Randomized phase III trial exploring the use of long-acting release octreotide in the prevention of chemotherapy-induced diarrhea in patients with colorectal cancer: the LARCID trial

J Clin Oncol. 2014 Apr 1;32(10):1006-11. doi: 10.1200/JCO.2013.50.8077. Epub 2014 Feb 10.

Abstract

Purpose: Chemotherapy-induced diarrhea (CID) is a relatively common adverse event in the treatment of patients with colorectal cancer. The LAR for Chemotherapy-Induced Diarrhea (LARCID) trial evaluated the efficacy and safety of long-acting release octreotide (octreotide LAR) for the prevention of CID in this population.

Patients and methods: Patients with colorectal cancer starting adjuvant or first-line treatment with a chemotherapy combination containing fluorouracil, capecitabine, and/or irinotecan were randomly assigned to receive octreotide LAR 30 mg intramuscularly every 4 weeks (experimental arm) or the physician's treatment of choice in case of diarrhea (control arm).

Results: A total of 139 patients were randomly assigned, most of whom received fluorouracil- and oxaliplatin-containing chemotherapy regimens. The rate of diarrhea was 76.1% in the experimental group (n = 68) and 78.9% in the control group (n = 71). Treatment with octreotide LAR did not prevent or reduce the severity of CID. Treatment choices for diarrhea management included loperamide in the majority of patients. No benefit from octreotide LAR was identified in terms of need for diarrhea treatment, opioids, or intravenous hydration or in the rate of hospitalization or quality of life.

Conclusion: This study could not prove the efficacy of octreotide LAR in the prevention of CID.

Trial registration: ClinicalTrials.gov NCT00582426.

Publication types

  • Clinical Trial, Phase III
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antidiarrheals / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Camptothecin / administration & dosage
  • Camptothecin / analogs & derivatives
  • Capecitabine
  • Colorectal Neoplasms / drug therapy*
  • Delayed-Action Preparations
  • Deoxycytidine / administration & dosage
  • Deoxycytidine / analogs & derivatives
  • Diarrhea / chemically induced
  • Diarrhea / prevention & control*
  • Female
  • Fluorouracil / administration & dosage
  • Fluorouracil / analogs & derivatives
  • Humans
  • Irinotecan
  • Loperamide / therapeutic use
  • Male
  • Middle Aged
  • Octreotide / therapeutic use*
  • Quality of Life
  • Severity of Illness Index
  • Young Adult

Substances

  • Antidiarrheals
  • Delayed-Action Preparations
  • Deoxycytidine
  • Capecitabine
  • Loperamide
  • Irinotecan
  • Octreotide
  • Fluorouracil
  • Camptothecin

Associated data

  • ClinicalTrials.gov/NCT00582426