestinal

  • No prior chronic or acute regional enteritis
  • No malabsorption syndrome
  • No prior inflammatory bowel disease that may exacerbate the radiotherapy toxicity
  • No grade 2 or greater uncontrollable diarrhea at baseline
  • No prior cholecystitis or gallstones, unless a cholecystectomy has been performed
  • No prior incontinence of stool

Other

  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • HIV negative
  • No uncontrolled diabetes (e.g., fasting glucose > 250 mg/dL)
  • No prior allergy or hypersensitivity to study drug or other related drug or compound
  • No other medical condition or mental impairment that would preclude study treatment and compliance

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • Not specified

Chemotherapy

  • See Disease Characteristics
  • Prior chemotherapy allowed

Endocrine therapy

  • At least 6 months since prior administration of any of the following:

    • Glucocorticoid therapy
    • Insulin sensitizers (e.g., metformin, pioglitazone, or rosiglitazone)
    • Exogenous growth hormone therapy

Radiotherapy

  • See Disease Characteristics
  • No prior pelvic radiotherapy
  • No prior intensity-modulated radiotherapy
  • No concurrent radiotherapy for abdominal cancer
  • No concurrent hyperfractionated, split-course, or intensity-modulated radiotherapy
  • No brachytherapy prior to or after completion of all external beam radiotherapy

Surgery

  • No prior abdominal-perineal resection or other surgical procedure leaving the patient without a functioning rectum
  • No colostomy

Other

  • More than 30 days since other prior investigational drugs
  • No prior octreotide for cancer therapy-related diarrhea
  • No concurrent prophylactic antidiarrheal medication
04

Study design

Phase
Phase 3
Primary purpose
Supportive care
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double
Enrollment
233 participants (actual)

Study arms

  • Experimental
    Sandostatin LAR® Depot

    Sandostatin LAR® Depot Pre-RT (between day -7 and day -4 of RT) and Day 22 (± 3 days)

    Drug: octreotide acetate

  • Placebo comparator
    Placebo

    Placebo Pre-RT (between day -7 and day -4 of RT) and Day 22 (± 3 days)

    Other: Placebo

Interventions

  • Drugoctreotide acetate
  • OtherPlacebo
05

What researchers measure

Primary outcomes

  1. Prevention of the incidence of moderate, severe, or life-threatening diarrhea

Secondary outcomes

  1. Quality of life

  2. Economic measures

  3. Validity of the Functional Alterations due to Changes in Elimination-Changes in Bowel Function, the Quality of Life-Radiation Therapy Instrument, and the Expand Prostate Index Composite-Bowel questionnaires

  4. Prevention of the incidence of severe or life-threatening (i.e., grade 3-5) diarrhea

06

Study locations

112 sites
  • Mobile Infirmary Medical Center
    Mobile, Alabama 36652-2144, United States
  • Foundation for Cancer Research and Education
    Phoenix, Arizona 85013, United States
  • Enloe Cancer Center at Enloe Medical Center
    Chico, California 95926, United States
  • Saint Agnes Medical Center
    Fresno, California 93720-3397, United States
  • California Cancer Center - Woodward Park Office
    Fresno, California 93720, United States
  • Sutter Health Western Division Cancer Research Group
    Greenbrae, California 94904, United States
  • Cancer Care Consultants Medical Associates at Daniel Freeman Memorial Hospital
    Inglewood, California 90301, United States
  • Leavey Cancer Center at Northridge Hospital Medical Center
    Northridge, California 91328, United States
  • CCOP - Bay Area Tumor Institute
    Oakland, California 94609, United States
  • Pomona Valley Hospital Medical Center
    Pomona, California 91767, United States
  • Radiological Associates of Sacramento Medical Group, Incorporated
    Sacramento, California 95815, United States
  • University of California Davis Cancer Center
    Sacramento, California 95817, United States
  • Torrance Memorial Medical Center
    Torrance, California 90509, United States
  • Memorial Hospital Cancer Center
    Colorado Springs, Colorado 80909, United States
  • St. Mary's Regional Cancer Center at St. Mary's Hospital and Medical Center
    Grand Junction, Colorado 81502, United States
  • Sibley Memorial Hospital
    Washington, District of Columbia 20016, United States
  • Michael & Dianne Bienes Comprehensive Cancer Center at Holy Cross Hospital
    Fort Lauderdale, Florida 33308, United States
  • University of Florida Shands Cancer Center
    Gainesville, Florida 32610-0232, United States
  • Memorial Cancer Institute at Memorial Regional Hospital
    Hollywood, Florida 33021, United States
  • Baptist Cancer Institute - Jacksonville
    Jacksonville, Florida 32207, United States
  • Ella Milbank Foshay Cancer Center at Jupiter Medical Center
    Jupiter, Florida 33458, United States
  • CCOP - Mount Sinai Medical Center
    Miami Beach, Florida 33140, United States
  • University of Miami Sylvester Comprehensive Cancer Center
    Miami, Florida 33136, United States
  • Baptist-South Miami Regional Cancer Program
    Miami, Florida 33176, United States
  • H. Lee Moffitt Cancer Center and Research Institute at University of South Florida
    Tampa, Florida 33612-9497, United States
  • Veterans Affairs Medical Center - Tampa (Haley)
    Tampa, Florida 33612, United States
  • John B. Amos Community Cancer Center
    Columbus, Georgia 31904, United States
  • Ingalls Cancer Care Center at Ingalls Memorial Hospital
    Harvey, Illinois 60426, United States
  • St. John's Cancer Center at St. John's Medical Center
    Anderson, Indiana 46016, United States
  • Indiana University Cancer Center
    Indianapolis, Indiana 46202-5289, United States
  • Veterans Affairs Medical Center - Indianapolis
    Indianapolis, Indiana 46202, United States
  • Ball Memorial Hospital
    Muncie, Indiana 47303-3499, United States
  • Wendt Regional Cancer Center at Finley Hospital
    Dubuque, Iowa 52001, United States
  • Central Baptist Hospital
    Lexington, Kentucky 40503-9985, United States
  • Markey Cancer Center at University of Kentucky Chandler Medical Center
    Lexington, Kentucky 40536-0084, United States
  • Greenebaum Cancer Center at University of Maryland Medical Center
    Baltimore, Maryland 21201, United States
  • Cape Cod Hospital
    Hyannis, Massachusetts 02601, United States
  • St. Joseph Mercy Cancer Center at St. Joseph Mercy Hospital
    Ann Arbor, Michigan 48106-0995, United States
  • CCOP - Michigan Cancer Research Consortium
    Ann Arbor, Michigan 48106, United States
  • Josephine Ford Cancer Center at Henry Ford Hospital
    Detroit, Michigan 48202, United States
  • CCOP - Grand Rapids
    Grand Rapids, Michigan 49503, United States
  • West Michigan Cancer Center
    Kalamazoo, Michigan 49007-3731, United States
  • Sparrow Regional Cancer Center
    Lansing, Michigan 48909, United States
  • William Beaumont Hospital - Royal Oak Campus
    Royal Oak, Michigan 48073, United States
  • Mayo Clinic Cancer Center
    Rochester, Minnesota 55905, United States
  • Regional Cancer Center at Singing River Hospital
    Pascagoula, Mississippi 39581, United States
  • CCOP - Kansas City
    Kansas City, Missouri 64131, United States
  • CCOP - Cancer Research for the Ozarks
    Springfield, Missouri 65802, United States
  • St. John's Regional Health Center
    Springfield, Missouri 65804, United States
  • Siteman Cancer Center at Barnes-Jewish Hospital
    St Louis, Missouri 63110, United States
  • Methodist Cancer Center at Methodist Hospital - Omaha
    Omaha, Nebraska 68114, United States
  • University Medical Center of Southern Nevada
    Las Vegas, Nevada 89102, United States
  • CCOP - Nevada Cancer Research Foundation
    Las Vegas, Nevada 89106, United States
  • Washoe Cancer Services at Washoe Medical Center - Reno
    Reno, Nevada 89502, United States
  • Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center
    Lebanon, New Hampshire 03756-0002, United States
  • Cancer Institute of New Jersey at Cooper University Hospital - Camden
    Camden, New Jersey 08103, United States
  • Monmouth Medical Center
    Long Branch, New Jersey 07740-6395, United States
  • Community Regional Cancer Center at Community Medical Center
    Toms River, New Jersey 08755, United States
  • Fox Chase Cancer Center at St. Francis Medical Center
    Trenton, New Jersey 08629, United States
  • South Jersey Healthcare Regional Cancer Center
    Vineland, New Jersey 08360, United States
  • Long Island College Hospital
    Brooklyn, New York 11201, United States
  • SUNY Downstate Medical Center
    Brooklyn, New York 11203, United States
  • New York Methodist Hospital
    Brooklyn, New York 11215, United States
  • Roswell Park Cancer Institute
    Buffalo, New York 14263-0001, United States
  • CCOP - North Shore University Hospital
    Manhasset, New York 11030, United States
  • Lipson Cancer and Blood Center at Rochester General Hospital
    Rochester, New York 14621, United States
  • Duke Comprehensive Cancer Center
    Durham, North Carolina 27710, United States
  • Iredell Memorial Hospital
    Statesville, North Carolina 28677, United States
  • Trinity Cancer Care Center
    Minot, North Dakota 58701, United States
  • Akron City Hospital
    Akron, Ohio 44309-2090, United States
  • Aultman Hospital Cancer Center at Aultman Health Foundation
    Canton, Ohio 44710-1799, United States
  • Cleveland Clinic Taussig Cancer Center
    Cleveland, Ohio 44195, United States
  • CCOP - Columbus
    Columbus, Ohio 43215, United States
  • St. Rita's Medical Center
    Lima, Ohio 45801, United States
  • Hillcrest Cancer Center at Hillcrest Hospital
    Mayfield Heights, Ohio 44124, United States
  • Cancer Research UK Medical Oncology Unit at Churchill Hospital & Weatherall Institute of Molecular Medicine - Oxford
    Salem, Ohio 44460, United States
  • Cancer Treatment Center
    Wooster, Ohio 44691, United States
  • LaFortune Cancer Center at St. John Medical Center
    Tulsa, Oklahoma 74104, United States
  • Legacy Mount Hood Medical Center
    Gresham, Oregon 97030, United States
  • Providence Milwaukie Hospital
    Milwaukie, Oregon 97222, United States
  • Legacy Good Samaritan Hospital & Medical Center Comprehensive Cancer Center
    Portland, Oregon 97210, United States
  • Providence Cancer Center at Providence Portland Medical Center
    Portland, Oregon 97213-2967, United States
  • CCOP - Columbia River Oncology Program
    Portland, Oregon 97225, United States
  • Providence St. Vincent Medical Center
    Portland, Oregon 97225, United States
  • Institute of Oncology at Vilnius University
    Portland, Oregon 97227, United States
  • Legacy Meridian Park Hospital
    Tualatin, Oregon 97062, United States
  • Bryn Mawr Hospital
    Bryn Mawr, Pennsylvania 19010, United States
  • Delaware County Regional Cancer Center at Delaware County Memorial Hospital
    Drexel Hill, Pennsylvania 19026, United States
  • Penn State Cancer Institute at Milton S. Hershey Medical Center
    Hershey, Pennsylvania 17033-0850, United States
  • Paoli Memorial Hospital
    Paoli, Pennsylvania 19301-1792, United States
  • Allegheny Cancer Center at Allegheny General Hospital
    Pittsburgh, Pennsylvania 15212, United States
  • Mercy Cancer Institute at Mercy Hospital
    Pittsburgh, Pennsylvania 15219, United States
  • Western Pennsylvania Cancer Institute at Western Pennsylvania Hospital
    Pittsburgh, Pennsylvania 15224-1791, United States
  • Reading Hospital and Medical Center
    Reading, Pennsylvania 19612-6052, United States
  • CCOP - MainLine Health
    Wynnewood, Pennsylvania 19096, United States
  • Lankenau Cancer Center at Lankenau Hospital
    Wynnewood, Pennsylvania 19096, United States
  • CCOP - Greenville
    Greenville, South Carolina 29615, United States
  • CCOP - Upstate Carolina
    Spartanburg, South Carolina 29303, United States
  • CCOP - Scott and White Hospital
    Temple, Texas 76508, United States
  • McKay-Dee Hospital Center
    Ogden, Utah 84403, United States

Showing the first 100 of 112 sites.

07

References and documents

Publications

  • Zachariah B, Gwede CK, James J, Ajani J, Chin LJ, Donath D, Rosenthal SA, Kane BL, Rotman M, Berk L, Kachnic LA. Octreotide acetate in prevention of chemoradiation-induced diarrhea in anorectal cancer: randomized RTOG trial 0315. J Natl Cancer Inst. 2010 Apr 21;102(8):547-56. doi: 10.1093/jnci/djq063. Epub 2010 Mar 25. PubMed 20339140 ↗
  • Zachariah B, James J, Gwede CK, et al.: RTOG 0315: a randomized, double-blind, placebo-controlled phase III study to determine the efficacy of octreotide acetate in preventing or reducing the severity of chemoradiation-induced diarrhea in patients with anal or rectal cancer. [Abstract] J Clin Oncol 25 (Suppl 18): A-4032, 2007.
08

Registry details

Key details

Study ID
NCT00075868
Lead sponsor
Radiation Therapy Oncology Group
Collaborators
National Cancer Institute (NCI)
Responsible party
Sponsor
First posted
Jan 13, 2004
Start date
Dec 2003
Primary completion
Aug 2006
Last update
Nov 17, 2015

Study contacts

Babu Zachariah, MD
principal investigator · H. Lee Moffitt Cancer Center and Research Institute
Jaffer A. Ajani, MD
study chair · M.D. Anderson Cancer Center

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

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