跳至主要内容
临床试验/2023-507443-10-00
2023-507443-10-00进行中(未招募)3 期

A phase III multi-center, randomized, open-label study to evaluate the efficacy and safety of Lutathera in patients with Grade 2 and Grade 3 advanced GEP-NET (NETTER-2)

Advanced Accelerator Applications, Advanced Accelerator Applications20 个研究点 分布在 5 个国家目标入组 90 人开始时间: 2024年6月13日最近更新:

试验速览

阶段
3 期
状态
进行中(未招募)
发起方
入组人数
90
试验地点
20
主要终点
Progression Free Survival (PFS): Time from randomization to the first line progression (centrally assessed according to RECIST 1.1) or death due to any cause

研究概览

简要总结

To demonstrate that Lutathera is superior to active comparator in delaying the time-to-first occurrence of progression or death (PFS) as first line treatment.

研究设计

分配方式
Not Applicable
主要目的
Optional Re-treatment Phase
盲法
None

入排标准

年龄范围
0 years 至 65+ years(65+ Years, 0-17 Years, 18-64 Years)
接受健康志愿者

入选标准

  • Presence of metastasized or locally advanced, inoperable (curative intent) histologically proven, well differentiated Grade 2 or Grade 3 gastroenteropancreatic neuroendocrine (GEP-NET) tumor diagnosed within 6 months prior to screening.
  • Ki67 index ≥10 and ≤ 55%
  • Patients ≥15 years of age and a body weight of >40 kg at screening
  • Expression of somatostatin receptors on all target lesions documented by CT/MRI scans, assessed by any of the following somatostatin receptor imaging (SRI) modalities within 3 months prior to randomization: [68Ga]-DOTA-TOC (e.g. Somakit-TOC®) PET/CT (or MRI when applicable based on target lesions) imaging, [68Ga]-DOTA-TATE PET/CT (or MRI when applicable based on target lesions) imaging (e.g. NETSPOT®), Somatostatin Receptor scintigraphy (SRS) with [111In]- pentetreotide (Octreoscan® SPECT/CT), SRS with [99mTc]-Tektrotyd, [64Cu]-DOTA-TATE PET/CT (or MRI when applicable based on target lesions)
  • The tumor uptake observed in the target lesions must be > normal liver uptake
  • Karnofsky Performance Score (KPS) ≥60
  • Presence of at least 1 measurable site of disease
  • Patients who have provided a signed informed consent form to participate in the study, obtained prior to the start of any protocol related activities

排除标准

  • Creatinine clearance <40 mL/min calculated by the Cockroft Gault method
  • Any previous therapy with Interferons, Everolimus (mTOR-inhibitors), chemotherapy or other systemic therapies of GEP-NET administered for more than 1 month or within 12 weeks prior to randomization in the study
  • Any previous radioembolization, chemoembolization and radiofrequency ablation for GEP-NET
  • Any surgery within 12 weeks prior to randomization in the study
  • Known brain metastases, unless these metastases have been treated and stabilized for at least 24 weeks, prior to screening in the study. Patients with a history of brain metastases must have a head CT or MRI with contrast to document stable disease prior to randomization in the study
  • Uncontrolled congestive heart failure (NYHA II, III, IV). Patients with history of congestive heart failure who do not violate this exclusion criterion will undergo an evaluation of their cardiac ejection fraction prior to randomization via echocardiography. The results from an earlier assessment (not exceeding 30 days prior to randomization) may substitute the evaluation at the discretion of the Investigator, if no clinical worsening is noted. The patient's measured cardiac ejection fraction in these patients must be >40% before randomization
  • QTcF > 470 msec for females and QTcF > 450 msec for males or congenital long QT syndrome
  • Uncontrolled diabetes mellitus as defined by hemoglobin A1c value > 7.5%
  • Hyperkaleamia >6.0 mmol/L (CTCAE Grade 3) which is not corrected prior to study enrolment
  • Any patient receiving treatment with short-acting octreotide, which cannot be interrupted for 24 h before and 24 h after the administration of Lutathera, or any patient receiving treatment with SSAs (eg octreotide long-acting), which cannot be interrupted for at least 6 weeks before the administration of Lutathera
  • Patients with any other significant medical, psychiatric, or surgical condition, currently uncontrolled by treatment, which may interfere with the completion of the study
  • Hb concentration <5.0 mmol/L (<8.0 g/dL); WBC <2x10^9/L (2000/mm^3); platelets <75x10^9/L (75x10^3/mm^3)
  • Prior external beam radiation therapy to more than 25% of the bone marrow
  • Current spontaneous urinary incontinence
  • Other known co-existing malignancies except non-melanoma skin cancer and carcinoma in situ of the uterine cervix, unless definitively treated and proven no evidence of recurrence for 5 years
  • Patient with known incompatibility to CT Scans with I.V. contrast due to allergic reaction or renal insufficiency. If such a patient can be imaged with MRI, then the patient would not be excluded
  • Hypersensitivity to any somatostatin analogues, the IMPs active substance or to any of the excipients
  • Patients who have participated in any therapeutic clinical study/received any investigational agent within the last 30 day
  • Total bilirubin >3 x ULN
  • Serum albumin <3.0 g/dL unless prothrombin time is within the normal range
  • Pregnancy or lactation
  • A) Women of child-bearing potential, defined as all women physiologically capable of becoming pregnant, are not allowed to participate in this study UNLESS they are using highly effective methods of contraception throughout the study treatment period (including cross- over and re-treatment, if applicable) and for 7 months after study drug discontinuation. B) Sexually active male patients, unless they agree to remain abstinent (refrain from heterosexual intercourse) or be willing to use condoms and highly effective methods of contraception with female partners of childbearing potential or pregnant female partners during the treatment period (including cross-over and re-treatment, if applicable) and for 4 months after study drug discontinuation. In addition, male patients must refrain from donating sperm during this same period
  • Peptide receptor radionuclide therapy (PRRT) at any time prior to randomization in the study
  • Documented RECIST progression to previous treatments for the current GEP-NET at any time prior to randomization
  • Patients for whom in the opinion of the investigator other therapeutic options (eg chemo-, targeted therapy) are considered more appropriate than the therapy offered in the study, based on patient and disease characteristics

结局指标

主要结局

Progression Free Survival (PFS): Time from randomization to the first line progression (centrally assessed according to RECIST 1.1) or death due to any cause

Progression Free Survival (PFS): Time from randomization to the first line progression (centrally assessed according to RECIST 1.1) or death due to any cause

次要结局

  • ORR: Rate of patients with best overall response of partial response (PR) or complete response (CR) (centrally assessed according to RECIST 1.1)
  • Time to decline (TTD) by 10 points from baseline in the following scores measured by the EORTC QLQ-C30 questionnaire: global health status, diarrhea, fatigue and pain

研究者

发起方
Advanced Accelerator Applications, Advanced Accelerator Applications
申办方类型
Pharmaceutical company, Pharmaceutical company
责任方
Principal Investigator
主要研究者

Regulatory Affairs Team

Scientific

Advanced Accelerator Applications

研究点 (20)

Loading locations...

相似试验