Trial Outcomes & Findings for Study of Adrenalectomy Versus Observation for Subclinical Hypercortisolism (NCT NCT02001051)

NCT ID: NCT02001051

Last Updated: 2018-06-14

Results Overview

Normalization and/or improvement of metabolic complications including hypertension, diabetes, osteoporosis, hypercholesterolemia and/or obesity after adrenalectomy is defined as 35% of patients who improve with surgery versus 5% who do not have surgery.

Recruitment status

TERMINATED

Study phase

PHASE2

Target enrollment

4 participants

Primary outcome timeframe

Assessed at 6 months

Results posted on

2018-06-14

Participant Flow

One participant was enrolled to the delayed operative arm but did not complete. The participant did not have biochemical evidence of subclinical Cushing's and therefore was not eligible.

Participant milestones

Participant milestones
Measure
Operative Arm
operative arm Adrenalectomy: Surgery to remove tumor when enrolled in the protocol.
Delayed Operative Arm Followed by Surgery
delayed operative arm Observation: Observation for 6 months prior to surgery
Overall Study
STARTED
2
2
Overall Study
COMPLETED
2
1
Overall Study
NOT COMPLETED
0
1

Reasons for withdrawal

Reasons for withdrawal
Measure
Operative Arm
operative arm Adrenalectomy: Surgery to remove tumor when enrolled in the protocol.
Delayed Operative Arm Followed by Surgery
delayed operative arm Observation: Observation for 6 months prior to surgery
Overall Study
Deemed not eligible following enrollment
0
1

Baseline Characteristics

Study of Adrenalectomy Versus Observation for Subclinical Hypercortisolism

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Operative Arm
n=2 Participants
operative arm Adrenalectomy: Surgery to remove tumor when enrolled in the protocol.
Delayed Operative Arm Followed by Surgery
n=2 Participants
delayed operative arm Observation: Observation for 6 months prior to surgery
Total
n=4 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
2 Participants
n=5 Participants
2 Participants
n=7 Participants
4 Participants
n=5 Participants
Age, Categorical
>=65 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Continuous
48.56 years
STANDARD_DEVIATION 11.68 • n=5 Participants
43.25 years
STANDARD_DEVIATION 12.09 • n=7 Participants
45.91 years
STANDARD_DEVIATION 10.18 • n=5 Participants
Sex: Female, Male
Female
1 Participants
n=5 Participants
1 Participants
n=7 Participants
2 Participants
n=5 Participants
Sex: Female, Male
Male
1 Participants
n=5 Participants
1 Participants
n=7 Participants
2 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
1 Participants
n=5 Participants
2 Participants
n=7 Participants
3 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
White
2 Participants
n=5 Participants
1 Participants
n=7 Participants
3 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Region of Enrollment
United States
2 Participants
n=5 Participants
2 Participants
n=7 Participants
4 Participants
n=5 Participants

PRIMARY outcome

Timeframe: Assessed at 6 months

Normalization and/or improvement of metabolic complications including hypertension, diabetes, osteoporosis, hypercholesterolemia and/or obesity after adrenalectomy is defined as 35% of patients who improve with surgery versus 5% who do not have surgery.

Outcome measures

Outcome measures
Measure
Operative Arm
n=2 Participants
operative arm Adrenalectomy: Surgery to remove tumor when enrolled in the protocol.
Delayed Operative Arm
n=1 Participants
delayed operative arm Observation: Observation for 6 months prior to surgery
Proportion of Patients That Have Normalization and/or Improvement of Metabolic Complications After Adrenalectomy
1 proportion of participants
0 proportion of participants

PRIMARY outcome

Timeframe: Date treatment consent signed to date off study, approximately 39 months and 27 days

Population: No toxicities were experienced by any participants on this trial.

Here is the count of participants with serious and non-serious adverse events assessed by the Common Terminology Criteria in Adverse Events (CTCAE v4.0). A non-serious adverse event is any untoward medical occurrence. A serious adverse event is an adverse event or suspected adverse reaction that results in death, a life threatening adverse drug experience, hospitalization, disruption of the ability to conduct normal life functions, congenital anomaly/birth defect or important medical events that jeopardize the patient or subject and may require medical or surgical intervention to prevent one of the previous outcomes mentioned.

Outcome measures

Outcome measures
Measure
Operative Arm
n=2 Participants
operative arm Adrenalectomy: Surgery to remove tumor when enrolled in the protocol.
Delayed Operative Arm
n=1 Participants
delayed operative arm Observation: Observation for 6 months prior to surgery
Count of Participants With Serious and Non-serious Adverse Events Assessed by the Common Terminology Criteria in Adverse Events (CTCAE v4.0)
0 Participants
0 Participants

SECONDARY outcome

Timeframe: Assessed at 6 months

Patients who were tested for and found to have adrenal cancer after adrenalectomy.

Outcome measures

Outcome measures
Measure
Operative Arm
n=2 Participants
operative arm Adrenalectomy: Surgery to remove tumor when enrolled in the protocol.
Delayed Operative Arm
n=1 Participants
delayed operative arm Observation: Observation for 6 months prior to surgery
Proportion of Patients Who Are Found to Have Adrenal Cancer After Adrenalectomy
0 proportion of participants
0 proportion of participants

SECONDARY outcome

Timeframe: Assessed at 6 months

Proportion of patients who were diagnosed with subclinical hypercortisolism by FDG/PET/CT scan.

Outcome measures

Outcome measures
Measure
Operative Arm
n=2 Participants
operative arm Adrenalectomy: Surgery to remove tumor when enrolled in the protocol.
Delayed Operative Arm
n=1 Participants
delayed operative arm Observation: Observation for 6 months prior to surgery
Proportion of Patients Who Were Diagnosed With Subclinical Hypercortisolism by Fluorodeoxyglucose (FDG) Positron Emission Tomography (PET)/Computed Tomography (CT) Scan
1 proportion of participants
1 proportion of participants

SECONDARY outcome

Timeframe: Assessed at 6 months

Population: This outcome measure was not done. Data was collected and not analyzed because we were not able to determine the optimal test since we only had four patients enrolled, and three patients on study (e.g. low accrual). Therefore, we couldn't do a head to head comparison calculating the sensitivity and specificity.

An assessment of whether 1 mg dexamethasone suppression test, basal adrenocorticotropic hormone (ACTH), midnight salivary cortisol, or urinary free cortisol is the optimal test to diagnose patients with subclinical hypercortisolism.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Assessed at 6 months

QOL questionnaires were provided to participants to assess well being pre and post operatively. Participants take a self-administered questionnaire to assess physical and mental health according to Cushing's Quality of Life Questionnaire. The score has a minimum of 12 and maximum of 60. A higher score indicates an improved quality of life.

Outcome measures

Outcome measures
Measure
Operative Arm
n=2 Participants
operative arm Adrenalectomy: Surgery to remove tumor when enrolled in the protocol.
Delayed Operative Arm
n=1 Participants
delayed operative arm Observation: Observation for 6 months prior to surgery
Proportion of Patients That Have Improvement in Quality of Life (QOL) After Adrenalectomy Compared to Medical Therapy
2 proportion of participants
0 proportion of participants

SECONDARY outcome

Timeframe: Assessed at 6 months

Proportion of patients that developed deep venous thrombosis with subclinical hypercortisolism regardless of whether the participants received adrenalectomy or not.

Outcome measures

Outcome measures
Measure
Operative Arm
n=2 Participants
operative arm Adrenalectomy: Surgery to remove tumor when enrolled in the protocol.
Delayed Operative Arm
n=1 Participants
delayed operative arm Observation: Observation for 6 months prior to surgery
Proportion of Patients That Developed Deep Venous Thrombosis With Subclinical Hypercortisolism
0 proportion of participants
0 proportion of participants

SECONDARY outcome

Timeframe: Assessed at 6 months

A skin biopsy and skin ultrasound were done to measure the dermal layer of skin to look for a decrease in the thickness of skin as compared to normal values reported in the literature as measured in millimeters of thickness. Diagnostic sensitivity and changes in skin thickness were assessed.

Outcome measures

Outcome measures
Measure
Operative Arm
n=2 Participants
operative arm Adrenalectomy: Surgery to remove tumor when enrolled in the protocol.
Delayed Operative Arm
n=1 Participants
delayed operative arm Observation: Observation for 6 months prior to surgery
Correlation Between Dermal Thickness and Patients With Subclinical Hypercortisolism
0 Participants
0 Participants

Adverse Events

Operative Arm

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Delayed Operative Arm

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. Dhaval Patel

National Cancer Institute

Phone: 301-827-4989

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place