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ET-02: Second line therapy for patients with progressive poorly differentiated extra-pulmonary neuroendocrine carcinoma

Phase 1
Conditions
Poorly differentiated extra-pulmonary neuroendocrine carcinoma
MedDRA version: 20.0Level: PTClassification code 10057270Term: Neuroendocrine carcinomaSystem Organ Class: 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Therapeutic area: Diseases [C] - Cancer [C04]
Registration Number
EUCTR2017-002453-11-GB
Lead Sponsor
The Christie NHS Foundation Trust
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
Authorised-recruitment may be ongoing or finished
Sex
All
Target Recruitment
102
Inclusion Criteria

1.Age =18 years and life expectancy >3 months.
2.Diagnosed with poorly differentiated (as defined by the World Health Organisation in 2010, Ki 67 >20%) extra-pulmonary neuroendocrine carcinoma (NEC grade 3). (Carcinoma of unknown primary is allowed if lung primary has been excluded).
3.Prior treatment with first-line platinum-based chemotherapy for NEC in the advanced setting and =28 days from Day 1 of the previous treatment cycle.
4.Documented radiological evidence of disease progression OR discontinuation of first-line platinum-based chemotherapy due to intolerance.
5.Measurable disease according to RECIST 1.1 (Appendix 1).
6.Eastern Co-operative Oncology Group (ECOG) performance status =2 (see Appendix 2).
7.Adequate renal function with serum creatinine =1.5 times upper limit of normal (ULN) and creatinine clearance =50ml/min according to Cockroft-Gault or Wright formula (see Appendix 3).
8.Adequate haematological function: Hb =90g/L, WBC =3.0 x 109/L, ANC =1.5 x 109/L, platelet count =100 x 109/L.
9.Adequate liver function: serum total bilirubin ?1.5 x ULN (biliary drainage is allowed for biliary obstruction) and ALT and/or AST ?2.5 x ULN in the absence of liver metastases, or ?5 x ULN in the presence of liver metastases.
10.A negative pregnancy test is required at registration in women of childbearing potential .
11.Men* and women** of reproductive potential must agree to use a highly effective form of contraception*** during the study and for 6 months following the last dose of trial treatment. In addition, male participants should use a condom during study participation and for 6 months following the last dose of trial treatment.
12.Patients must be able to provide written informed consent.
13.Patients must be able and willing to comply with the terms of the protocol.

* Women of reproductive potential are defined as fertile, following menarche and until becoming post-menopausal unless permanently sterile. Permanent sterilisation methods include hysterectomy, bilateral salpingectomy and bilateral oophorectomy.
** Men of reproductive potential are defined as post-pubescent and not permanently sterile by vasectomy or bilateral orchidectomy.
*** Highly effective contraception is defined as one of the following: combined (oestrogen and progesterone-containing) hormonal contraception associated with inhibition of ovulation (oral, intravaginal or transdermal); progesterone-only hormonal contraception associated with inhibition of ovulation (oral, injectable, implantable); intrauterine device (IUD); intrauterine hormone-releasing system (IUS); bilateral tubal occlusion; vasectomised partner; practising true abstinence (when this is in line with the preferred and usual lifestyle of the subject).

Are the trial subjects under 18? no
Number of subjects for this age range: 0
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 92
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 10

Exclusion Criteria

1.Known or suspected allergy or hypersensitivity reaction to any of the components of study treatment or their excipients.
2.Use (including self-medication) within one week of randomisation and for the duration of the study of any of the following: St. John’s wort, grapefruit, Seville oranges, medicines known to inhibit UGT1A1 and medicines known to inhibit or induce either CYP3A4 or CYP3A5 (see Appendix 8 of protocol for list*).
3.Previous treatment (for neuroendocrine carcinoma) with any of the components of combination chemotherapy regimens detailed in this study (nal-IRI or 5-FU or irinotecan or topoisomerase inhibitors or taxane-based therapy).
4.Incomplete recovery from previous therapy in the opinion of the investigator (surgery/adjuvant therapy/radiotherapy/chemotherapy in advanced setting), including ongoing peripheral neuropathy of > CTCAE grade 2 from previous platinum-based therapy.
5.First line treatment administered within 4 weeks, or within a time interval less than at least 5 half-lives of the agent, whichever is longer, prior to treatment start in this study.
6.Concurrent palliative radiotherapy involving target lesions used for this study (<28 days from discontinuation of radiotherapy). Radiotherapy for non-target lesions is allowed if other target lesions are available outside the involved field.
7.Patients must not have a history of other malignant diseases (within the previous 3 years, and there must be no evidence of recurrence), other than:
•Extra-pulmonary neuroendocrine carcinoma.
•Non-melanoma skin cancer where treatment consisted of resection only or radiotherapy.
•Ductal carcinoma in situ (DCIS) where treatment consisted of resection only.
•Cervical carcinoma in situ where treatment consisted of resection only.
•Superficial bladder carcinoma where treatment consisted of resection only.
8.Documented brain metastases, unless adequately treated (surgery or radiotherapy only), with no evidence of progression and neurologically stable off anticonvulsants and steroids.
9.Clinically significant gastrointestinal disorder (in the opinion of the treating clinician) including hepatic disorders, bleeding, inflammation, obstruction, or diarrhoea > CTCAE grade 1 (at time of study entry).
10.Severe arterial thromboembolic events (myocardial infarction, unstable angina pectoris, stroke) less than 6 months before inclusion.
11.New York Heart Association (NYHA) Class III or IV congestive heart failure, ventricular arrhythmias or uncontrolled blood pressure**.
12.Severe bone marrow failure or bone marrow depression after radiotherapy or treatment with other antineoplastic agents (defined as haematological values of haemoglobin or white blood cells or neutrophils or platelets not meeting inclusion criteria).
13.Known active hepatitis B virus, hepatitis C virus or HIV infection.
14.Active chronic inflammatory bowel disease.
15.Breastfeeding women.
16.Evidence of severe or uncontrolled systemic diseases which, in the view of the treating clinician, makes it undesirable for the patient to participate in the trial.
17.Evidence of significant clinical disorder or laboratory finding which, in the opinion of the treating clinician, makes it undesirable for the patient to participate in the trial.
18.Medical or psychiatric conditions that impair the ability to give informed consent.
19.Any other serious uncontrolled medical conditions (in the opinion of the treating clinician).

* For patients receiving any of

Study & Design

Study Type
Interventional clinical trial of medicinal product
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Secondary Outcome Measures
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