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    Clinical Trial Results:
    A european, multicentre, phase II/III randomised double-blind, placebo controlled study evaluating lanreotide as maintenance therapy in patients with non-resectable duodeno-pancreatic neuroendocrine tumours after first-line treatment

    Summary
    EudraCT number
    2013-004069-14
    Trial protocol
    DE   BE   IE   GB  
    Global end of trial date
    22 Jan 2020

    Results information
    Results version number
    v1(current)
    This version publication date
    31 Mar 2022
    First version publication date
    31 Mar 2022
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    PRODIGE31
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02288377
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Fédération Francophone de Cancérologie Digestive (FFCD)
    Sponsor organisation address
    7 Bd Jeanne d'Arc, Dijon, France, 21000
    Public contact
    Karine Le Malicot, Fédération Francophone de Cancérologie Digestive (FFCD), 33 380393479, karine.le-malicot@u-bourgogne.fr
    Scientific contact
    Karine Le Malicot, Fédération Francophone de Cancérologie Digestive (FFCD), 33 380393479, karine.le-malicot@u-bourgogne.fr
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    15 Apr 2020
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    22 Jan 2020
    Global end of trial reached?
    Yes
    Global end of trial date
    22 Jan 2020
    Was the trial ended prematurely?
    Yes
    General information about the trial
    Main objective of the trial
    To evaluate the rate of patients alive and progression free at 6 months, assessed by the investigator according to RECIST criteria, version 1.1.
    Protection of trial subjects
    The study was done in accordance with the Declaration of Helsinki (amended 2000) and the International Conference on Harmonization of Technical Requirements of Pharmaceuticals for Human Use (ICH) Note for Guidance on Good Clinical Practice and approved by the appropriate Ethics Committees.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    01 Sep 2014
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    United Kingdom: 2
    Country: Number of subjects enrolled
    Belgium: 1
    Country: Number of subjects enrolled
    France: 50
    Worldwide total number of subjects
    53
    EEA total number of subjects
    51
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    23
    From 65 to 84 years
    30
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Fifty-three pts were randomised in 15 centres in 3 countries (France, Belgium and UK) between January 2015 and October 2018.

    Pre-assignment
    Screening details
    Before randomisation, standard examinations (biological, clinical, ECG) and quality of life evaluations (QLQ-C30 + GINET 21) as well as the EQ-5D questionnaire including the Spitzer scale were done. In terms of imaging, chest, abdomen and pelvis CT scan with early arterial timing, or abdominal and pelvic MRI with contrast + chest CT-scan with contr

    Period 1
    Period 1 title
    Randomized Patients (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Monitor, Data analyst, Carer, Assessor
    Blinding implementation details
    In order to guarantee blinding of the investigator and all the staff, all injections were administered by a specifically trained and qualified person (for example, a nurse) otherwise not involved in the study procedures in the centre. Pts were given a randomisation/treatment arm number according to their order of entry into the study by an Interactive Web Response System (IWRS).

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Placebo Arm
    Arm description
    The study treatment was initiated after randomisation, within the 6 weeks following the confirmation date of stable disease or objective response. Once the randomisation was performed, the patients received a single dose every 4 weeks (every 28 days).
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Injection
    Dosage and administration details
    The placebo injection consisted of a 0.9% saline solution provided as follows: • A 2 mL ampoule containing 1 mL of NaCl at 0.9% • An empty syringe of 0.5 ml with an automatic security system and a 20 mm needle of 1.2 mm external diameter and 1.0 mm internal diameter sealed in a laminate bag. The placebo was stored at the recommended temperature: between +2°C and +8°C. The instructions regarding the subcutaneous product injection were provided in a leaflet accompanying each batch. Both products were provided by the logistics department of CMC&E, Beaufour IPSEN Industry, 20 rue Ethe Virton, 28100 Dreux (France), and delivered to the study sites.

    Arm title
    Lanreotide Arm
    Arm description
    T
    Arm type
    Active comparator

    Investigational medicinal product name
    SOMATULINE LP 120 mg
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Injection
    Dosage and administration details
    This treatment was similar to the commercialised form available in France under the name SOMATULINE® LP 120 mg, apart from tertiary packaging and labelling. Treatment was provided in a pre-filled syringe of 0.5 mL with a 20 mm needle of 1.2 mm external diameter, sealed in a laminated bag and in a cardboard box. Each pre-filled syringe hadan automatic security system. Each 0.5 mL syringe contained a supersaturated acetate solution of lanreotide corresponding to 0.246 mg of lanreotide base/mg of solution, for subcutaneous injection of a 120 mg dose of lanreotide. The lanreotide was stored at the recommended temperature: between +2°C and +8°C. The instructions regarding the product injection were provided in a leaflet accompanying each batch.

    Number of subjects in period 1
    Placebo Arm Lanreotide Arm
    Started
    26
    27
    Treated Patients (mITT population)
    25
    27
    Completed
    25
    27
    Not completed
    1
    0
         Not treated
    1
    -

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Placebo Arm
    Reporting group description
    The study treatment was initiated after randomisation, within the 6 weeks following the confirmation date of stable disease or objective response. Once the randomisation was performed, the patients received a single dose every 4 weeks (every 28 days).

    Reporting group title
    Lanreotide Arm
    Reporting group description
    T

    Reporting group values
    Placebo Arm Lanreotide Arm Total
    Number of subjects
    26 27 53
    Age categorical
    Units: Subjects
        In utero
    0 0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0 0
        Newborns (0-27 days)
    0 0 0
        Infants and toddlers (28 days-23 months)
    0 0 0
        Children (2-11 years)
    0 0 0
        Adolescents (12-17 years)
    0 0 0
        Adults (18-64 years)
    14 9 23
        From 65-84 years
    12 18 30
        85 years and over
    0 0 0
    Age continuous
    Units: years
        median (inter-quartile range (Q1-Q3))
    62.5 (51 to 71) 66 (57 to 72) -
    Gender categorical
    Units: Subjects
        Female
    13 12 25
        Male
    13 15 28
    Gender
    Units: Subjects
        Male
    13 15 28
        Female
    13 12 25
    Subject analysis sets

    Subject analysis set title
    Placebo Arm
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    All randomised patients in the study who did not withdrew their consent before the randomisation. These patients were considered in the allocated group by randomisation, even if they receive a different treatment. mITT population was considered as the primary population for efficacy analysis.

    Subject analysis set title
    Lanreotide Arm
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    All randomised patients in the study who did not withdrew their consent before the randomisation. These patients were considered in the allocated group by randomisation, even if they receive a different treatment. mITT population was considered as the primary population for efficacy analysis.

    Subject analysis sets values
    Placebo Arm Lanreotide Arm
    Number of subjects
    25
    27
    Age categorical
    Units: Subjects
        In utero
        Preterm newborn infants (gestational age < 37 wks)
        Newborns (0-27 days)
        Infants and toddlers (28 days-23 months)
        Children (2-11 years)
        Adolescents (12-17 years)
        Adults (18-64 years)
    13
    9
        From 65-84 years
    12
    18
        85 years and over
    0
    0
    Age continuous
    Units: years
        median (inter-quartile range (Q1-Q3))
    Gender categorical
    Units: Subjects
        Female
        Male
    Gender
    Units: Subjects
        Male
    12
    15
        Female
    13
    12

    End points

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    End points reporting groups
    Reporting group title
    Placebo Arm
    Reporting group description
    The study treatment was initiated after randomisation, within the 6 weeks following the confirmation date of stable disease or objective response. Once the randomisation was performed, the patients received a single dose every 4 weeks (every 28 days).

    Reporting group title
    Lanreotide Arm
    Reporting group description
    T

    Subject analysis set title
    Placebo Arm
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    All randomised patients in the study who did not withdrew their consent before the randomisation. These patients were considered in the allocated group by randomisation, even if they receive a different treatment. mITT population was considered as the primary population for efficacy analysis.

    Subject analysis set title
    Lanreotide Arm
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    All randomised patients in the study who did not withdrew their consent before the randomisation. These patients were considered in the allocated group by randomisation, even if they receive a different treatment. mITT population was considered as the primary population for efficacy analysis.

    Primary: Rate of patients alive without progression at 6 months

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    End point title
    Rate of patients alive without progression at 6 months [1]
    End point description
    The primary endpoint for phase II is the rate of patients alive and progression free at 6 months, evaluated according to the results of imaging assessment done 6 months after the randomisation. This evaluation is done by the investigator according to RECI
    End point type
    Primary
    End point timeframe
    6 months after the randomisation
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: The study was a non-comparative study and was stopped prematurely at 53 patients. That's why no statistical analyses was done.
    End point values
    Placebo Arm Lanreotide Arm
    Number of subjects analysed
    25
    27
    Units: patients
        Progression and/or death
    11
    7
        Alive without Progression
    13
    19
        Not evaluable
    1
    1
    No statistical analyses for this end point

    Secondary: Progression-Free Survival

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    End point title
    Progression-Free Survival
    End point description
    PFS was defined as the time between randomisation and the date of the first event (radiological or clinical progression or death). Pts who were alive and progression-free were censored at the time of the last news
    End point type
    Secondary
    End point timeframe
    until the end of the follow-up or the apperance of progression or death
    End point values
    Placebo Arm Lanreotide Arm
    Number of subjects analysed
    25
    27
    Units: Months
        median (inter-quartile range (Q1-Q3))
    7.6 (3 to 9)
    19.4 (7.6 to 32.6)
    No statistical analyses for this end point

    Secondary: Overall Survival

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    End point title
    Overall Survival
    End point description
    Overall survival considered all deaths, and time was calculated from randomisation to death.
    End point type
    Secondary
    End point timeframe
    Until the end of the follow-up or death (Whatever the cause)
    End point values
    Placebo Arm Lanreotide Arm
    Number of subjects analysed
    25
    27
    Units: patients
        Death
    7
    2
        Alive
    18
    25
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    All AEs (related and unrelated, expected and unexpected) occurring in the course of the study, from the signature of the informed consent form and until 30 days after the last dose of the study drug were reported by the investigator.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    22.0
    Reporting groups
    Reporting group title
    Placebo arm
    Reporting group description
    All patients included in the mITT population having received at least one treatment injection. These patients were analysed in terms of the treatment received.

    Reporting group title
    Lanreotide Arm
    Reporting group description
    All patients included in the mITT population having received at least one treatment injection. These patients were analysed in terms of the treatment received.

    Serious adverse events
    Placebo arm Lanreotide Arm
    Total subjects affected by serious adverse events
         subjects affected / exposed
    3 / 25 (12.00%)
    5 / 27 (18.52%)
         number of deaths (all causes)
    7
    2
         number of deaths resulting from adverse events
    0
    0
    General disorders and administration site conditions
    Pyrexia
         subjects affected / exposed
    0 / 25 (0.00%)
    1 / 27 (3.70%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Peritoneal Haemorraghe
         subjects affected / exposed
    0 / 25 (0.00%)
    1 / 27 (3.70%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haemorrhage
         subjects affected / exposed
    0 / 25 (0.00%)
    1 / 27 (3.70%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Abdominal pain upper
         subjects affected / exposed
    0 / 25 (0.00%)
    1 / 27 (3.70%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Constipation
         subjects affected / exposed
    1 / 25 (4.00%)
    0 / 27 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Small intestinal obstruction
         subjects affected / exposed
    1 / 25 (4.00%)
    0 / 27 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Cholangitis
         subjects affected / exposed
    0 / 25 (0.00%)
    2 / 27 (7.41%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Malignant biliary obstruction
         subjects affected / exposed
    0 / 25 (0.00%)
    1 / 27 (3.70%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cholescystitis acute
         subjects affected / exposed
    0 / 25 (0.00%)
    1 / 27 (3.70%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Hypercalcaemia
         subjects affected / exposed
    0 / 25 (0.00%)
    1 / 27 (3.70%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypokalaemia
         subjects affected / exposed
    1 / 25 (4.00%)
    0 / 27 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Placebo arm Lanreotide Arm
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    22 / 25 (88.00%)
    26 / 27 (96.30%)
    Vascular disorders
    Flushing
         subjects affected / exposed
    1 / 25 (4.00%)
    2 / 27 (7.41%)
         occurrences all number
    1
    2
    Hot flush
         subjects affected / exposed
    1 / 25 (4.00%)
    2 / 27 (7.41%)
         occurrences all number
    1
    2
    Nervous system disorders
    Headache
         subjects affected / exposed
    4 / 25 (16.00%)
    2 / 27 (7.41%)
         occurrences all number
    4
    2
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    2 / 25 (8.00%)
    1 / 27 (3.70%)
         occurrences all number
    2
    1
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    7 / 25 (28.00%)
    12 / 27 (44.44%)
         occurrences all number
    7
    12
    Fatigue
         subjects affected / exposed
    7 / 25 (28.00%)
    8 / 27 (29.63%)
         occurrences all number
    7
    8
    Injection site reaction
         subjects affected / exposed
    1 / 25 (4.00%)
    4 / 27 (14.81%)
         occurrences all number
    1
    4
    Oedema peripheral
         subjects affected / exposed
    1 / 25 (4.00%)
    2 / 27 (7.41%)
         occurrences all number
    1
    2
    Gastrointestinal disorders
    Abdominal distension
         subjects affected / exposed
    3 / 25 (12.00%)
    9 / 27 (33.33%)
         occurrences all number
    3
    9
    Abdominal pain
         subjects affected / exposed
    8 / 25 (32.00%)
    14 / 27 (51.85%)
         occurrences all number
    8
    14
    Constipation
         subjects affected / exposed
    5 / 25 (20.00%)
    4 / 27 (14.81%)
         occurrences all number
    5
    4
    Diarrhoea
         subjects affected / exposed
    7 / 25 (28.00%)
    20 / 27 (74.07%)
         occurrences all number
    7
    20
    Nausea
         subjects affected / exposed
    4 / 25 (16.00%)
    7 / 27 (25.93%)
         occurrences all number
    4
    7
    Vomiting
         subjects affected / exposed
    1 / 25 (4.00%)
    4 / 27 (14.81%)
         occurrences all number
    1
    4
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea
         subjects affected / exposed
    1 / 25 (4.00%)
    4 / 27 (14.81%)
         occurrences all number
    1
    4
    Skin and subcutaneous tissue disorders
    Dry skin
         subjects affected / exposed
    1 / 25 (4.00%)
    3 / 27 (11.11%)
         occurrences all number
    1
    3
    Pruritus
         subjects affected / exposed
    0 / 25 (0.00%)
    3 / 27 (11.11%)
         occurrences all number
    0
    3
    Psychiatric disorders
    Insomnia
         subjects affected / exposed
    2 / 25 (8.00%)
    3 / 27 (11.11%)
         occurrences all number
    2
    3
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    1 / 25 (4.00%)
    2 / 27 (7.41%)
         occurrences all number
    1
    2
    Back Pain
         subjects affected / exposed
    0 / 25 (0.00%)
    6 / 27 (22.22%)
         occurrences all number
    0
    6
    Infections and infestations
    Bronchitis
         subjects affected / exposed
    3 / 25 (12.00%)
    3 / 27 (11.11%)
         occurrences all number
    3
    3
    Metabolism and nutrition disorders
    Hyperglycaemia
         subjects affected / exposed
    4 / 25 (16.00%)
    5 / 27 (18.52%)
         occurrences all number
    4
    5
    Hypoglycaemia
         subjects affected / exposed
    2 / 25 (8.00%)
    2 / 27 (7.41%)
         occurrences all number
    2
    2

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? No

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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