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Peptide Receptor Radionuclide Therapy (PRRT) for the Treatment of Neuroendocrine Tumors

Recruiting
Conditions
Neuroendocrine Tumors
Interventions
Procedure: Peptide Receptor Radionuclide Therapy
Registration Number
NCT04090034
Lead Sponsor
Methodist Health System
Brief Summary

The specific aim is of this study is to gain a better understanding of the patient characteristics, treatment responses, survival outcomes, and adverse events associated with PRRT in patients with gastroenteropancreatic primary NETs.

Detailed Description

Neuroendocrine tumors (NETs) make up a large range of malignancies that arise from neuroendocrine cells in multiple organs of the body. Hallet et al conducted a large population-based study that demonstrated that 21% of NET patients presented with metastatic disease and another 38% developed metastases after resection of the primary tumor (Hallet et al., 2015). This burden demonstrates the need for effective systemic therapy for advanced NETs. Options for systemic therapy include peptide receptor radionuclide therapy (PRRT).

A need for more prospective series are needed on treatment responses and survival outcomes related to gastroenteropancreatic primary NETs treated with PRRT was identified. Thus the purpose of this study is to collect clinical data related to treatment of gastroenteropancreatic primary NETs s with PRRT. Clinical data related to patient characteristics, treatment responses and survival outcomes related to the treatment of gastroenteropancreatic primary NETs with PRRT and on adverse events and complications related to PRRT treatment will be collected.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
50
Inclusion Criteria
  1. > 18 years of age

  2. Diagnosed with gastroenteropancreatic primary NET and has consented to undergo PRRT per the treating physician. Specifically:

    • Will consider other primaries on a case by case basis if dotatate scan (+) and meet all other criteria.

    • Metastatic or Locally Advanced AND Inoperable

    • Clear disease progression on Octreotide over less than 3 years (RECIST 1.1)

    • Presence of disease within 24 weeks as identified by PET/CT scans with Ga-68 DOTATATE reporting the Krenning score for low-grade NET and/or PET/CT scans with FDG for transformation to high-grade NET

    • Well differentiated on path - Ki67 < 20%

    • Octreotide positive on pathology (if not documented, acceptable if PET/CT imaging shows lesions with Ga-68 DOTATATE uptakeLabs:

      • Cr. <1.7
      • Hgb >8
      • WBC >2K
      • Plt >75K
      • Bili < 3x normal limit
    • No Octreotide within 30 days of administration.

  3. Willing and able to comply with the protocol requirements

  4. Able to comprehend and sign the Informed Consent Form in English.

Exclusion Criteria
  • Do not meet the Study Inclusion Criteria laid out in section 6.3

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Treated w PRRTPeptide Receptor Radionuclide TherapyPatients who received treatment of gastroenteropancreatic primary NETs with PRRT per the treating physicians discretion.
Primary Outcome Measures
NameTimeMethod
Biomarker data (chromogranin A and pancreastatin)7 years from date of procedure

at the time of diagnosis, before and after the first PRRT, and after the second PRRT were also extracted

Demographics and other patient data7 years from date of procedure

(such as age at diagnosis, sex, history of smoking alcohol use and symptoms at the time of diagnosis)

Use of somatostatin analogs7 years from date of procedure

at the time of PRRT, location, isotope used and dose of isotope for each PRRT

Diagnostic imaging findings7 years from date of procedure

prior to PRRT and response after PRRT, date of progression on imaging after PRRT, and status of disease on imaging at the last follow-up were also recorded

Time to progression (TTP)7 years from date of procedure

the time from the first PRRT until any progression on diagnostic imaging

Overall survival (OS)7 years from date of procedure

the time from diagnosis to death of any cause.

Tumor specific data7 years from date of procedure

Tumor site, tumor grade, stage, presence of tumor necrosis, number of mitoses and percentage of Ki-67 and MIB-1 positive cells (proliferative index)

Response7 years from date of procedure

any response of any magnitude

Disease progression7 years from date of procedure

any increase in lesion sizes and/or appearance of new metastatic lesions on diagnostic imaging exams.

Adverse events7 years from date of procedure

will be assessed by the investigator who will determine whether or not the event is related to PRRT or related to progression of disease (gastroenteropancreatic primary NET), and whether or not the event meets serious criteria. AEs related to PRRT will be recorded in the study registry.

Treatment responses and progression7 years from date of procedure

assessed with cross-sectional imaging with either computerized tomography (CT) or magnetic resonance imaging (MRI) or positron emission tomography (PET) or single-photon emission computed tomography (SPECT).

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (2)

Clinical Research Institute at Methodist Health System

🇺🇸

Dallas, Texas, United States

Methodist Dallas Medical Center

🇺🇸

Dallas, Texas, United States

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