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Trial registered on ANZCTR
Registration number
ACTRN12617000801314
Ethics application status
Approved
Date submitted
25/05/2017
Date registered
31/05/2017
Date last updated
31/05/2017
Type of registration
Retrospectively registered
Titles & IDs
Public title
Evaluating Pancreatic Enzyme Replacement Therapy (PERT) supplements in pancreatic cancer treatment
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Scientific title
An evaluation of pancreatic enzyme supplementation in treating pancreatic cancer symptoms in the palliative setting
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Secondary ID [1]
291993
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nil
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Universal Trial Number (UTN)
U1111-1196-7366
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Trial acronym
nil
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Linked study record
nil
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Health condition
Health condition(s) or problem(s) studied:
Pancreatic cancer
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Malabsorption
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Condition category
Condition code
Cancer
302774
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0
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Pancreatic
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Oral and Gastrointestinal
302871
302871
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
1. This is an observational trial of best practice. This is not an interventional trial. Malabsorption symptoms - each patient will be assessed by the dietician, or clinical nurse specialist or palliative physician for malabsorption and offered treatment with enzyme replacement therapy (PERT). If the patient consents to taking PERT, symptoms will be recorded at the initial assessment and at 7 and 21 days after taking PERT or until the following endpoints - the patient is unable to swallow tablets, is discharged from the service or dies. Any side effects of PERT (e.g. constipation) will be also noted.
2. Nutritional assessment - the dietician will perform a nutritional assessment and recommend dietary changes based on the patient’s identified needs. If the patient agrees to commence PERT, the dietician will provide an education pamphlet on the action of PERT for the patient and carer. The dietician will also liaise with the Hospice Medical Specialist regarding appropriate dosages of PERT to be prescribed according to the patient’s meal requirements. The effectiveness of PERT on malabsorption symptoms will be reviewed weekly and dosages increased through GP liaison.
3. This study will also measure quality of life in this patient group using the EORTC QLQ C30 and PAN26 instruments. The PAN26 instrument has been tested internationally and comprises 26 questions assessing pain, dietary changes, jaundice, altered bowel habit, emotional problems related to pancreatic cancer, and other symptoms (cachexia, indigestion, flatulence, dry mouth, taste changes). Measurement of quality of life will be recorded at the initial visit and then at 7 and 21 days after taking PERT or until the following endpoints - the patient is unable to swallow tablets, is discharged from the service or dies.
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Intervention code [1]
298115
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Not applicable
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Quality of life using 2 validated tools- EORTC Q-30 and PAN 26. The data analysis was performed according to the manuals of each tool.
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Assessment method [1]
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Timepoint [1]
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Initial visit, then 7 days and 21 days
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Secondary outcome [1]
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There was no secondary outcome.
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Assessment method [1]
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Timepoint [1]
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There was no secondary outcome timepoint.
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Eligibility
Key inclusion criteria
Patients with advanced pancreatic cancer referred to Nurse Maude's Palliative Care (NMPC) service will be eligible for the study until 50 patients in total have been recruited. The intervention will be given to patients who have had pancreatic surgery and those who have not, as exocrine pancreatic insufficiency (EPI) can be caused by tumour-related pancreatic duct obstruction (Fieker et al, 2009).
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Those patients who have cognitive impairment or are unable to complete the quality of life questionnaire for any reason, including language difficulties, will be excluded..
Patients who have been prescribed PERT already.
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Study design
Purpose
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Duration
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Selection
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Timing
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Statistical methods / analysis
The EORTC QLQ-C30 and QLQ-PAN26 results were analysed in accordance with the EORTC manual . Missing data was assigned the mean value of the answered items of each domain if more than 50% of the items were completed. There were no clear patterns evident for the missing data except that many did not complete the sex domain questions and therefore these have not been summarised. Mean changes for each domain between the baseline and two follow-up periods were analysed using paired t-tests. All analyses were undertaken using SPSS v22.0 (SPSS Inc., Armonk, NY, USA). A two tailed p-value <0.05 was taken to indicate statistical significance.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
31/05/2013
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Date of last participant enrolment
Anticipated
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Actual
27/03/2015
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Date of last data collection
Anticipated
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Actual
16/04/2015
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Sample size
Target
50
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Accrual to date
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Final
44
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
8910
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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Canterbury Medical research Foundation
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Address [1]
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Level 1/230 Antigua Street, Christchurch 8011
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Country [1]
296503
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New Zealand
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Primary sponsor type
Charities/Societies/Foundations
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Name
Nurse Maude Association
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Address
15 Mansfield Ave, Merivale, Christchurch, NZ 8011
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
295465
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Country [1]
295465
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Nurse Maude Ethics Advisory Committee
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Ethics committee address [1]
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15 Mansfield Ave, Merivale,, Christchurch, New Zealand 8146
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
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01/04/2013
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Approval date [1]
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03/05/2013
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Ethics approval number [1]
297728
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Summary
Brief summary
Introduction: Advanced pancreatic cancer has a poor prognosis and is associated with a constellation of symptoms leading to poor quality of life. Malabsorption (MA) due to pancreatic exocrine dysfunction is common and can cause bloating/fullness, flatulence, weight loss and steatorrhoea, and may develop without obvious clinical signs. Pancreatic enzyme replacement therapy, which can alleviate MA, is underutilised in advanced pancreatic cancer (APC). A recent study found 80% of advanced pancreatic cancer patients were not prescribed PERT, in spite of exhibiting symptoms consistent with MA. Objectives: To determine the efficacy of PERT in improving MA symptoms, and consequent impact on global and pancreas-specific quality of life (QOL) in APC patients. Method: Consecutive patients with advanced pancreatic cancer referred to Nurse Maude Hospice Palliative Care Service not previously prescribed PERT were enrolled on this study. PERT (CREON 25,000) was initiated following dietary and symptom assessment by a specialist dietitian. QOL was assessed using the EORTC-QLQ C30 v3 and PAN26 questionnaires at baseline and at 1 and 3 weeks of PERT
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Trial website
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Trial related presentations / publications
Landers A, Brown H, Strother M (2016) Pancreatic enzyme replacement therapy (PERT) in advanced pancreatic cancer (APC). Multidisciplinary Association of Supportive Care in Cancer (MASCC) Conference. Adelaide, Australia Landers A, Brown H, Strother M (2015) Pancreatic enzyme replacement therapy (PERT): an underutilised therapy for advanced pancreatic cancer New Zealand Society of Oncology Conference. Christchurch, New Zealand
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Public notes
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Contacts
Principal investigator
Name
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Dr Amanda Landers
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Address
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Nurse Maude Association, 15 Mansfield Ave, Merivale, Christchurch 8164
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Country
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New Zealand
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Phone
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+64 3 375 4274
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Amanda Landers
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Address
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Nurse Maude Association, 15 Mansfield Ave, Merivale, Christchurch 8164
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Country
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New Zealand
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Phone
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+64 3 375 4274
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Amanda Landers
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Address
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Nurse Maude, 15 Mansfield Ave, Merivale, Christchurch 8164
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Country
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New Zealand
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Phone
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+64 3 375 4274
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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