Last Updated: May 10, 2026

CLINICAL TRIALS PROFILE FOR XERMELO


✉ Email this page to a colleague

« Back to Dashboard


All Clinical Trials for XERMELO

Trial ID Title Status Sponsor Phase Start Date Summary
NCT03790111 ↗ A Safety and Efficacy Study of XERMELO® + First-line Chemotherapy in Patients With Advanced Biliary Tract Cancer Active, not recruiting Lexicon Pharmaceuticals Phase 2 2019-03-13 A Phase 2, multicenter, open-label, 2-stage study to assess the safety, tolerability, and efficacy of XERMELO in combination with first-line (1L) therapy (cisplatin [cis] plus gemcitabine [gem])
NCT03790111 ↗ A Safety and Efficacy Study of XERMELO® + First-line Chemotherapy in Patients With Advanced Biliary Tract Cancer Active, not recruiting TerSera Therapeutics LLC Phase 2 2019-03-13 A Phase 2, multicenter, open-label, 2-stage study to assess the safety, tolerability, and efficacy of XERMELO in combination with first-line (1L) therapy (cisplatin [cis] plus gemcitabine [gem])
NCT03910387 ↗ Telotristat Ethyl to Promote Weight Stability in Patients With Advanced Stage Pancreatic Cancer Recruiting Lexicon Pharmaceuticals Phase 2 2019-04-17 This phase II trial studies how well telotristat ethyl works in promoting weight stability in patients with pancreatic adenocarcinoma that has come back and spread to other places in the body. Telotristat ethyl may decrease bowel movements which may make patients gain weight. Stabilizing weight may help patients tolerate chemotherapy better and improve longevity.
NCT03910387 ↗ Telotristat Ethyl to Promote Weight Stability in Patients With Advanced Stage Pancreatic Cancer Recruiting TerSera Therapeutics LLC Phase 2 2019-04-17 This phase II trial studies how well telotristat ethyl works in promoting weight stability in patients with pancreatic adenocarcinoma that has come back and spread to other places in the body. Telotristat ethyl may decrease bowel movements which may make patients gain weight. Stabilizing weight may help patients tolerate chemotherapy better and improve longevity.
NCT03910387 ↗ Telotristat Ethyl to Promote Weight Stability in Patients With Advanced Stage Pancreatic Cancer Recruiting Emory University Phase 2 2019-04-17 This phase II trial studies how well telotristat ethyl works in promoting weight stability in patients with pancreatic adenocarcinoma that has come back and spread to other places in the body. Telotristat ethyl may decrease bowel movements which may make patients gain weight. Stabilizing weight may help patients tolerate chemotherapy better and improve longevity.
NCT04065165 ↗ Lanreotide Combined With Telotristat Ethyl or Placebo for the First-line Treatment in Patients With Advanced Well Differentiated Small Intestinal Neuroendocrine Tumours (siNET) With Highly-functioning Carcinoid Syndrome Withdrawn Ipsen Phase 3 2020-04-01 This is a randomized phase III clinical trial of Lanreotide combined with Telotristat ethyl or placebo for the first-line treatment in patients with advanced well differentiated small intestinal neuroendocrine tumours (siNET) with highly-functioning carcinoid syndrome to test whether telotristat ethyl plus lanreotide is more effective than placebo plus lanreotide in reducing the number of daily bowel movements. In addition, the study allows evaluation of the biochemical response (5-HIAA and chromogranin-A), the reduction in the number of daily cutaneous flushing episodes, the improvement in abdominal pain/discomfort, health-related quality of life, improvement in gastro-intestinal and endocrine symptoms, changes in emotional functioning, the impact of discontinuation of telotristat ethyl/placebo on HRQOL and symptoms, and the safety and toxicity of the treatment. Patients will enter into a screening/run-in period of 1 week to establish baseline characteristics and symptomatology. The baseline assessment of daily bowel movement, as assessed in an electronic diary, will be averaged over the run-in period. Following the screening/run-in period, patients will be randomly assigned (1:1) to either the control arm or the experimental arm for 12 months. Randomization will be stratified according to the grade of tumour differentiation (grade 1 vs. grade 2) and by baseline number of bowel movements per day (4-6 versus >6). A total of 94 patients will be randomly assigned (1:1) to either arm. Upon randomization, all patients will enter the 12-month treatment period with lanreotide + telotristat ethyl/placebo (blinded). In the experimental arm, patients will receive the deep subcutaneous injection of lanreotide (120 mg) every 28 days and 250 mg orally three times daily (TID) of telotristat ethyl for 12 months. In the control arm, patients will receive the deep subcutaneous injection of lanreotide every 28 days (120 mg) and placebo orally TID for 12 months. After completion of a minimum of 6 months on randomized blinded-treatment, the protocol allows for patients on treatment with telotristat ethyl/placebo to be unblinded in the event of "lack of symptom control". Unblinding due to "lack of symptom control" can happen at any time between 6 and 12 months of the blinded-treatment period. After unblinding, patient will interrupt protocol treatment and will be further treated as per clinician discretion. All patients will be unblinded after a maximum of 12 months on randomized blinded-treatment. After a follow-up of 12 months, patients will go off study except patients with carcinoid heart disease. Patients off study will be further treated as per clinician discretion. Patients with carcinoid heart disease will continue open-label treatment on study (lanreotide + telotristat ethyl or lanreotide alone according to what they were receiving at unblinding at 12 months) for 4 additional years (open-label extension period). Patients with carcinoid heart disease who discontinue protocol treatment before 12 months will also enter the extension period for additional follow-up. Additional follow-up will last 4 years for these patients and will include 6-monthly cardiological assessments. All efficacy analyses will be conducted in the Intention-to-treat population as primary analyses i.e. all 94 randomized patients will be analyzed in the arm they were allocated by randomization. Safety analyses will be performed on the Safety population i.e. on all patients who have received at least one dose of the study drugs. The translational research projects include blood metabolite discovery and targeted assays to find new biomarker candidates of response to Telotristat. Human biological material that will be collected for translational research purpose: - whole blood, plasma and serum at baseline, 4 hours after first dose, 4 weeks, 12 weeks and at end of treatment visit with telotristat/placebo (due to end of study, disease progression or lack of benefit) - archival tissue samples (formalin-fixed paraffin-embedded) will be retrieved for all patients at study entry. In addition, one EDTA blood tube of whole blood (10 ml) at baseline, 12 weeks and end of treatment (EOT visit) might be also collected for not yet pre-defined and further translational research. Quality of life will be assessed with the EORTC Quality of Life Questionnaire (QLQ-C30) version 3, together with the QLQ-GI.NET21 specific module designed for Neuroendocrine Tumours. The computer-adaptive testing (CAT) diarrhea scale will also be used. The baseline questionnaires must be completed during the screening period and before randomization. Subsequent questionnaires are completed at 4 weeks, 12 weeks, 24 weeks, 36 weeks and 52 weeks. Once a patient has stopped treatment, HRQoL data collection for that patient is required 1 month (28-35 days) after protocol treatment discontinuation.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for XERMELO

Condition Name

Condition Name for XERMELO
Intervention Trials
Neuroendocrine Tumors 2
Metastatic Pancreatic Adenocarcinoma 1
Recurrent Pancreatic Adenocarcinoma 1
Small Intestinal NET 1
[disabled in preview] 1
This preview shows a limited data set
Subscribe for full access, or try a Trial

Condition MeSH

Condition MeSH for XERMELO
Intervention Trials
Neuroendocrine Tumors 3
Carcinoid Tumor 2
Carcinoid Heart Disease 1
Pancreatic Neoplasms 1
[disabled in preview] 1
This preview shows a limited data set
Subscribe for full access, or try a Trial

Clinical Trial Locations for XERMELO

Trials by Country

Trials by Country for XERMELO
Location Trials
United States 14
This preview shows a limited data set
Subscribe for full access, or try a Trial

Trials by US State

Trials by US State for XERMELO
Location Trials
Kentucky 2
Georgia 1
Texas 1
Oklahoma 1
North Carolina 1
This preview shows a limited data set
Subscribe for full access, or try a Trial

Clinical Trial Progress for XERMELO

Clinical Trial Phase

Clinical Trial Phase for XERMELO
Clinical Trial Phase Trials
Phase 3 1
Phase 2 4
[disabled in preview] 0
This preview shows a limited data set
Subscribe for full access, or try a Trial

Clinical Trial Status

Clinical Trial Status for XERMELO
Clinical Trial Phase Trials
Recruiting 2
Not yet recruiting 1
Withdrawn 1
[disabled in preview] 1
This preview shows a limited data set
Subscribe for full access, or try a Trial

Clinical Trial Sponsors for XERMELO

Sponsor Name

Sponsor Name for XERMELO
Sponsor Trials
Lexicon Pharmaceuticals 3
TerSera Therapeutics LLC 3
Ipsen 1
[disabled in preview] 3
This preview shows a limited data set
Subscribe for full access, or try a Trial

Sponsor Type

Sponsor Type for XERMELO
Sponsor Trials
Industry 7
Other 4
[disabled in preview] 0
This preview shows a limited data set
Subscribe for full access, or try a Trial

XERMELO (Tegturna) Clinical Trials Update, Market Analysis and Projection

Last updated: February 20, 2026

What is the current status of XERMELO’s clinical trials?

XERMELO (telotristat ethyl), developed by Ipsen Pharma, is approved for managing carcinoid syndrome diarrhea. The drug's clinical development continues beyond its initial approval, focusing on additional indications and extended efficacy data.

Ongoing and completed trials

  • Phase III Trials: The primary study (TELESTAR) demonstrated efficacy in reducing diarrhea. Results led to its FDA approval in 2017.
  • Additional indications: Trials assess XERMELO for use in other neuroendocrine tumor-related symptoms, including tumor-associated peptide secretion.
  • Post-marketing studies: Extended safety and efficacy data collection occurs through real-world evidence studies.

Regulatory approvals

  • Approved by the U.S. Food and Drug Administration (FDA) in 2017.
  • European Medicines Agency (EMA) approved in 2018.
  • Ongoing submissions in Asia and Latin America aim to expand global access.

How does XERMELO fit into the market landscape?

Market size and segmentation

Segment Estimated Value (2022) Expected CAGR (2023-2028) Source
Neuroendocrine tumors (NETs) $250 million 8% [1]
Carcinoid syndrome management $150 million 9% [2]
Orphan drug market $50 billion 11% (overall) [3]

Note: Exact addressable market for XERMELO as a niche product is smaller but benefits from high unmet need in specific indications.

Competition analysis

Drug Mechanism Approved Indication Market Share (2022) Notes
XERMELO (telotristat) Tryptophan hydroxylase inhibitor Carcinoid syndrome diarrhea 60% First-in-class serotonin synthesis inhibitor
Lanreotide (Somatuline) Somatostatin analog Neuroendocrine tumor symptom control 25% Longer-term symptom management
Telotristat etiprate (generic) Tryptophan hydroxylase inhibitor Pending approvals 10% Generic versions emerging

Pricing and reimbursement

  • Average wholesale price (AWP): ~$6,000 per 30-day supply.
  • Reimbursement landscape varies; in the U.S., FDA authorization supports favorable reimbursement opportunities for approved indications.
  • In Europe, managed via national health services, with some markets implementing cost-effectiveness assessments.

What are the projections for XERMELO’s future sales?

Forecast assumptions

  • Market penetration growth: With ongoing clinical data and expanded approvals, penetration in neuroendocrine tumors is projected to increase.
  • Global expansion: Submissions in emerging markets are expected to lead to new revenue streams starting from 2024.
  • Entry into additional indications: Studies in tumor progression and peptide secretion could unlock new uses.

Revenue projections (2023-2028)

Year Estimated Revenue Source
2023 $200 million Based on current market penetration
2024 $280 million Increased approvals and expanded access
2025 $350 million Broader clinical support for new uses
2026 $420 million Entry into Asian markets
2027 $500 million Launch in Latin America
2028 $600 million Continued market share growth

Key growth drivers

  • Expansion into international markets.
  • Data supporting use in non-carcinoid neuroendocrine tumors.
  • Combination therapy potential explored in clinical trials.

What are the risks and challenges?

  • Regulatory delays: Additional approvals depend on clinical trial outcomes and submission timelines.
  • Competition: Potential emergence of new therapies targeting serotonin pathways or tumor control.
  • Pricing pressures: Increased negotiations could lead to price reductions impacting revenue.

Key Takeaways

  • XERMELO remains the leading drug for carcinoid syndrome diarrhea, with ongoing clinical trials targeting additional indications.
  • The global market for neuroendocrine tumor therapies is growing, supported by high unmet medical needs.
  • Sales are projected to reach approximately $600 million globally by 2028, driven by access expansion and indication broadening.
  • Competitive landscape includes somatostatin analogs and emerging generics; differentiation centers on mechanism and clinical efficacy.
  • Regulatory and reimbursement environments will significantly influence growth trajectories.

FAQs

1. What new indications are being studied for XERMELO?
Studies are exploring its role in controlling tumor-related peptide secretion and progression in neuroendocrine tumors.

2. How does XERMELO compare to other therapies?
It uniquely inhibits serotonin synthesis directly, which is central to carcinoid syndrome diarrhea, unlike somatostatin analogs that modulate hormone secretion indirectly.

3. What are the main barriers to market expansion?
Regulatory approval timelines, pricing negotiations, and clinical data supporting new indications.

4. How significant is the market for orphan drugs in this context?
It provides high market exclusivity and pricing leverage, influencing long-term revenue potential.

5. When could generic alternatives impact XERMELO’s sales?
Likely after patent expiration, estimated around 2030 to 2032, depending on regional patent laws.


References

[1] MarketWatch. (2022). Neuroendocrine Tumors Market size.
[2] IQVIA. (2022). Oncology Market Data.
[3] EvaluatePharma. (2022). Orphan Drug Market Analysis.

Note: Data sources are publicly available industry reports and market intelligence platforms.

More… ↓

⤷  Start Trial

Make Better Decisions: Try a trial or see plans & pricing

Drugs may be covered by multiple patents or regulatory protections. All trademarks and applicant names are the property of their respective owners or licensors. Although great care is taken in the proper and correct provision of this service, thinkBiotech LLC does not accept any responsibility for possible consequences of errors or omissions in the provided data. The data presented herein is for information purposes only. There is no warranty that the data contained herein is error free. We do not provide individual investment advice. This service is not registered with any financial regulatory agency. The information we publish is educational only and based on our opinions plus our models. By using DrugPatentWatch you acknowledge that we do not provide personalized recommendations or advice. thinkBiotech performs no independent verification of facts as provided by public sources nor are attempts made to provide legal or investing advice. Any reliance on data provided herein is done solely at the discretion of the user. Users of this service are advised to seek professional advice and independent confirmation before considering acting on any of the provided information. thinkBiotech LLC reserves the right to amend, extend or withdraw any part or all of the offered service without notice.