Trial Outcomes & Findings for Evaluation of 68Gallium-DOTATATE PET/CT for Detecting Neuroendocrine Tumors (NCT NCT01967537)

NCT ID: NCT01967537

Last Updated: 2019-11-19

Results Overview

Patients with neuroendocrine tumors (NETs) were scanned with the 68Gallium-DOTATATE Positron Emission Tomography (PET/Computed Tomography (CT)) and the number of lesions detected are collected.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

341 participants

Primary outcome timeframe

During PET Scan, up to 2 hours annually for up to 5 years

Results posted on

2019-11-19

Participant Flow

Participant milestones

Participant milestones
Measure
68Gallium DOTATATE Imaging
68Gallium DOTATATE imaging 68Gallium DOTATATE: Fasting is not required prior to the imaging study. An IV line with a large bore (21 gauge or more) will be placed preferably in the antecubital vein, and, with the patient supine, around 5mCi of the 68Ga-DOTATATE will be administered intravenously, followed by incubation for approximately 60 minutes. Then the patient will be positioned in a PET/CT scanner and images from the upper thighs to the base of the skull will be obtained. In patients with tumor induced osteomalacia, images from the top of the head to the toes will be obtained. Radio-guided surgery: Using 68Gallium DOTATATE
Overall Study
STARTED
341
Overall Study
COMPLETED
281
Overall Study
NOT COMPLETED
60

Reasons for withdrawal

Reasons for withdrawal
Measure
68Gallium DOTATATE Imaging
68Gallium DOTATATE imaging 68Gallium DOTATATE: Fasting is not required prior to the imaging study. An IV line with a large bore (21 gauge or more) will be placed preferably in the antecubital vein, and, with the patient supine, around 5mCi of the 68Ga-DOTATATE will be administered intravenously, followed by incubation for approximately 60 minutes. Then the patient will be positioned in a PET/CT scanner and images from the upper thighs to the base of the skull will be obtained. In patients with tumor induced osteomalacia, images from the top of the head to the toes will be obtained. Radio-guided surgery: Using 68Gallium DOTATATE
Overall Study
Withdrawal by Subject
52
Overall Study
Refuse treatment
2
Overall Study
Lost to Follow-up
6

Baseline Characteristics

Evaluation of 68Gallium-DOTATATE PET/CT for Detecting Neuroendocrine Tumors

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
68Gallium DOTATATE Imaging
n=341 Participants
68Gallium DOTATATE imaging 68Gallium DOTATATE: Fasting is not required prior to the imaging study. An IV line with a large bore (21 gauge or more) will be placed preferably in the antecubital vein, and, with the patient supine, around 5mCi of the 68Ga-DOTATATE will be administered intravenously, followed by incubation for approximately 60 minutes. Then the patient will be positioned in a PET/CT scanner and images from the upper thighs to the base of the skull will be obtained. In patients with tumor induced osteomalacia, images from the top of the head to the toes will be obtained. Radio-guided surgery: Using 68Gallium DOTATATE
Age, Categorical
<=18 years
1 Participants
n=93 Participants
Age, Categorical
Between 18 and 65 years
238 Participants
n=93 Participants
Age, Categorical
>=65 years
102 Participants
n=93 Participants
Age, Continuous
55.89 years
STANDARD_DEVIATION 14.43 • n=93 Participants
Sex: Female, Male
Female
194 Participants
n=93 Participants
Sex: Female, Male
Male
147 Participants
n=93 Participants
Race/Ethnicity, Customized
American Indian or Alaska Native
1 Participants
n=93 Participants
Race/Ethnicity, Customized
Asian
9 Participants
n=93 Participants
Race/Ethnicity, Customized
Black or African American
24 Participants
n=93 Participants
Race/Ethnicity, Customized
Native Hawaiian or Other Pacific Islander
1 Participants
n=93 Participants
Race/Ethnicity, Customized
Other
7 Participants
n=93 Participants
Race/Ethnicity, Customized
Race Unknown
9 Participants
n=93 Participants
Race/Ethnicity, Customized
White
290 Participants
n=93 Participants
Race/Ethnicity, Customized
Hispanic or Latino
17 Participants
n=93 Participants
Race/Ethnicity, Customized
Not Hispanic or Latino
323 Participants
n=93 Participants
Race/Ethnicity, Customized
Ethnicity Unknown
1 Participants
n=93 Participants
Region of Enrollment
United States
341 Participants
n=93 Participants

PRIMARY outcome

Timeframe: During PET Scan, up to 2 hours annually for up to 5 years

Population: Analysis was performed in the initial 131/341 participants scanned because 52 withdrew consent and 2 refused treatment. Subsequent scans in the remaining 156 participants were used to assess secondary objectives.

Patients with neuroendocrine tumors (NETs) were scanned with the 68Gallium-DOTATATE Positron Emission Tomography (PET/Computed Tomography (CT)) and the number of lesions detected are collected.

Outcome measures

Outcome measures
Measure
68Gallium DOTATATE Imaging
n=131 Participants
68Gallium DOTATATE imaging 68Gallium DOTATATE: Fasting is not required prior to the imaging study. An IV line with a large bore (21 gauge or more) will be placed preferably in the antecubital vein, and, with the patient supine, around 5mCi of the 68Ga-DOTATATE will be administered intravenously, followed by incubation for approximately 60 minutes. Then the patient will be positioned in a PET/CT scanner and images from the upper thighs to the base of the skull will be obtained. In patients with tumor induced osteomalacia, images from the top of the head to the toes will be obtained. Radio-guided surgery: Using 68Gallium DOTATATE
Number of Lesions Detected Using the 68Gallium-DOTATATE Positron Emission Tomography (PET/Computed Tomography (CT)) Scan
847 Number of lesions

SECONDARY outcome

Timeframe: During radioguided surgery, up to 2 hours

Population: As of 12/22/14 when the analysis was performed, 14/140 subjects required surgical intervention with intraoperative radiation detector and thus were analyzed. 126 participants were not surgical candidates or did not receive intraoperative dose of 68Gallium-DOTATATE and did not have radiation detector.

The radioactivity was assessed using intraoperative radiation detector following the 68Gallium-DOTATATE injection. Low grade neuroendocrine tumors is defined as tumors with slow cell division determined in histology. Low grade tumors is associated with the best outcome. Intermediate grade tumor is defined as the tumor with medium (3-20%) rate of actively dividing cells and is associated with less favorably outcome.

Outcome measures

Outcome measures
Measure
68Gallium DOTATATE Imaging
n=14 Participants
68Gallium DOTATATE imaging 68Gallium DOTATATE: Fasting is not required prior to the imaging study. An IV line with a large bore (21 gauge or more) will be placed preferably in the antecubital vein, and, with the patient supine, around 5mCi of the 68Ga-DOTATATE will be administered intravenously, followed by incubation for approximately 60 minutes. Then the patient will be positioned in a PET/CT scanner and images from the upper thighs to the base of the skull will be obtained. In patients with tumor induced osteomalacia, images from the top of the head to the toes will be obtained. Radio-guided surgery: Using 68Gallium DOTATATE
Mean Radiation Activity Between Low Grade and Intermediate Grade Neuroendocrine Tumor
Low grade
504.9 511KeV count per ten seconds
Standard Deviation 534
Mean Radiation Activity Between Low Grade and Intermediate Grade Neuroendocrine Tumor
Intermediate grade
205 511KeV count per ten seconds
Standard Deviation 147

SECONDARY outcome

Timeframe: During radioguided surgery, up to 2 hours

Population: 184/341 participants were analyzed because 52 withdrew consent and 2 refused treatment, 22 did not have a diagnosis of neuroendocrine tumor, and 81 had no 68Ga-DOTATATE uptake and were excluded.

Participants were scanned using the 68Gallium-DOTATATE Scan. Tumor volume more than 7ml is associated with shorter time to disease progression. Tumor volume more than 36 ml is associated with shorter disease specific survival.

Outcome measures

Outcome measures
Measure
68Gallium DOTATATE Imaging
n=184 Participants
68Gallium DOTATATE imaging 68Gallium DOTATATE: Fasting is not required prior to the imaging study. An IV line with a large bore (21 gauge or more) will be placed preferably in the antecubital vein, and, with the patient supine, around 5mCi of the 68Ga-DOTATATE will be administered intravenously, followed by incubation for approximately 60 minutes. Then the patient will be positioned in a PET/CT scanner and images from the upper thighs to the base of the skull will be obtained. In patients with tumor induced osteomalacia, images from the top of the head to the toes will be obtained. Radio-guided surgery: Using 68Gallium DOTATATE
Tumor Volume of Neuroendocrine Tumors Assessed by the 68Gallium-DOTATATE Scan
9.24 ml
Interval 0.06 to 1136.7

SECONDARY outcome

Timeframe: During PET Scan, up to 2 hours annually

Population: As of 12/22/14 when the analysis was performed, 12/140 subj. required surgical intervention with intraoperative radiation detector \& thus were analyzed. 12 subj. had their tumors analyzed for the expression of SSTR, 126 subj. were not surgical candidates or did not receive intraoperative dose of 68Gallium-DOTATATE \& did not have radiation detector.

High expression of somatostatin receptor 2 (SSTR2) is based on the intensity grading on immunohistochemistry. High SSTR2 expression may be associated with well-differentiated tumor and high avidity on DOTATATE scan, compared to intermediate or low expression of SSTR that can be seen in poorly differentiated and often aggressive neuroendocrine tumors. Because the correlation can only be from the comparison of preoperative DOTATATE and the tumors that were removed, it is a one time analysis. Subsequent DOTATATE studies are for surveillance and follow up for disease progression or recurrence.

Outcome measures

Outcome measures
Measure
68Gallium DOTATATE Imaging
n=12 Participants
68Gallium DOTATATE imaging 68Gallium DOTATATE: Fasting is not required prior to the imaging study. An IV line with a large bore (21 gauge or more) will be placed preferably in the antecubital vein, and, with the patient supine, around 5mCi of the 68Ga-DOTATATE will be administered intravenously, followed by incubation for approximately 60 minutes. Then the patient will be positioned in a PET/CT scanner and images from the upper thighs to the base of the skull will be obtained. In patients with tumor induced osteomalacia, images from the top of the head to the toes will be obtained. Radio-guided surgery: Using 68Gallium DOTATATE
Median Radioactivity of Tumors With High Expression of Somatostatin Receptor 2 Compared to Tumors With Intermediate Expression of Somatostatin Receptor 2
High expression
6.5 Tumor to background ratio
Interval 3.4 to 14.9
Median Radioactivity of Tumors With High Expression of Somatostatin Receptor 2 Compared to Tumors With Intermediate Expression of Somatostatin Receptor 2
Low expression
3.7 Tumor to background ratio
Interval 3.5 to 6.3

SECONDARY outcome

Timeframe: Radio-guided surgery, up to 2 hours

Population: As of 02.14.2018 when the analysis was performed, 44/326 subjects required surgical intervention with intraoperative radiation detector and thus were analyzed for the number of tumors identified. 282 participants were not surgical candidates and did not receive intraoperative dose of 68 Gallium-DOTATATE and did not have radiation detector used.

Radio-guided surgery in neuroendocrine tumors using 68Gallium-DOTATATE was performed to detect tumors in the stomach and small bowel neuroendocrine tumors, pancreas, metastatic sites to lymph nodes and liver, and pheochromocytoma or paraganglioma. The number of tumors identified by the radiation detector were assessed.

Outcome measures

Outcome measures
Measure
68Gallium DOTATATE Imaging
n=44 Participants
68Gallium DOTATATE imaging 68Gallium DOTATATE: Fasting is not required prior to the imaging study. An IV line with a large bore (21 gauge or more) will be placed preferably in the antecubital vein, and, with the patient supine, around 5mCi of the 68Ga-DOTATATE will be administered intravenously, followed by incubation for approximately 60 minutes. Then the patient will be positioned in a PET/CT scanner and images from the upper thighs to the base of the skull will be obtained. In patients with tumor induced osteomalacia, images from the top of the head to the toes will be obtained. Radio-guided surgery: Using 68Gallium DOTATATE
The Number of Tumors Identified in Participants by the Radiation Detector During Radio-guided Surgery Using 68Gallium-DOTATATE
Stomach and small bowel
23 Number of tumors
The Number of Tumors Identified in Participants by the Radiation Detector During Radio-guided Surgery Using 68Gallium-DOTATATE
Pancreas tumors
24 Number of tumors
The Number of Tumors Identified in Participants by the Radiation Detector During Radio-guided Surgery Using 68Gallium-DOTATATE
Pheochromocytoma and paraganglioma
6 Number of tumors
The Number of Tumors Identified in Participants by the Radiation Detector During Radio-guided Surgery Using 68Gallium-DOTATATE
Liver metastasis
9 Number of tumors
The Number of Tumors Identified in Participants by the Radiation Detector During Radio-guided Surgery Using 68Gallium-DOTATATE
Metastatic lymph nodes
71 Number of tumors

SECONDARY outcome

Timeframe: Date treatment consent signed to date off study, approximately 50 months and 17 days.

Here is the count of participants with serious and non-serious adverse events assessed by the Common Terminology Criteria in Adverse Events (CTCAE v4.0). A non-serious adverse event is any untoward medical occurrence. A serious adverse event is an adverse event or suspected adverse reaction that results in death, a life threatening adverse drug experience, hospitalization, disruption of the ability to conduct normal life functions, congenital anomaly/birth defect or important medical events that jeopardize the patient or subject and may require medical or surgical intervention to prevent one of the previous outcomes mentioned.

Outcome measures

Outcome measures
Measure
68Gallium DOTATATE Imaging
n=341 Participants
68Gallium DOTATATE imaging 68Gallium DOTATATE: Fasting is not required prior to the imaging study. An IV line with a large bore (21 gauge or more) will be placed preferably in the antecubital vein, and, with the patient supine, around 5mCi of the 68Ga-DOTATATE will be administered intravenously, followed by incubation for approximately 60 minutes. Then the patient will be positioned in a PET/CT scanner and images from the upper thighs to the base of the skull will be obtained. In patients with tumor induced osteomalacia, images from the top of the head to the toes will be obtained. Radio-guided surgery: Using 68Gallium DOTATATE
Count of Participants With Serious and Non-serious Adverse Events Assessed by the Common Terminology Criteria in Adverse Events (CTCAE v4.0)
21 Participants

Adverse Events

68Gallium DOTATATE Imaging

Serious events: 20 serious events
Other events: 1 other events
Deaths: 16 deaths

Serious adverse events

Serious adverse events
Measure
68Gallium DOTATATE Imaging
n=341 participants at risk
68Gallium DOTATATE imaging 68Gallium DOTATATE: Fasting is not required prior to the imaging study. An IV line with a large bore (21 gauge or more) will be placed preferably in the antecubital vein, and, with the patient supine, around 5mCi of the 68Ga-DOTATATE will be administered intravenously, followed by incubation for approximately 60 minutes. Then the patient will be positioned in a PET/CT scanner and images from the upper thighs to the base of the skull will be obtained. In patients with tumor induced osteomalacia, images from the top of the head to the toes will be obtained. Radio-guided surgery: Using 68Gallium DOTATATE
Vascular disorders
Thromboembolic event
0.88%
3/341 • Number of events 3 • Date treatment consent signed to date off study, approximately 50 months and 17 days.
Metabolism and nutrition disorders
Hyperglycemia
0.29%
1/341 • Number of events 1 • Date treatment consent signed to date off study, approximately 50 months and 17 days.
General disorders
Death (unrelated to 68 Gallium DOTATATE)
4.7%
16/341 • Number of events 16 • Date treatment consent signed to date off study, approximately 50 months and 17 days.

Other adverse events

Other adverse events
Measure
68Gallium DOTATATE Imaging
n=341 participants at risk
68Gallium DOTATATE imaging 68Gallium DOTATATE: Fasting is not required prior to the imaging study. An IV line with a large bore (21 gauge or more) will be placed preferably in the antecubital vein, and, with the patient supine, around 5mCi of the 68Ga-DOTATATE will be administered intravenously, followed by incubation for approximately 60 minutes. Then the patient will be positioned in a PET/CT scanner and images from the upper thighs to the base of the skull will be obtained. In patients with tumor induced osteomalacia, images from the top of the head to the toes will be obtained. Radio-guided surgery: Using 68Gallium DOTATATE
Nervous system disorders
Alteration of consciousness
0.29%
1/341 • Number of events 1 • Date treatment consent signed to date off study, approximately 50 months and 17 days.

Additional Information

Dr. Naris Nilubol

Principal Investigator

Phone: 301-451-2355

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place