“I think it’s really important that people keep signing up to these type of trials to push research forward.”
A trial of telotristat etiprate for people who have symptoms of carcinoid syndrome (TELECAST)
Please note - this trial is no longer recruiting patients. We hope to add results when they are available.
This trial is looking at a new drug called telotristat etiprate (also known as LX1606) for people who have symptoms of carcinoid syndrome.
A carcinoid tumour can produce a substance called serotonin which causes symptoms such as diarrhoea, frequent bowel movements, tummy (abdominal) pain and redness of the face (flushing). This is known as carcinoid syndrome.
Doctors may treat carcinoid syndrome with drugs called somatostatin analogues. These drugs can help, but after a while, they may stop working. There are currently no other treatments available if somatostatin analogues stop working, or for people who can’t or don’t want to take them.
Researchers are looking for new treatments to help people in these situations. In this trial, they are looking at a drug called telotristat etiprate which reduces the production of serotonin.
The aims of this trial are to
- See if different doses of telotristat etiprate can help to relieve the symptoms of carcinoid syndrome
- Learn more about the side effects
Who can enter
You may be able to enter this trial if you
- Have a neuroendocrine tumour that has spread from where it first started and can be measured on a CT scan or MRI scan
- Have carcinoid syndrome
- Have satisfactory blood test results
- Are at least 18 years old
- Are willing to use reliable contraception during the trial and for 3 months afterwards if there is any chance you or your partner could become pregnant
As well as the above, if you are currently having a somatostatin analogue, you must be having fewer than 4 bowel movements each day and have at least 1 of the following symptoms
- Passing a soft stool or diarrhoea on 4 or more days a week
- Facial flushing on average twice a day (or more)
- Tummy (abdominal) pain every day
- Feeling sick on at least 1 in every 5 days (or more)
- Have a large amount of a substance called u5-HIAA in your urine (the trial team will test for this)
If your aren’t currently having a somatostatin analogue, you must have at least 1 of the symptoms listed above, or be having at least 4 bowel movements on average each day.
You cannot enter this trial if you
- Have watery diarrhoea more than 12 times a day that is causing problems such as dehydration or low blood pressure – the trial doctor can advise you about this
- Have an infection in your bowel – the trial team will test a stool sample to check for this
- Need help to care for yourself (you have a Karnofsky performance status of 60% or less)
- Have had drug treatment aiming to reduce the size of your tumour in the last 4 weeks, or treatment such as radiotherapy or hepatic embolisation in the last 12 weeks
- Have had major surgery in the last 8 weeks
- Have had surgery to remove some of your small bowel, or have ever had a medical condition that affects how you absorb nutrients from food (short bowel syndrome)
- Have had problems with constipation in the last 2 years
- Have already had LX1606 (telotristat etiprate)
- Have had another experimental drug in the last month or treatment with an antibody in the last 3 months
- Have certain heart problems – the trial team can advise you about this
- Have abused drugs or alcohol in the last 2 years
- Have any other medical condition or test result that the trial team think could make it unsafe for you to take part
- Are pregnant or breastfeeding
This phase 3 trial will recruit about 60 people. The people taking part are put into treatment groups by a computer. Neither you nor your doctor will be able to decide which group you are in. And neither of you will know which group you are in. This is called a double blind trial.
In this trial there are 3 treatment groups
- A lower dose of telotristat etiprate
- A higher dose of telotristat etiprate
- A dummy drug (
Whichever group you are in, you take 2 tablets, 3 times a day. After 12 weeks of treatment, everybody can start having the higher dose of telotristat etiprate. This is called the extension period of the trial and lasts for about 9 months (36 weeks).
Before you start taking the tablets, the trial team want to gather information about any symptoms you have. They will do this for up to 4 weeks. This is called the run-in period.
If you are taking a somatostatin analogue when you join the trial, your doctors can’t change the dose during the run-in period or during the first 12 weeks of treatment. If you aren’t taking a somatostatin analogue when you join the trial, you can’t start taking one during the run-in period or during the first 12 weeks of treatment.
The trial team will give you an electronic diary which is like a mobile phone. You use this to keep track of how you feel and how many bowel movements you have each day. You start keeping the diary at least 3 weeks before you start the tablets. And you must use it every day throughout the trial.
The researchers will ask your permission to take an extra blood sample to study your DNA to learn more about how genes affects peoples’ responses to telotristat etiprate. You don’t have to give this extra sample for research if you don’t want to. You can still take part in the main trial.
You see the trial team and have some tests before you start treatment. The tests include
- Physical examination
- Heart trace (
- Blood tests
- Urine test and stool test
During the first 12 weeks of treatment, you see the trial team up to 4 times. At these visits you have a physical examination, blood tests and urine tests. You may also have an ECG. And the trial team may ask you to collect all the urine you pass in a 24 hour period.
During the 9 months of the extension period you see the trial team 8 times. At each visit you have a physical examination, blood tests and urine tests. You may have more ECGs.
When you finish treatment, you see the trial team again 2 weeks later. They will ask you to collect all the urine you pass in a 24 hour period. You also have more blood tests and you may have an ECG.
As telotristat etiprate is a new drug, there may be side effects we don’t know about yet. In earlier trials looking at this drug for carcinoid syndrome, the most common side effects have been
How to join a clinical trial
Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.
Professor Martyn Caplin
Experimental Cancer Medicine Centre (ECMC)