A Phase 2 interventional study of lanreotide (Autogel formulation) in Intestinal Obstruction, sponsored by Ipsen. Terminated at 13 sites in Italy. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2019-11-22.
Sponsored by Ipsen · Phase 2, Interventional, and Supportive care
The primary objective of the study is to evaluate the impact on quality of life of Lanreotide Autogel 120 mg in combination with standard care, in comparison to the standard care alone, in subjects affected by inoperable malignant bowel obstruction.
160 studies on the registry are indexed under Intestinal Obstruction; 27 are open to participants now.
This study's enrollment of 43 is below the median of 80 across 80 interventional studies indexed under Intestinal Obstruction.
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Exclusion Criteria:
Standard care according to site clinical practice and Lanreotide Autogel 120 mg by deep subcutaneous route, at the maximal scheduled standard dose of 120 mg/28 days, just for 1 administration.
Drug: lanreotide (Autogel formulation)
Standard care according to site clinical practice.
Lanreotide Autogel 120 mg by deep subcutaneous route, at the maximal scheduled standard dose of 120 mg/28 days, just for 1 administration.
Least Squares (LS) Mean Area Under Curve (AUC) of Edmonton Symptom Assessment System (ESAS) Total Scores Collected for the First 7 Days; Full Analysis Set (FAS)
Quality of Life was assessed using ESAS, evaluating 9 common symptoms in cancer patients: pain, activity, nausea, depression, anxiety, drowsiness, appetite, well-being and shortness of breath. Symptom severity is rated 0-10 on a numerical scale (0=symptom absent; 10=worst severity). ESAS total score is sum of the 9 items (min score=0, max score=90). Low scores indicate good quality of life; high scores indicate strong discomfort. Questionnaire assessments by the patient or by nurse/caregiver in case of patient's physical inability. AUC is area under the line which joins the points defined by plotting ESAS total score on vertical axis and time values on horizontal axis, computed using trapezoidal rule. Primary endpoint was analysed using the FAS. LS mean AUC of ESAS total scores during first 7 days is presented.
Time frame: Baseline (Day 1, before randomisation), Days 2, 3, 4, 5, 6 and 7.
Mean Change From Baseline in ESAS Total Score; FAS
Quality of Life was assessed using ESAS, evaluating 9 common symptoms in cancer patients: pain, activity, nausea, depression, anxiety, drowsiness, appetite, well-being and shortness of breath. Symptom severity is rated 0-10 on a numerical scale (0=symptom absent; 10=worst severity). ESAS total score is sum of the 9 items (min score=0, max score=90). Low scores indicate good quality of life; high scores indicate strong discomfort. Questionnaire assessments by the patient or by nurse/caregiver in case of patient's physical inability. Secondary endpoints were analysed using the ITT population but to permit following the FAS which was used for primary endpoint analysis, ESAS total score results are reported for both the ITT and the FAS. Mean change from baseline of ESAS total score at Days 7, 14 and 28 is presented here for the FAS; a positive change indicates a worsening condition.
Time frame: Baseline (Day 1, before randomisation) and Days 7, 14 and 28.
Mean Change From Baseline in ESAS Total Score; ITT Population
Quality of Life was assessed using ESAS, evaluating 9 common symptoms in cancer patients: pain, activity, nausea, depression, anxiety, drowsiness, appetite, well-being and shortness of breath. Symptom severity is rated 0-10 on a numerical scale (0=symptom absent; 10=worst severity). ESAS total score is sum of the 9 items (min score=0, max score=90). Low scores indicate good quality of life; high scores indicate strong discomfort. Questionnaire assessments by the patient or by nurse/caregiver in case of patient's physical inability. Secondary endpoints were analysed using the ITT population but to permit following the FAS which was used for primary endpoint analysis, ESAS total score results are reported for both the ITT and the FAS. Mean change from baseline of ESAS total score at Days 7, 14 and 28 is presented here for the ITT population; a positive change indicates a worsening condition.
Time frame: Baseline (Day 1, before randomisation) and Days 7, 14 and 28.
Mean Change From Baseline in Single ESAS Items Symptom Scores; ITT Population
Quality of Life was assessed using ESAS, evaluating 9 common symptoms in cancer patients: pain, activity, nausea, depression, anxiety, drowsiness, appetite, well-being and shortness of breath. Symptom severity is rated 0-10 on a numerical scale (0=symptom absent; 10=worst severity). Low scores indicate good quality of life; high scores indicate strong discomfort. Questionnaire assessments by the patient or by nurse/caregiver in case of patient's physical inability. Mean change from baseline of each individual ESAS item score at Days 7, 14 and 28 is presented; a positive change indicates a worsening condition.
Time frame: Baseline (Day 1, before randomisation) and Days 7, 14 and 28.
Mean Change From Baseline in Performing General Activity (Karnofsky Performance Status [KPS]); ITT Population
The KPS allows patients to be classified as to their functional impairment and was used to assess general activity. KPS scores range from 0 (dead) to 100 (normal/no disease) and are classified as 0-40 = unable to care for self; 50-70 = unable to work; 80-100 = able to work. The lower the KPS score, the worse the survival for most serious illnesses. Scores were recorded on the patient's medical file at each study visit (Days 1, 7, 14 and 28). Mean change from baseline of KPS score at Days 7, 14 and 28 is presented for the ITT population (all randomised patients); a negative change indicates a worsening condition.
Time frame: Baseline (Day 1, before randomisation) and Days 7, 14 and 28.
Mean Change From Baseline in Daily Intensity of Abdominal Pain Score (Visual Analogue Scale [VAS]); ITT Population
Abdominal pain was assessed using the VAS numeric pain distress scale which is a 100-millimetre (10-centimetre) scoring scale on which patients mark their perceived level of pain. Scores range from 0 to 100 where 0=no pain and 100=unbearable pain. Higher scores indicate a worse outcome. Scores were recorded on the Patient Diary daily until the end of study (Day 28), by the patient or filled in by the nurse/caregiver in case of patient's physical inability. Mean change from baseline of VAS for abdominal pain at Days 7, 14 and 28 is presented for the ITT population; a positive change indicates a worsening condition.
Time frame: Baseline (Day 1, before randomisation) and Days 7, 14 and 28.
Number of Patients Experiencing ≤ 2 Vomiting Episodes/Day During at Least 3 Consecutive Days, in Patients Without NGT
Vomiting episodes and NGT presence were recorded on the Patient Diary daily until the end of study (Day 28), by the patient or filled in by the nurse/caregiver in case of patient's physical inability. Number of patients experiencing ≤ 2 vomiting episodes/day during at least 3 consecutive days, in patients without NGT, is presented.
Time frame: From Baseline (Day 1, before randomisation) to Days 7, 14 and 28.
Mean Daily NGT Secretion Volume, in Patients With a NGT
NGT presence and related secretion volume were recorded on the Patient Diary daily until the end of study (Day 28), by the patient or filled in by the nurse/caregiver in case of patient's physical inability. Mean daily secretion volumes, in patients with NGT, is presented.
Time frame: Baseline (Day 1, before randomisation) and Days 7, 14 and 28.
Mean Change From Baseline in Number of Daily Vomiting Episodes; ITT Population
Vomiting episodes were recorded on the Patient Diary daily until the end of study (Day 28), by the patient or filled in by the nurse/caregiver in case of patient's physical inability. Mean change from baseline in number of daily vomiting episodes is presented for the ITT population.
Time frame: Baseline (Day 1, before randomisation) and Days 7, 14 and 28.
Assessment of Passage of Stools; ITT Population
Passage of stools assessments (Yes/No) were recorded on the Patient Diary daily until the end of study (Day 28), by the patient or filled in by the nurse/caregiver in case of patient's physical inability.
Time frame: From Baseline (Day 1, before randomisation) to Day 28.
Recruitment to this prospective, randomised, parallel arm, open-label study began on 14 Jan 2015. Patients with a documented diagnosis of inoperable malignant bowel obstruction who had a nasogastric tube (NGT) or presented with ≥ 3 vomiting episodes/day in the last consecutive 48 hours at time of enrolment were recruited to 14 centres in Italy.
| Milestone | Standard Care | Standard Care + Lanreotide Autogel |
|---|---|---|
| Started | 21 | 22 |
| Completed | 9 | 8 |
| Not completed | 12 | 14 |
| Withdrew: Adverse event | 2 | 2 |
| Withdrew: Withdrawal by subject | 1 | 0 |
| Withdrew: Disease progression | 9 | 12 |
Quality of Life was assessed using ESAS, evaluating 9 common symptoms in cancer patients: pain, activity, nausea, depression, anxiety, drowsiness, appetite, well-being and shortness of breath. Symptom severity is rated 0-10 on a numerical scale (0=symptom absent; 10=worst severity). ESAS total score is sum of the 9 items (min score=0, max score=90). Low scores indicate good quality of life; high scores indicate strong discomfort. Questionnaire assessments by the patient or by nurse/caregiver in case of patient's physical inability. AUC is area under the line which joins the points defined by plotting ESAS total score on vertical axis and time values on horizontal axis, computed using trapezoidal rule. Primary endpoint was analysed using the FAS. LS mean AUC of ESAS total scores during first 7 days is presented.
| Scores on a scale x time (day) | Standard Care | Standard Care + Lanreotide Autogel |
|---|---|---|
| Least Squares (LS) Mean Area Under Curve (AUC) of Edmonton Symptom Assessment System (ESAS) Total Scores Collected for the First 7 Days; Full Analysis Set (FAS) | 179 ± 12.4 | 190 ± 12.4 |
Quality of Life was assessed using ESAS, evaluating 9 common symptoms in cancer patients: pain, activity, nausea, depression, anxiety, drowsiness, appetite, well-being and shortness of breath. Symptom severity is rated 0-10 on a numerical scale (0=symptom absent; 10=worst severity). ESAS total score is sum of the 9 items (min score=0, max score=90). Low scores indicate good quality of life; high scores indicate strong discomfort. Questionnaire assessments by the patient or by nurse/caregiver in case of patient's physical inability. Secondary endpoints were analysed using the ITT population but to permit following the FAS which was used for primary endpoint analysis, ESAS total score results are reported for both the ITT and the FAS. Mean change from baseline of ESAS total score at Days 7, 14 and 28 is presented here for the FAS; a positive change indicates a worsening condition.
| Scores on a scale | Standard Care | Standard Care + Lanreotide Autogel |
|---|---|---|
| Change at Day 7 | -5.1 ± 15.7 | 1.9 ± 18.4 |
| Change at Day 14 | -1.3 ± 21.4 | -7.3 ± 16.7 |
| Change at Day 28 | -6.8 ± 15.2 | -10.3 ± 16.7 |
Quality of Life was assessed using ESAS, evaluating 9 common symptoms in cancer patients: pain, activity, nausea, depression, anxiety, drowsiness, appetite, well-being and shortness of breath. Symptom severity is rated 0-10 on a numerical scale (0=symptom absent; 10=worst severity). ESAS total score is sum of the 9 items (min score=0, max score=90). Low scores indicate good quality of life; high scores indicate strong discomfort. Questionnaire assessments by the patient or by nurse/caregiver in case of patient's physical inability. Secondary endpoints were analysed using the ITT population but to permit following the FAS which was used for primary endpoint analysis, ESAS total score results are reported for both the ITT and the FAS. Mean change from baseline of ESAS total score at Days 7, 14 and 28 is presented here for the ITT population; a positive change indicates a worsening condition.
| Scores on a scale | Standard Care | Standard Care + Lanreotide Autogel |
|---|---|---|
| Change at Day 7 | -5.1 ± 15.7 | 1.5 ± 18.1 |
| Change at Day 14 | -1.3 ± 21.4 | -7.3 ± 16.7 |
| Change at Day 28 | -6.8 ± 15.2 | -10.3 ± 16.7 |
Quality of Life was assessed using ESAS, evaluating 9 common symptoms in cancer patients: pain, activity, nausea, depression, anxiety, drowsiness, appetite, well-being and shortness of breath. Symptom severity is rated 0-10 on a numerical scale (0=symptom absent; 10=worst severity). Low scores indicate good quality of life; high scores indicate strong discomfort. Questionnaire assessments by the patient or by nurse/caregiver in case of patient's physical inability. Mean change from baseline of each individual ESAS item score at Days 7, 14 and 28 is presented; a positive change indicates a worsening condition.
| Scores on a scale | Standard Care | Standard Care + Lanreotide Autogel |
|---|---|---|
| Change at Day 7: Pain | -1.8 ± 3.6 | 0.1 ± 3.4 |
| Change at Day 14: Pain | -1.3 ± 3.6 | -1.9 ± 2.9 |
| Change at Day 28: Pain | -3.0 ± 3.1 | -1.3 ± 4.2 |
| Change at Day 7: Activity | -0.3 ± 2.6 | 0.7 ± 2.6 |
| Change at Day 14: Activity | -0.3 ± 3.3 | -0.7 ± 3.0 |
| Change at Day 28: Activity | -1.4 ± 2.8 | -0.3 ± 3.2 |
| Change at Day 7: Nausea | 0.5 ± 3.2 | 0.9 ± 3.2 |
| Change at Day 14: Nausea | 0.1 ± 3.8 | 0.5 ± 4.1 |
| Change at Day 28: Nausea | -0.6 ± 4.6 | 0.0 ± 3.9 |
| Change at Day 7: Depression | -1.8 ± 3.5 | -1.1 ± 3.7 |
| Change at Day 14 Depression | -1.9 ± 3.5 | -2.4 ± 3.2 |
| Change at Day 28: Depression | -2.6 ± 1.9 | -3.7 ± 4.0 |
| Change at Day 7: Anxiety | 0.0 ± 2.7 | -0.2 ± 3.2 |
| Change at Day 14: Anxiety | 0.4 ± 3.3 | -2.7 ± 3.8 |
| Change at Day 28: Anxiety | -1.1 ± 1.9 | -1.5 ± 1.0 |
| Change at Day 7: Drowsiness | -0.7 ± 2.7 | 0.4 ± 3.1 |
| Change at Day 14: Drowsiness | -0.1 ± 3.5 | -0.6 ± 2.6 |
| Change at Day 28: Drowsiness | -1.9 ± 3.1 | -1.5 ± 1.5 |
| Change at Day 7: Appetite | -0.2 ± 3.1 | 0.5 ± 3.2 |
| Change at Day 14: Appetite | 0.9 ± 3.0 | 0.4 ± 3.9 |
| Change at Day 28: Appetite | 0.4 ± 3.1 | -2.0 ± 2.3 |
| Change at Day 7: Well-being | -0.8 ± 2.6 | -0.4 ± 3.1 |
| Change at Day 14: Well-being | 0.4 ± 2.5 | -0.5 ± 4.3 |
| Change at Day 28: Well-being | 0.4 ± 2.4 | -2.3 ± 2.9 |
| Change at Day 7: Shortness of breath | -0.1 ± 2.3 | 0.7 ± 2.6 |
| Change at Day 14: Shortness of breath | 0.6 ± 3.4 | 0.7 ± 2.9 |
| Change at Day 28: Shortness of breath | -0.4 ± 2.0 | -0.2 ± 3.8 |
The KPS allows patients to be classified as to their functional impairment and was used to assess general activity. KPS scores range from 0 (dead) to 100 (normal/no disease) and are classified as 0-40 = unable to care for self; 50-70 = unable to work; 80-100 = able to work. The lower the KPS score, the worse the survival for most serious illnesses. Scores were recorded on the patient's medical file at each study visit (Days 1, 7, 14 and 28). Mean change from baseline of KPS score at Days 7, 14 and 28 is presented for the ITT population (all randomised patients); a negative change indicates a worsening condition.
| Scores on a scale | Standard Care | Standard Care + Lanreotide Autogel |
|---|---|---|
| Change at Day 7 | -2.8 ± 12.3 | -3.7 ± 6.8 |
| Change at Day 14 | -5.6 ± 11.5 | -5.4 ± 12.7 |
| Change at Day 28 | -5.0 ± 16.0 | -7.1 ± 20.6 |
Abdominal pain was assessed using the VAS numeric pain distress scale which is a 100-millimetre (10-centimetre) scoring scale on which patients mark their perceived level of pain. Scores range from 0 to 100 where 0=no pain and 100=unbearable pain. Higher scores indicate a worse outcome. Scores were recorded on the Patient Diary daily until the end of study (Day 28), by the patient or filled in by the nurse/caregiver in case of patient's physical inability. Mean change from baseline of VAS for abdominal pain at Days 7, 14 and 28 is presented for the ITT population; a positive change indicates a worsening condition.
| Scores on a scale | Standard Care | Standard Care + Lanreotide Autogel |
|---|---|---|
| Change at Day 7 | -22.0 ± 32.5 | -9.6 ± 30.8 |
| Change at Day 14 | -15.6 ± 34.9 | -27.7 ± 28.8 |
| Change at Day 28 | -32.0 ± 31.5 | -17.0 ± 34.9 |
Vomiting episodes and NGT presence were recorded on the Patient Diary daily until the end of study (Day 28), by the patient or filled in by the nurse/caregiver in case of patient's physical inability. Number of patients experiencing ≤ 2 vomiting episodes/day during at least 3 consecutive days, in patients without NGT, is presented.
| Participants | Standard Care | Standard Care + Lanreotide Autogel |
|---|---|---|
| From Day 1 to Day 7 | 5 | 4 |
| From Day 1 to Day 14 | 4 | 4 |
| From Day 1 to Day 28 | 4 | 4 |
NGT presence and related secretion volume were recorded on the Patient Diary daily until the end of study (Day 28), by the patient or filled in by the nurse/caregiver in case of patient's physical inability. Mean daily secretion volumes, in patients with NGT, is presented.
| millilitres | Standard Care | Standard Care + Lanreotide Autogel |
|---|---|---|
| Baseline | 200.0 ± NA | 700.0 ± 141.4 |
| Day 7 | 4875.0 ± 4023.6 | 1025.0 ± 813.2 |
| Day 14 | 12675.0 ± 2863.8 | 7090.8 ± 2433.9 |
| Day 28 | 27501.0 ± 27081.8 | 18301.4 ± 11657.9 |
Vomiting episodes were recorded on the Patient Diary daily until the end of study (Day 28), by the patient or filled in by the nurse/caregiver in case of patient's physical inability. Mean change from baseline in number of daily vomiting episodes is presented for the ITT population.
| Episodes (daily) | Standard Care | Standard Care + Lanreotide Autogel |
|---|---|---|
| Change at Day 7 | 5.7 ± 6.2 | 6.0 ± 9.9 |
| Change at Day 14 | 10.6 ± 12.7 | 10.4 ± 15.8 |
| Change at Day 28 | 16.5 ± 19.9 | 14.1 ± 20.2 |
Passage of stools assessments (Yes/No) were recorded on the Patient Diary daily until the end of study (Day 28), by the patient or filled in by the nurse/caregiver in case of patient's physical inability.
| Participants | Standard Care | Standard Care + Lanreotide Autogel |
|---|---|---|
| Day 1 — Yes | 2 | 2 |
| Day 1 — No | 19 | 20 |
| Day 2 — Yes | 6 | 3 |
| Day 2 — No | 13 | 16 |
| Day 3 — Yes | 4 | 3 |
| Day 3 — No | 15 | 17 |
| Day 4 — Yes | 4 | 2 |
| Day 4 — No | 15 | 18 |
| Day 5 — Yes | 6 | 3 |
| Day 5 — No | 13 | 17 |
| Day 6 — Yes | 4 | 2 |
| Day 6 — No | 15 | 17 |
| Day 7 — Yes | 3 | 3 |
| Day 7 — No | 16 | 16 |
| Day 8 — Yes | 6 | 3 |
| Day 8 — No | 12 | 17 |
| Day 9 — Yes | 4 | 5 |
| Day 9 — No | 13 | 14 |
| Day 10 — Yes | 3 | 1 |
| Day 10 — No | 13 | 15 |
| Day 11 — Yes | 5 | 1 |
| Day 11 — No | 10 | 14 |
| Day 12 — Yes | 4 | 1 |
| Day 12 — No | 11 | 11 |
| Day 13 — Yes | 3 | 1 |
| Day 13 — No | 12 | 13 |
| Day 14 — Yes | 5 | 1 |
| Day 14 — No | 10 | 14 |
| Day 15 — Yes | 2 | 2 |
| Day 15 — No | 12 | 10 |
| Day 16 — Yes | 3 | 2 |
| Day 16 — No | 11 | 9 |
| Day 17 — Yes | 2 | 3 |
| Day 17 — No | 12 | 9 |
| Day 18 — Yes | 3 | 2 |
| Day 18 — No | 11 | 8 |
| Day 19 — Yes | 3 | 2 |
| Day 19 — No | 8 | 8 |
| Day 20 — Yes | 2 | 2 |
| Day 20 — No | 9 | 8 |
| Day 21 — Yes | 2 | 2 |
| Day 21 — No | 9 | 7 |
| Day 22 — Yes | 2 | 2 |
| Day 22 — No | 9 | 6 |
| Day 23 — Yes | 3 | 2 |
| Day 23 — No | 7 | 5 |
| Day 24 — Yes | 3 | 2 |
| Day 24 — No | 7 | 6 |
| Day 25 — Yes | 2 | 2 |
| Day 25 — No | 7 | 5 |
| Day 26 — Yes | 2 | 2 |
| Day 26 — No | 6 | 6 |
| Day 27 — Yes | 1 | 2 |
| Day 27 — No | 7 | 4 |
| Day 28 — Yes | 3 | 2 |
| Day 28 — No | 4 | 5 |
Collected over From baseline (Day 1) until end of study (Day 28).. Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Standard Care | 2/21 (9.5%) | 2/21 (9.5%) | 5/21 (23.8%) |
| Standard Care + Lanreotide Autogel | 2/22 (9.1%) | 2/22 (9.1%) | 5/22 (22.7%) |
| Event | Standard Care | Standard Care + Lanreotide Autogel |
|---|---|---|
| Gastrointestinal haemorrhageGastrointestinal disorders | 2/21 | 0/22 |
| Cardiac failureCardiac disorders | 0/21 | 1/22 |
| Myocardial infarctionCardiac disorders | 0/21 | 1/22 |
| Event | Standard Care | Standard Care + Lanreotide Autogel |
|---|---|---|
| HypokalaemiaMetabolism and nutrition disorders | 3/21 | 0/22 |
| PyrexiaGeneral disorders | 2/21 | 1/22 |
| PharyngitisInfections and infestations | 0/21 | 2/22 |
| HypotensionVascular disorders | 0/21 | 2/22 |
Baseline analysis was performed on the intention to treat (ITT) population which included all randomised patients.
| Age, Continuous(Years) | Standard Care | Standard Care + Lanreotide Autogel | Total Title |
|---|---|---|---|
| Mean | 61.8 ± 9.6 | 62.8 ± 12.3 | 62.3 ± 10.9 |
| Sex: Female, Male(Participants) | Standard Care | Standard Care + Lanreotide Autogel | Total Title |
|---|---|---|---|
| Female | 14 | 19 | 33 |
| Male | 7 | 3 | 10 |
| Race/Ethnicity, Customized(Participants) | Standard Care | Standard Care + Lanreotide Autogel | Total Title |
|---|---|---|---|
| Caucasian / White | 21 | 22 | 43 |
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