177Lu-edotreotide compared to everolimus in neuroendocrine tumors of the lung and thymus
- Conditions
- Patients with well to moderately differentiated neuroendocrine tumors of the lung and thymus who require systemic therapy.MedDRA version: 21.0Level: LLTClassification code: 10062476Term: Neuroendocrine tumor Class: 10029104MedDRA version: 20.0Level: LLTClassification code: 10078183Term: Neuroendocrine tumor of the lung Class: 10029104Therapeutic area: Diseases [C] - Neoplasms [C04]
- Registration Number
- CTIS2022-502154-13-00
- Lead Sponsor
- Grupo Espanol De Tumores Neuroendocrinos
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Recruiting
- Sex
- All
- Target Recruitment
- 120
Institutional Review Board (IRB)/Independent Ethics Committee (IEC) approved written informed consent., Patients who have Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1., Adequate organ and bone marrow function based upon meeting all of the following laboratory criteria: Neutrophil count (ANC) = 1,500/mm3 Platelet count = 75 × 109/L Hemoglobin = 8 g/dL Serum bilirubin = 1.5 × upper limit of normal (ULN) or = 3 × ULN for subjects with Gilbert’s disease or liver metastases Creatinine clearance (CrCl) = 40 mL/min as estimated by the Cockroft-Gault formula or as measured by 24-hour urine collection (GFR can also be used instead of CrCl). Note: renal tract obstruction is not allowed. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) = 2.5 × ULN or = 5 xULN for subjects with liver metastases, Female subject must provide a negative urine pregnancy test at screening, and must agree to use a medically accepted and highly effective birth control method (i.e. those with a failure rate less than 1%) for the duration of the study treatment and for 6 months after the final dose of study treatment., Female patients must agree not to breastfeed or donate ovules starting at screening and throughout the study period, and for at least 6 months after the final study drug administration., Male patients must agree not to donate sperm starting at screening and throughout the study period, and for at least 6 months after the final study drug administration., Male patients must agree to abstinence or use a condom for the duration of the study period and for at least 6 months after the final study drug administration., Subject agrees not to participate in another interventional study while on treatment in the present study., Patients = 18 years of age., Patients who have histologically confirmed metastatic or locally advanced unresectable well/moderately differentiated (World Health Organization [WHO] 2015 criteria) neuroendocrine tumor of lung (typical and atypical carcinoids) or thymus origin either functioning or non-functioning candidates to receive everolimus or PRRT., Patients must have the appropriate pathological features based on WHO classification, and description of proliferation activity as indicated by mitotic count per 10 high-power fields (HPF) and presence of necrosis, or Ki67 index., In SSTR imaging all RECIST v1.1 selected target lesions and all other lesions considered dominant by the investigator should be somatostatin receptor positive (SSRT+). If an FDG PET is performed (not mandatory), all FDG PET positive RECIST v1.1 target lesions and all other FDG PET positive lesions considered dominant by the investigator should also be somtostatin receptor positive in SSRT imaging., Lesions must have shown radiological evidence of disease progression in the 12 months prior to inclusion in the study. Patients who were receiving systemic anticancer therapy, progression should be documented on therapy or after stopping therapy due to adverse events or other reasons. Patients without prior therapy, documentation of progression is also mandatory to watch and wait strategy or during the follow up after surgery., Patients may be included in first-line therapy (systemic treatment naïve) or may have experienced progression on somatostatin analogues or additional systemic treatments, which may include but not limited to chemotherapy, targeted agents or immunotherapy (maximum of 2 prior systemic anti-tumor treatments).
Patients who are not able to swallow tablets., Patients who have ongoing clinically significant toxicity (Grade 2 or higher with the exception of alopecia) associated with prior treatment (including systemic therapy, radiotherapy or surgery)., Patients who have a recent diagnosis of another malignancy (within 12 months prior to inclusion), patients who are on active treatment for other cancer before the first dose of study drug, or any evidence of residual disease from a previously diagnosed malignancy., Patients who have a known active Hepatitis B (e.g., HBsAg reactive) or active hepatitis C (e.g., HCV RNA [qualitative] is detected). Patients who have a known history of human immunodeficiency virus (HIV) infection (HIV 1 or 2)., Patients who have received a live vaccine up to 4 weeks prior to the first dose of trial treatment. Note:Live attenuated vaccines should not be administered during the trial treatment and over the next 3 months after the last treatment dose., Patients who have documented history of a cerebral vascular event (stroke or transient ischemic attack), unstable angina, myocardial infarction, or cardiac symptoms (including congestive heart failure) consistent with New York Heart Association Class III-IV within 6 months prior to the first dose of study drug., Prior peptide receptor radionuclide therapy (PRRT) or mammalian target of rapamycin (mTOR) inhibitors (e.g. deforolimus, everolimus, sirolimus, temsirolimus, etc.); or hepatic radioembolization (within 6 months prior to first dose of study treatment)., Patients who have limited their capability to freely decide to participate (patients under guardianship / curatorship), or are in a situation of institutional or hierarchical dependency that could inappropriately influence their decision to participate., Prior radiotherapy or major surgery within 12 weeks prior to the first dose of study drug., Patients who have had chemotherapy, biologics, investigational agents, and/or antitumor treatment with immunotherapy that is not completed 4 weeks prior to the first dose of study drug., Patients who have known hypersensitivity to Everolimus or to any excipient contained in the drug formulation of Everolimus. Patients who have hypersensitivity to other rapamycin derivatives., Patients who have known hypersensitivity to 177Lu-edotreotide or to any excipient contained in the drug formulation of 177Lu-edotreotide or the nephroprotective amino acid solution (AAS)., Current spontaneous urinary incontinence preventing safe administration of the IMP, in the investigator’s opinion., Patients who have other underlying medical conditions that, in the opinion of the investigator, would impair the ability of the subject to receive or tolerate the planned treatment and follow-up., Patients with poorly-differentiated or high-grade neuroendocrine carcinoma (i.e. large cell neuroendocrine carcinoma of lung, small cell lung cancer) or mixed tumors (i.e. adenocarcinoid tumor) are not eligible., Patients with brain mets unless stable on treatment for > 12 weeks and with no evidence of raised intracranial pressure or mass effect.
Study & Design
- Study Type
- Interventional clinical trial of medicinal product
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method
- Secondary Outcome Measures
Name Time Method