Efficacy of PERT for PEI in Unresectable Pancreatic Cancer.

NCT ID: NCT06099119

Last Updated: 2025-06-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE4

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-02-20

Study Completion Date

2026-12-31

Brief Summary

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\- This will a be an open label, multicentre, randomized, controlled study in patients with unresectable pancreatic cancer, locally advanced or metastatic, with significant weight loss, and the tumour located in the head of the pancreas associated with dilated main pancreatic duct. Pancreatic Exocrine Replacement Therapy (PERT) in these patients will be given on top of other required therapies (best standard of care, BSC), including oncologic therapies, diabetes mellitus therapies and acid suppressants and nutritional support as appropriate. The duration of the study will be up to six months.

Consecutive patients meeting inclusion criteria and none of the exclusion criteria will be evaluated for the study. Those patients signing the informed consent for study participation will be randomized to one of the following two arms:

* The experimental arm will receive the best standard of care (BSC) and PERT (capsules containing pancreatin 35,000 Ph.U.) at a fixed dose of 3 capsules with main meals (breakfast, lunch and dinner) and 2 capsules with snacks over 6 months.
* The control arm will receive the BSC over 3 months, followed by a further 3-month open uncontrolled phase of BSC + PERT at the dose mentioned above.

All patients will receive in addition a proton pump inhibitor (PPI) bid (any PPI at standard dose is acceptable -omeprazole 20 mg, lansoprazole 30 mg, pantoprazole 40 mg, rabeprazole 20 mg, esomeprazole 40 mg) while on PERT, 20-30 minutes before breakfast and dinner.

To make the two arms comparable, patients will be stratified in two groups (locally advanced and metastatic pancreatic cancer) for randomization using computer generated random numbers.

Detailed Description

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Conditions

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Unresectable Pancreatic Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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experimental arm

Creon 35.000 Ph.U (R) at a fixed dose of 3 capsules orally with main meals (breakfast, lunch and dinner) and 2 capsules with snacks over 6 months post randomization.

Group Type EXPERIMENTAL

creon 35.000 Ph.U (R)

Intervention Type DRUG

Experimental arm: Pancreatic Exocrine Replacement Therapy (PERT) treatment during the six months study period.

control arm

Creon 35.000 Ph.U (R) at a fixed dose of 3 capsules orally with main meals (breakfast, lunch and dinner) and 2 capsules with snacks during the last 3 months post randomization.

Group Type OTHER

Best Standarard of Care

Intervention Type OTHER

Control arm: no treatment over 3 months from randomization. PERT from third month untill last visit in sixt month

Interventions

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creon 35.000 Ph.U (R)

Experimental arm: Pancreatic Exocrine Replacement Therapy (PERT) treatment during the six months study period.

Intervention Type DRUG

Best Standarard of Care

Control arm: no treatment over 3 months from randomization. PERT from third month untill last visit in sixt month

Intervention Type OTHER

Other Intervention Names

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creon 35.000 Ph.U (R)

Eligibility Criteria

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Inclusion Criteria

1. Pathologically confirmed unresectable, locally advanced or metastatic, pancreatic cancer.
2. Tumour located in the head of the pancreas.
3. Dilated main pancreatic duct confirmed by imaging methods (CT scan, MRI and/or EUS).
4. Significant weight loss (≥5% of the usual body weight) at screening.
5. Life expectancy of at least six months at screening.
6. Signed informed consent to the study.

Exclusion Criteria

1. Hypersensitivity to pancreatin of porcine origin or to any of the excipients.
2. Patients on neoadjuvant therapy, or in whom neoadjuvant therapy is planned.
3. Patients already on PERT.
4. Prior history of upper gastrointestinal or pancreatic surgery.
5. Short life expectancy (shorter than 6 months).
6. Patients on second line or beyond chemotherapy (those who failed with first line chemotherapy therapy).
7. Patients in whom a pancreatic stent has been placed.
8. Unsolved gastric outlet obstruction.
9. Unwillingness to participate in the study.
10. Inability to comply with the study visits and study protocol, whatever the reason.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Complejo Hospitalario de Navarra

OTHER

Sponsor Role collaborator

Karolinska Institutet

OTHER

Sponsor Role collaborator

San Raffaele University Hospital, Italy

OTHER

Sponsor Role collaborator

Beaujon Hospital

OTHER

Sponsor Role collaborator

Hospital Clinico Universitario de Santiago

OTHER

Sponsor Role lead

Responsible Party

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J. Enrique Domínguez-Muñoz

Prof. PhD. MD.

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Istituto di Ricovero e Cura Carattere Scientifico San Raffaele

Milan, Milan, Italy

Site Status RECRUITING

University Hospital of Santiago de Compostela

Santiago de Compostela, A Coruna, Spain

Site Status RECRUITING

Hospital Universitario de Navarra

Pamplona, Navarre, Spain

Site Status RECRUITING

Karolinska Institutet

Stockholm, Stockholm County, Sweden

Site Status NOT_YET_RECRUITING

Countries

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Italy Spain Sweden

Central Contacts

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J. Enrique Dominguez-Munoz, PhD, MD

Role: CONTACT

+34981951364

Facility Contacts

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MhD

Role: primary

+39 06 660581

J. Enrique Dominguez-Munoz, PhD, MD

Role: primary

+34981951364

MhD

Role: primary

848422222

MhD

Role: primary

+46 8 524 800 00

Other Identifiers

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PEI004/2021

Identifier Type: -

Identifier Source: org_study_id

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