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Pancreatic Enzyme Suppletion in Pancreatic Cancer


2011-10


2013-05


2013-05


0

Study Overview

Pancreatic Enzyme Suppletion in Pancreatic Cancer

This study will evaluate the effect of immediate pancreatic enzyme suppletion on the physical and mental health status and survival of patients who are diagnosed with pancreatic cancer and are highly likely to develop exocrine pancreatic insufficiency during their disease process.

Weight loss in cancer is caused by primary tumour effects and secondary effects (e.g. side effects of treatment, mechanical and intestinal obstruction). In pancreatic cancer, additional weight loss and malnutrition may be due to the development of exocrine pancreatic insufficiency (EPI). The presence of EPI in pancreatic cancer is frequently overlooked, because the focus of treatment is directed at possible surgery or chemotherapy and its potential side effects. Although studies have proven that pancreatic enzymes may prevent or decrease weight loss, they are seldom being prescribed.

  • Adenocarcinoma of the Pancreas
  • Normal Pancreatic Exocrine Function
  • OTHER: Timing of start treatment with pancreatic enzymes
  • OTHER: Timing of start treatment with pancreatic enzymes
  • EPC 11-01
  • 2011-003373-28 (EUDRACT_NUMBER Identifier) (EUDRACT_NUMBER: )

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates Results Reporting Dates Study Record Updates

2011-07-21  

N/A  

2013-02-21  

2011-07-22  

N/A  

2013-02-22  

2011-07-25  

N/A  

2013-02  

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

Design Details

Primary Purpose:
Treatment


Allocation:
Randomized


Interventional Model:
Parallel


Masking:
None


Arms and Interventions

Participant Group/ArmIntervention/Treatment
ACTIVE_COMPARATOR: Standard treatment

Treatment with pancreatic enzymes after clinical sings and symptoms of steatorrhea and 10% decrease of weight at time of randomisation.

OTHER: Timing of start treatment with pancreatic enzymes

  • Patients who are randomised to standard treatment will start taking pancreatic enzymes only if they develop steatorrhea-related symptoms in combination with at least a 10% decrease in body weight (index weight at the time of randomisation).
ACTIVE_COMPARATOR: Preventive treatment

Patients will be prescribed with pancreatic enzymes immediately after diagnosis with pancreatic cancer, regardless of the presence of steatorrhea

OTHER: Timing of start treatment with pancreatic enzymes

  • Patients who are allocated to the anticipative group will start enzyme suppletion immediately and receive dietary consultation after randomization, regardless of symptoms.
Primary Outcome MeasuresMeasure DescriptionTime Frame
To evaluate if prescribing pancreatic enzymes in patients with pancreatic cancer leads to a decrease in weight loss.Percentage of change in body weight ((index weight - monthly weight)/ index weight) x100% during the 6 months of follow-up. This will be measured on a monthly basis and measured by area under the ROC (Receiver Operating Characteristic) curveevery month during 6 months after inclusion
Secondary Outcome MeasuresMeasure DescriptionTime Frame
improvement of the nutritional statusNutritional deficiencies, 1 sample of blood will be drawn (3 times 8ml of blood): * Glucose, HbA1c (glycol Hb) * Magnesium, phosphate, ferritin * Hb * albumin * total protein * calcium * folic acid * vitamin A, E, B12 * 1,25-di-OH-Vitamine D * 25-hydroxy vitamin D (25-OH-vitamin D)every three months
quality-of-lifeSF36 questionnaireon a monthly base during 6 months after inclusion
improvement of the nutritional statusA monthly patient journal which will focus on the presence or absence of steatorrhea-related symptomsevery month during six months after inclusion

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person’s general health condition or prior treatments.

Ages Eligible for Study:
ALL

Sexes Eligible for Study:
18 Years

Accepts Healthy Volunteers:

    Inclusion Criteria:

  • Adenocarcinoma of the pancreas (histologically confirmed)
  • Normal exocrine pancreatic function (Fecal Elastase test > 0.2 mg/g)
  • Capable and willing to follow instructions given by the physician.

  • Exclusion Criteria:

  • Other causes of fat malabsorption (celiac disease, IBD, and major gastrointestinal surgery).
  • < 18 years.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.


    • PRINCIPAL_INVESTIGATOR: Marco Bruno, MD, PhD, Erasmus Medical Center

    Publications

    The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

    General Publications

    No publications available