Pancreatic Cancer Research

Clinical trialPhase 2Completed

Telotristat Ethyl to Promote Weight Stability in Patients With Advanced Stage Pancreatic Cancer

Weight Loss in Patients With Advanced Stage Pancreatic Cancer: Role of Serotonin and Effects of Telotristat Ethyl

Outcome
Outcome unknown
Phase
Phase 2
Status
Completed
Study type
Interventional
Start
17 April 2019
Expected end
29 June 2022
Enrollment
23 participants
Sites
3
Primary outcomes
Weight Stability
Sponsor
Other
Results posted
2025-12-16
Last update
16 December 2025

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Brief summary public domain (ClinicalTrials.gov)

This phase II trial studies how well telotristat ethyl works in promoting weight stability in patients with pancreatic adenocarcinoma that has come back and spread to other places in the body. Telotristat ethyl may decrease bowel movements which may make patients gain weight. Stabilizing weight may help patients tolerate chemotherapy better and improve longevity.

Detailed description public domain (ClinicalTrials.gov)

PRIMARY OBJECTIVES: I. Evaluate weight stability after 3 months of telotristat ethyl treatment in patients who have significant weight loss (documented to be more than or equal to 10%) prior to the start of treatment. (Group 1). II. Evaluate the change in serum and 24-hours (hr) urine 5-hydroxyindoleacetic acid (5-HIAA) in patients with locally advanced unresectable, recurrent or metastatic pancreatic adenocarcinoma (PDAC) receiving chemotherapy. (Group 2). SECONDARY OBJECTIVES: I. Evaluate the impact of weight stabilization/gain on patients in Group 1 on performance status, quality of life (QOL), mid arm circumference (MAC) and muscle mass on cross sectional imaging. II. Evaluate correlations between changes in serotonin/ 5HIAA levels on radiologic response, weight stability, mid arm circumference (MAC), and muscle mass on cross sectional imaging. III. Evaluate the relation of baseline serum and 24-hr urine 5-HIAA on weight loss in patients with advanced PDAC. IV. Safety and tolerability of telotristat ethyl with gemcitabine/nab-paclitaxel combination chemotherapy. V. Evaluate response rate (RR) assessed per Response Evaluation Criteria in Solid Tumors (RECIST), progression free survival and overall survival in patients receiving telotristat ethyl (Group 1). OUTLINE: Patients are randomized to 1 of 2 groups. GROUP 1: Patients receive gemcitabine/nab-paclitaxel combination chemotherapy on days 1, 8 and 15, and telotristat ethyl orally (PO) once daily (QD), twice daily (BID), or thrice daily (TID) on days 1 and 8. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. GROUP 2: Patients receive chemotherapy (at the discretion of the investigator) on days 1, 8 and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up at 30 days, then every 8 weeks thereafter.

Posted results (ClinicalTrials.gov registry) · primary outcome public domain (ClinicalTrials.gov)

Weight Stability [Baseline up to 3 months after study start]. Mean, Percent weight change (Standard Deviation). Group 1 (gemcitabine/nab-paclitaxel and telotristat ethyl) (n=14): -1.98 (6.87); Group 2 (gemcitabine/nab-paclitaxel) (n=8): -5.58 (5.89).

Posted results (ClinicalTrials.gov registry) · secondary outcome public domain (ClinicalTrials.gov)

Change in 24-hr Urine 5-hydroxyindoleacetic Acid (5-HIAA) Levels [Baseline up to 4 months after study start]. Mean, Milligrams (Standard Deviation). Screening: Group 1 (gemcitabine/nab-paclitaxel and telotristat ethyl) (n=10): 3 (261.67); Group 2 (gemcitabine/nab-paclitaxel) (n=5): 4 (46.25). Cycle 1 Day 1 (Treatment day 0): Group 1 (gemcitabine/nab-paclitaxel and telotristat ethyl) (n=10): 8 (232.38); Group 2 (gemcitabine/nab-paclitaxel) (n=5): 3 (44.87). Cycle 2 Day 1 (Treatment day 28): Group 1 (gemcitabine/nab-paclitaxel and telotristat ethyl) (n=10): 8 (58.63); Group 2 (gemcitabine/nab-paclitaxel) (n=5): 2 (144.00). Cycle 3 Day 1 (Treatment day 56): Group 1 (gemcitabine/nab-paclitaxel and telotristat ethyl) (n=10): 7 (119.10); Group 2 (gemcitabine/nab-paclitaxel) (n=5): 1 (273.00). Cycle 4 Day 1 (Treatment day 84): Group 1 (gemcitabine/nab-paclitaxel and telotristat ethyl) (n=10): 9 (91.56); Group 2 (gemcitabine/nab-paclitaxel) (n=5): 1 (10.00).

Posted results (ClinicalTrials.gov registry) · secondary outcome public domain (ClinicalTrials.gov)

Mid Arm Circumference (MAC) Measured in cm [Up to 2 years after study start]. Mean, cm (Standard Deviation). Screening: Group 1 (gemcitabine/nab-paclitaxel and telotristat ethyl) (n=14): 24.35 (9.43); Group 2 (gemcitabine/nab-paclitaxel) (n=5): 34.88 (6.17). Cycle 1 Day 1: Group 1 (gemcitabine/nab-paclitaxel and telotristat ethyl) (n=14): 24.39 (8.69); Group 2 (gemcitabine/nab-paclitaxel) (n=5): 35.88 (5.86). Cycle 2 Day 1: Group 1 (gemcitabine/nab-paclitaxel and telotristat ethyl) (n=14): 23.98 (7.28); Group 2 (gemcitabine/nab-paclitaxel) (n=5): 35.5 (5.89). Cycle 3 Day 1: Group 1 (gemcitabine/nab-paclitaxel and telotristat ethyl) (n=14): 25.71 (6.12); Group 2 (gemcitabine/nab-paclitaxel) (n=5): 27 (NA) [Only 1 participant analyzed. SD is NA.]. Cycle 4 Day 1: Group 1 (gemcitabine/nab-paclitaxel and telotristat ethyl) (n=14): 25.71 (6.52); Group 2 (gemcitabine/nab-paclitaxel) (n=5): 29 (7.07). Cycle 5 Day 1: Group 1 (gemcitabine/nab-paclitaxel and telotristat ethyl) (n=14): 24.81 (3.52); Group 2 (gemcitabine/nab-paclitaxel) (n=5): 31.5 (0.71). Cycle 6 Day 1: Group 1 (gemcitabine/nab-paclitaxel and telotristat ethyl) (n=14): 26.67 (6.24); Group 2 (gemcitabine/nab-paclitaxel) (n=5): 31 (NA) [Only 1 participant analyzed. SD is NA.]. Cycle 7 Day 1: Group 1 (gemcitabine/nab-paclitaxel and telotristat ethyl) (n=14): 27.81 (4.52). Cycle 8 Day 1: Group 1 (gemcitabine/nab-paclitaxel and telotristat ethyl) (n=14): 21.81 (8.59). Cycle 9 Day 1: Group 1 (gemcitabine/nab-paclitaxel and telotristat ethyl) (n=14): 25.4 (NA) [Only 1 participant analyzed. SD is NA.]; Group 2 (gemcitabine/nab-paclitaxel) (n=5): 29 (NA) [Only 1 participant analyzed. SD is NA.]. Cycle 10 Day 1: Group 2 (gemcitabine/nab-paclitaxel) (n=5): 30 (0). Cycle 11 Day 1: Group 2 (gemcitabine/nab-paclitaxel) (n=5): 30 (NA) [Only 1 participant analyzed. SD is NA.]. Cycle 12 Day 1: Group 2 (gemcitabine/nab-paclitaxel) (n=5): 30 (NA) [Only 1 participant analyzed. SD is NA.]. Cycle 13 Day 1: Group 2 (gemcitabine/nab-paclitaxel) (n=5): 26 (NA) [Only 1 participant analyzed. SD is NA.]. Cycle 14 Day 1: Group 2 (gemcitabine/nab-paclitaxel) (n=5): 24 (NA) [Only 1 participant analyzed. SD is NA.]. Cycle 16 Day 1: Group 1 (gemcitabine/nab-paclitaxel and telotristat ethyl) (n=14): 29.21 (NA) [Only 1 participant analyzed. SD is NA.]. Cycle 18 Day 1: Group 1 (gemcitabine/nab-paclitaxel and telotristat ethyl) (n=14): 23 (NA) [Only 1 participant analyzed. SD is NA.]. Cycle 19 Day 1: Group 1 (gemcitabine/nab-paclitaxel and telotristat ethyl) (n=14): 25 (NA) [Only 1 participant analyzed. SD is NA.]. Cycle 20 Day 1: Group 1 (gemcitabine/nab-paclitaxel and telotristat ethyl) (n=14): 23 (NA) [Only 1 participant analyzed. SD is NA.]. Cycle 21 Day 1: Group 1 (gemcitabine/nab-paclitaxel and telotristat ethyl) (n=14): 26 (NA) [Only 1 participant analyzed. SD is NA.]; Group 2 (gemcitabine/nab-paclitaxel) (n=5): 24.5 (NA) [Only 1 participant analyzed. SD is NA.]. Cycle 22 Day 1: Group 1 (gemcitabine/nab-paclitaxel and te

Posted results (ClinicalTrials.gov registry) · secondary outcome public domain (ClinicalTrials.gov)

Blood Serotonin Levels [Up to 2 years after study start]. Mean, ng/mL (95% Confidence Interval). Screening: Group 1 (gemcitabine/nab-paclitaxel and telotristat ethyl) (n=14): 170.92 (121.02 to 220.82); Group 2 (gemcitabine/nab-paclitaxel) (n=8): 294.67 (213.97 to 375.37). Cycle 1 Day 1 (Treatment day 0: Group 1 (gemcitabine/nab-paclitaxel and telotristat ethyl) (n=14): 152.75 (106.58 to 198.92); Group 2 (gemcitabine/nab-paclitaxel) (n=8): 201.33 (191.89 to 228.77). Cycle 2 Day 1 (Treatment day 28): Group 1 (gemcitabine/nab-paclitaxel and telotristat ethyl) (n=14): 96.09 (56.73 to 135.45); Group 2 (gemcitabine/nab-paclitaxel) (n=8): 217 (183.48 to 250.52). Cycle 3 Day 1 (Treatment day 56): Group 1 (gemcitabine/nab-paclitaxel and telotristat ethyl) (n=14): 97.67 (54.05 to 141.29); Group 2 (gemcitabine/nab-paclitaxel) (n=8): 112.67 (34.29 to 191.05). Cycle 4 Day 1 (Treatment day 84): Group 1 (gemcitabine/nab-paclitaxel and telotristat ethyl) (n=14): 85.33 (53.51 to 117.15); Group 2 (gemcitabine/nab-paclitaxel) (n=8): 265 (0 to 1531.81).

Posted results (ClinicalTrials.gov registry) · secondary outcome public domain (ClinicalTrials.gov)

Response Rate (RR) [Up to 2 years after study start]. Count Of Participants, Participants. Group 1 (gemcitabine/nab-paclitaxel and telotristat ethyl) (n=12): 11; Group 2 (gemcitabine/nab-paclitaxel) (n=6): 6.

Posted results (ClinicalTrials.gov registry) · secondary outcome public domain (ClinicalTrials.gov)

Median Overall Survival (MOS) [Up to 2 years after study start]. Median, Days (80% Confidence Interval). Group 1 (gemcitabine/nab-paclitaxel and telotristat ethyl) (n=14): 10.7 (5.4 to 16.9); Group 2 (gemcitabine/nab-paclitaxel) (n=8): 12.2 (6.1 to 21.4).

Posted results (ClinicalTrials.gov registry) · secondary outcome public domain (ClinicalTrials.gov)

Duration of Response [Up to 2 years after study start]. Median, Days (95% Confidence Interval). Group 1 (gemcitabine/nab-paclitaxel and telotristat ethyl) (n=9): 94 (9 to 172); Group 2 (gemcitabine/nab-paclitaxel) (n=6): 97 (60 to NA) [Insufficient number of participants with events to calculate the upper limit of the 95% confidence interval.].