Efficacy of Neoadjuvant Chemotherapy in Terms of DFS in Patients With Localized Digestive Neuroendocrine Carcinomas

NCT ID: NCT04268121

Last Updated: 2025-07-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE2

Total Enrollment

78 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-01-05

Study Completion Date

2031-01-31

Brief Summary

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NEONEC is a single-phase, phase II study evaluating the efficacy of the 12-month neoadjuvant chemotherapy in patients with locally differentiated digestive NEC. The recommended chemotherapy is based on the current reference combination of platinum (cisplatin or carboplatin) and etoposide (VP16). For anorectal locations, radiochemotherapy is proposed to avoid the morbidity of conventional surgery.

The objective of the study is to improve relapse-free survival (RFS) in NEC patients treated with neoadjuvant chemotherapy followed by surgery or chemoradiotherapy.

In parallel, we will perform a prospective cohort study with patients whose diagnosis is made during surgery, who have not received neoadjuvant treatment, and who are offered an adjuvant treatment of the same type (combination of platinum and platinum salts and etoposide).

Detailed Description

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A total of 48 patients is to be included in phase II and 30 patients in prospective cohort during the inclusion period of phase II.

Phase II study treatment:

Neoadjuvant chemotherapy: Administration of 4 cycles of chemotherapy (3 months) with platinum based chemotherapy (carboplatin or cisplatin, at the choice of the investigator) + etoposide.

Surgery or chemoradiotherapy depending on the tumor localization (the irradiation modalities and associated chemotherapy treatment will be left to the discretion of the referring radiotherapists according to current recommendations for each localization).

Prospective cohort:

* Surgery (prior to study entry)
* Adjuvant chemotherapy : Administration of 4 cycles of chemotherapy (3 months) with platinum based chemotherapy (carboplatin or cisplatin, at the choice of the investigator) + etoposide.

Conditions

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Neuroendocrine Carcinoma Digestive Cancer

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Phase II and prospective cohort
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Phase II

Prospective, open, multi center, one-arm, national phase II study evaluating the benefits in terms of disease-free survival (DFS) at 12 months after the administration of neoadjuvant treatment in patients with localized digestive neuroendocrine carcinomas

Group Type EXPERIMENTAL

Neoadjuvant treatment

Intervention Type DRUG

4 cycles of platinum-based chemotherapy (carboplatin or cisplatin) plus etoposide followed by surgery or chemoradiotherapy

Prospective cohort

Evaluation of DFS at 12 months in patients who underwent surgery and received adjuvant chemotherapy

Group Type ACTIVE_COMPARATOR

Adjuvant treatment

Intervention Type DRUG

Surgery (before study entry) followed by 4 cycles of platinum-based chemotherapy (carboplatin or cisplatin) plus etoposide

Interventions

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Neoadjuvant treatment

4 cycles of platinum-based chemotherapy (carboplatin or cisplatin) plus etoposide followed by surgery or chemoradiotherapy

Intervention Type DRUG

Adjuvant treatment

Surgery (before study entry) followed by 4 cycles of platinum-based chemotherapy (carboplatin or cisplatin) plus etoposide

Intervention Type DRUG

Other Intervention Names

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cisplatin / cisplatinum etoposide / vepesid carbopatin / paraplatin cisplatin / cisplatinum etoposide / vepesid carbopatin / paraplatin

Eligibility Criteria

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Inclusion Criteria

Phase II

1. Histologically proven digestive CNE, (the WHO 2017 classification: poorly differentiated and Ki 67 \> 20%),
2. Patients with localized CNE, without metastasis (computed tomography \[CT\], thoraco-abdominopelvic CT scan \[TAP\] according to RECIST 1.1; examinations performed no later than 21 days before starting the study treatment, possible locoregional lymph node involvement defined according to the TNM classification),
3. Positron emission tomography (PET) and CT for lymph node status and elimination of secondary visceral and/or bone disorders, 4. Resectable tumor, according to the consensus decision made during local multidisciplinary surgical consultation meeting,

5\. Age ≥ 18 years, 6. Written informed consent obtained from the patient, willing and able to comply with the protocol, 7. Registration in a National Health Care System (Protection Universelle Maladie \[PUMa\] included), 8. For female patients of childbearing potential, negative pregnancy test within 7 days before starting the study treatment.

Men and women are required to use a reliable and adequate birth control during the study (if applicable) during the period of treatment and during 6 months from the last treatment administration.

Prospective cohort

1. Patients with localized digestive CNE histologically proven on the operative specimen (the WHO 2017 classification: poorly differentiated and Ki 67\> 20%),
2. Localized, without metastasis on computed tomography \[CT\], thoracoabdominopelvic CT scan \[TAP\] RECIST 1.1, and/or locoregional lymph node involvement,
3. Age ≥ 18 years,
4. Written informed consent obtained from the patient, willing and able to comply with the protocol,
5. Registration in a National Health Care System (PUMa - Protection Universelle Maladie included),
6. For female patients of childbearing potential, negative pregnancy test within 7 days before starting the study treatment.

Men and women are required to use a reliable and adequate birth control methods during the study (if applicable) during the period of treatment and during 6 months from the last treatment administration.

Exclusion Criteria

Phase II

1. Well-differentiated NEC, whatever the grade,
2. Metastatic disease,
3. Cancer of unknown primary
4. Organ failure that does not allow chemotherapy treatment,
5. Previous malignancy within 5 years prior to the study except for cutaneous basal cell carcinoma and uterine cancer in situ
6. Tumor with a mixed component (component accounts for ≥ 30%),
7. Patient impossible to follow-up,
8. Other than platinum-etoposide chemotherapy administrated,
9. Tutelage or guardianship or patient protected by law

Prospective cohort

1. Well-differentiated NEC, whatever the grade,
2. Metastatic disease,
3. Cancer of unknown primary
4. Organ failure that does not allow chemotherapy treatment,
5. Previous malignancy within 5 years prior to the study except for cutaneous basal cell carcinoma and uterine cancer in situ
6. Tumor with a mixed component (component accounts for ≥ 30%),
7. Patient impossible to follow-up,
8. Other than platinum-etoposide chemotherapy administrated,
9. Tutelage or guardianship or patient protected by law.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Fondation ARCAD

OTHER

Sponsor Role collaborator

GERCOR - Multidisciplinary Oncology Cooperative Group

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Anna PELLAT

Role: PRINCIPAL_INVESTIGATOR

Saint-Antoine Hospital

Locations

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CHU Amiens - Hôpital Sud

Amiens, , France

Site Status RECRUITING

CHU Jean Minjoz

Besançon, , France

Site Status RECRUITING

Hôpital Beaujon

Clichy, , France

Site Status RECRUITING

CHU Dijon

Dijon, , France

Site Status RECRUITING

Hôpital Edouard Herriot

Lyon, , France

Site Status NOT_YET_RECRUITING

Institut Paoli-Calmettes

Marseille, , France

Site Status NOT_YET_RECRUITING

Saint Antoine Hospital

Paris, , France

Site Status RECRUITING

Groupe Hospitalier Diaconesses Croix Saint Simon

Paris, , France

Site Status NOT_YET_RECRUITING

Hôpital Cochin

Paris, , France

Site Status NOT_YET_RECRUITING

Hôpital Saint Antoine

Paris, , France

Site Status RECRUITING

Hôpital Haut Lévêque CHU Bordeaux

Pessac, , France

Site Status RECRUITING

CHU Poitiers

Poitiers, , France

Site Status RECRUITING

CHU Toulouse

Toulouse, , France

Site Status RECRUITING

Institut Gustave Roussy

Villejuif, , France

Site Status NOT_YET_RECRUITING

Countries

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France

Central Contacts

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Anna PELLAT, MD

Role: CONTACT

+33 (0) 1 49 28 23 45

Marie-Line GARCIA-LARNICOL

Role: CONTACT

Facility Contacts

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Vincent HAUTEFEUILLE, MD

Role: primary

+33(0)322088854

Fabien CALCAGNO, MD

Role: primary

+33(03)70632153

Olivia HENTIC, MD

Role: primary

+ 33 (0)1 40 87 52 41

Côme LEPAGE, MD

Role: primary

+33 (0)3 80 39 33 40

Thomas WALTER, MD

Role: primary

Patricia NICCOLI, MD

Role: primary

Anna PELLAT

Role: primary

+33 (0) 1 49 28 23 45

Pauline AFCHAIN

Role: backup

+33 (0) 1 49 28 23 45

Olivier DUBREUIL, MD

Role: primary

Romain CORIAT, md

Role: primary

Pauline AFCHAIN, MD

Role: primary

+33 (0)1 49 28 23 29

Denis SMITH, MD

Role: primary

+ 33 (0)5 57 65 64 39

David TOUGERON, MD

Role: primary

+33(05)49443751

Rosine GUIMBAUD, MD

Role: primary

+33 (0)561779649

Michel DUCREUX, MD

Role: primary

Other Identifiers

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NEONEC D19-01

Identifier Type: -

Identifier Source: org_study_id

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