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Pasireotide Treatment for Neuroendocrine Tumor

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT02779257
Recruitment Status : Withdrawn (Subject passed away prior to enrollment)
First Posted : May 20, 2016
Last Update Posted : November 7, 2019
Information provided by (Responsible Party):
Kashif Munir, University of Maryland, College Park

Tracking Information
First Submitted Date  ICMJE May 16, 2016
First Posted Date  ICMJE May 20, 2016
Last Update Posted Date November 7, 2019
Study Start Date  ICMJE April 2016
Actual Primary Completion Date June 2016   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: May 17, 2016)
Hypoglycemia [ Time Frame: up to 12 months ]
number of times glucose < 70 mg/dl with and without symptoms
Original Primary Outcome Measures  ICMJE Same as current
Change History Complete list of historical versions of study NCT02779257 on Archive Site
Current Secondary Outcome Measures  ICMJE Not Provided
Original Secondary Outcome Measures  ICMJE Not Provided
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
Descriptive Information
Brief Title  ICMJE Pasireotide Treatment for Neuroendocrine Tumor
Official Title  ICMJE Pasireotide Treatment for Insulin Producing Pancreatic Neuro-endocrine Tumor
Brief Summary Pasireotide binds to somatostatin receptors sst2 and sst5, which can lead to significant hyperglycemia. The investigators would like to administer pasireotide as a treatment for refractory hypoglycemia in the setting of metastatic insulin-producing pancreatic neuro-endocrine tumor.
Detailed Description Not Provided
Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 4
Study Design  ICMJE Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Condition  ICMJE Gastro-enteropancreatic Neuroendocrine Tumor
Intervention  ICMJE
  • Drug: Pasireotide
    Pasireotide will be used, in addition to diazoxide, as a medical treatment to blunt hypoglycemia in the setting of autonomous insulin secretion.
  • Drug: Diazoxide
    Pasireotide will be used, in addition to diazoxide, as a medical treatment to blunt hypoglycemia in the setting of autonomous insulin secretion.
Study Arms  ICMJE Experimental: Pasireotide
Off label use of pasireotide to treat refractory hypoglycemia due to an insulin-producing pancreatic neuroendocrine tumor
  • Drug: Pasireotide
  • Drug: Diazoxide
Publications * Tirosh A, Stemmer SM, Solomonov E, Elnekave E, Saeger W, Ravkin Y, Nir K, Talmor Y, Shimon I. Pasireotide for malignant insulinoma. Hormones (Athens). 2016 Apr;15(2):271-276. doi: 10.14310/horm.2002.1639.

*   Includes publications given by the data provider as well as publications identified by Identifier (NCT Number) in Medline.
Recruitment Information
Recruitment Status  ICMJE Withdrawn
Actual Enrollment  ICMJE
 (submitted: June 6, 2016)
Original Estimated Enrollment  ICMJE
 (submitted: May 17, 2016)
Actual Study Completion Date  ICMJE June 2016
Actual Primary Completion Date June 2016   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  1. Aged 18 years or older
  2. Biopsy-proven (primary or metastatic lesion) metastatic neuroendocrine tumor of the gastrointestinal and pancreatic location with disease determined by CT scan or MRI
  3. Patients with history of clinical syndrome symptoms (e.g. hypoglycemia)
  4. Patients not controlled by treatment with currently available somatostatin analogues.
  5. No evidence of significant liver disease:

    • Serum bilirubin ≤1.5 x ULN
    • INR < 1.3
    • ALT and AST ≤ 3x ULN,
    • Alkaline phosphatase ≤ 2.5 x ULN
  6. Written informed consent obtained prior to treatment to be consistent with local regulatory requirements
  7. Is suffering from a serious or life-threatening disease or condition
  8. Does not have access to a comparable or satisfactory alternative treatment (i.e., comparable or satisfactory treatment is not available or does not exist)
  9. Is not eligible for participation in any of the IMP's ongoing clinical trials or has recently completed a clinical trial that has been terminated and, after considering other options (e.g., trial extensions, amendments, etc.), the clinical team has determined that treatment is necessary and there are no other feasible alternatives for the patient
  10. Meets any other relevant medical criteria for compassionate use of the investigational product
  11. Is not being transferred from an ongoing clinical trial for which they are still eligible
  12. There are meaningful human clinical data to support an assessment that the potential benefits to patient outweigh risks.

Exclusion Criteria:

  1. Patients with a known hypersensitivity to somatostatin analogs or any component of the pasireotide LAR or s.c. formulations.
  2. Patients with abnormal coagulation (PT or aPTT elevated by 30% above normal limits).
  3. Patients on continuous anticoagulation therapy. Patients who were on anticoagulant therapy must complete a washout period of at least 10 days and have confirmed normal coagulation parameters before study inclusion.
  4. Patients currently using warfarin / warfarin derivatives
  5. Patients with symptomatic cholelithiasis.
  6. Patients who are not biochemically euthyroid. Patients with known history of hypothyroidism are eligible if they are on adequate and stable replacement thyroid hormone therapy for at least 3 months.
  7. QT-related exclusion criteria:.

    • QTcF at screening >450 msec in males, and > 460 msec in females.
    • Family history of idiopathic sudden death
    • Sustained or clinically significant cardiac arrhythmias
    • Risk factors for Torsades de Pointes such as hypokalemia, hypomagnesemia, cardiac failure, clinically significant/symptomatic bradycardia, or high-grade AV block
    • Concomitant disease(s) that could prolong QT such as autonomic neuropathy (caused by diabetes, or Parkinson's disease), HIV, cirrhosis, uncontrolled hypothyroidism or cardiac failure
    • Family history of long QT syndrome
    • Concomitant medications known to prolong the QT interval.
    • Potassium < or = 3.5 mmol/L
  8. Patients who have any severe and/or uncontrolled medical conditions :

    • Uncontrolled diabetes as defined by HbA1c > 8%
    • Patients with the presence of active or suspected acute or chronic uncontrolled infection or with a history of immunodeficiency, including a positive HIV test result (ELISA and Western blot). An HIV test will not be required; however, previous medical history will be reviewed.
    • Non-malignant medical illnesses that are uncontrolled or whose control may be jeopardized by the treatment with this study treatment.
    • Life-threatening autoimmune and ischemic disorders.
  9. Patients who have a history of another primary malignancy, with the exception of locally excised non-melanoma skin cancer and carcinoma in situ of uterine cervix. Patients who have had no evidence of disease from another primary cancer for 1 or more years are allowed to participate in the study.
  10. Patients with history of liver disease, such as cirrhosis or chronic active hepatitis B or C
  11. Presence of Hepatitis B surface antigen (HbsAg)
  12. Presence of Hepatitis C antibody (anti-HCV)
  13. History of, or current alcohol misuse/abuse within the past 12 months.
  14. Known gallbladder or bile duct disease, acute or chronic pancreatitis
  15. Patients with hypomagnesaemia (< 0.7 mmol/L)
  16. Patients with a history of non-compliance to medical regimens
  17. If the patient is a sexually active male he is excluded unless he agrees to use a condom during intercourse while taking pasireotide and for 3 months after stopping pasireotide medication. They should not father a child in this period. A condom is required to be used also by vasectomized men in order to prevent delivery of the drug via seminal fluid
Sex/Gender  ICMJE
Sexes Eligible for Study: Male
Ages  ICMJE 18 Years to 75 Years   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE Contact information is only displayed when the study is recruiting subjects
Listed Location Countries  ICMJE Not Provided
Removed Location Countries  
Administrative Information
NCT Number  ICMJE NCT02779257
Other Study ID Numbers  ICMJE HP-00069513EU
Has Data Monitoring Committee No
U.S. FDA-regulated Product Not Provided
IPD Sharing Statement  ICMJE Not Provided
Responsible Party Kashif Munir, University of Maryland, College Park
Study Sponsor  ICMJE University of Maryland, Baltimore
Collaborators  ICMJE Novartis
Investigators  ICMJE
Principal Investigator: Kashif M Munir, MD University of Maryland, College Park
PRS Account University of Maryland, Baltimore
Verification Date November 2019

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP