Escitalopram to Placebo in Patients With Localized Pancreatic Cancer

Phase 2

Terminated

• Conditions: Pancreatic Ductal Adenocarcinoma; Periampullary Cancer
• Interventions: Other: Placebo; Drug: Escitalopram

• Registration Number: NCT05289830
• Lead Sponsor: Case Comprehensive Cancer Center

Brief Summary

Use of antidepressants for participants with localized pancreatic and periampullary cancer receiving neoadjuvant therapy.

Detailed Description

Anti-depressants have been shown to be beneficial in cancer participants. They reduce depressive symptoms and improve quality of life. Randomized trials have shown that antidepressants can reduce the development of depression in non-depressed participants with breast, melanoma, and head and neck cancers. It has been shown that treating depression can impact survival in cancer participants. Additionally, depressed pancreatic cancer participants have worse survival. Therefore, anti-depressants may also have implications for cancer treatment.

Study Timeline

• Study First Submitted: 2022-03-11
• Study First Submitted QC: 2022-03-11
• Study First Posted: 2022-03-21
• Study Start: 2022-08-05
• Primary Completion: 2023-08-27
• Study Completion: 2023-08-27
• Status Verified: 2024-06
• Last Update Submitted: 2024-06-17
• Last Update Posted: 2024-06-18

Recruitment & Eligibility

• Status: TERMINATED
• Sex: All
• Target Recruitment: 4

Inclusion Criteria

1. Subjects must have histologically or cytologically confirmed localized or locally advanced pancreatic ductal adenocarcinoma or other periampullary adenocarcinoma (bile duct, duodenal, ampullary)
2. Subjects must not currently be on an antidepressant, anti-anxiety, anti-bipolar, or anti-psychotic medicine
3. Aged 18-80 years.
4. ECOG PS (Eastern Cooperative Oncology Group Performance Status) score of 0-2
5. Planned to have at least 12 weeks of neoadjuvant chemotherapy as standard of care cancer treatment
6. No diagnosis of bipolar disease
7. Willing to comply with all study procedures and be available for the duration of the study
8. Subjects must be mentally competent and must have the ability to understand and the willingness to sign a written informed consent document.

Exclusion Criteria

1. Patients under the age of 18 or over 80

2. Metastatic pancreatic or other periampullary cancer

3. Resection of pancreatic cancer within the past year prior to study enrollment or planned surgery within the next 12 weeks.

4. Currently on an antidepressant, anti-anxiety, anti-bipolar or anti-psychotic medicine. Patients who have taken MAOIs (Monoamine Oxidase Inhibitors) within the past 6 months are excluded.

5. Patients with a history of seizure disorder

6. Patients with a recent medical history of myocardial infarction or unstable heart disease

7. Patients with a history of QTc prolongation or torsade de points, a baseline QTc

   1. interval of > 500ms, a history of drug-induced QTc prolongation or congenital long QT
   2. syndrome

8. Patients with Child-Pugh score of B or C

9. Patients with moderate to severe renal disease with a GFR (glomerular filtration rate) < 45.

10. Patients who cannot ingest oral medication

11. Patients with any history of mania

12. Known allergy to escitalopram

13. Pregnancy or lactation

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Participants receiving Placebo	Placebo	-
Participants receiving Escitalopram	Escitalopram	-

Primary Outcome Measures

Name	Time	Method
Change in the rate of depression	12 weeks from the start of treatment	The rate of depression will be measured using the Quick Inventory of Depressive Symptoms (QIDS) survey. This survey has 16 questions that are specific to the symptomatology of depression. Answers are given in the form of a four-point Likert scale ranging from 0-3, with zero relating to a standard sense of well-being and three correlating to the greatest feelings of depression. Depression is reflected by a score ≥ 11 (moderate depression or worse).

Secondary Outcome Measures

Name	Time	Method
Quality of Life using FACT-Hep (The Functional Assesment of Cancer Therapy-Hepatobiliary) survey	Up to 3 years from the treatment date	The FACT-Hep has 27 general questions and 18 questions that are specific to hepatopancreatobiliary cancer, for a total of 45 questions. The general questions span four domains: physical, social/family, emotional, and functional well-being 21. It requires less than 10 minutes to complete and targets the 6th-grade reading level. Answers are given in the form of a five-point Likert scale as follows: 0 (Not at all), 1 (A little bit), 2 (Somewhat), 3 (Quite a bit), and 4 (Very much). Points are re-calibrated and compiled, such that high scores indicate a higher quality of life

Trial Locations

Locations (1)

University Hospitals Cleveland Medical Center; 🇺🇸 Cleveland, Ohio, United States