Peptide Receptor Radionuclide Therapy (PRRT) in Tumors With High Expression of Somatostatin Receptors (Phase 2)

NCT ID: NCT04790708

Last Updated: 2021-03-10

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

250 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-07-02

Study Completion Date

2023-06-30

Brief Summary

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The rationale behind the purpose of this study lays on:

* the evidence that PRRT could represent a valuable treatment for the majority of patients with neuroendocrine tumor (NET) in disease progression, operated or inoperable, presenting lesions expressing somatostatin receptors and for which standard treatments are not already available;
* the current impossibility of acquiring on the market radiolabelled analogues of somatostatin used for PRRT with marketing authorisation;
* the need to collect a larger case history than in previous studies;
* the need to stratify the various histotypes based on the response obtained;
* the need to define new treatment schemes that guarantee the maximum efficacy and the lowest possible toxicity - with low cumulative (and per cycle) activities radiopharmaceutical and according to the concept of dose hyperfractionation - with a view to an optimal balance between risk and benefit.

Detailed Description

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Conditions

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Neuroendocrine Tumors Peptide Receptor Radionuclide Therapy (PRRT)

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Midgut NETs

75 patients affected by non-functional and functional NETs arising from: stomach, duodenum, jejunum, ileum, colon and rectum.

Group Type EXPERIMENTAL

Lutetium-177 (177Lu)-DOTATOC

Intervention Type RADIATION

5 cycles of 3,7 e 5,55 gigabequerel (GBq) of 177Lu-DOTATOC every 8-10 weeks. Cumulative activity: 18,5 e 27,75 GBq

Yttrium-90 (90Y)-DOTATOC

Intervention Type RADIATION

5 cycles of 1,85 e 2,775 GBq of 90Y-DOTATOC every 8-10 weeks. Cumulative activity: 9,25 e 13,875 GBq

177Lu-DOTATOC + 90Y-DOTATOC

Intervention Type RADIATION

3 cycles of 3,7 e 5,55 GBq of 177Lu-DOTATOC alternated with 2 cycles of 1,85 e 2,775 GBq of 90Y-DOTATOC every 8-10 weeks.

Cumulative activity: 18,5 e 27,75 GBq of 177Lu-DOTATOC and 9,25 e 13,875 GBq of 90Y-DOTATOC

Re-treatment 177Lu-DOTATOC

Intervention Type RADIATION

3 cycles of 3,7 e 5,55 GBq of 177Lu-DOTATOC every 8-10weeks. Cumulative activity: 11,1 e 16,65 GBq of 177Lu-DOTATOC

Re-treatment 90Y-DOTATOC

Intervention Type RADIATION

3 cycles of 1,85 e 2,775 GBq of 90Y-DOTATOC every 8-10 weeks Cumulative activity: 5,55 e 8,325 GBq of 90Y-DOTATOC

Pancreatic NETs

75 patients affected by non-functional and functional NETs arising from Pancreas.

Group Type EXPERIMENTAL

Lutetium-177 (177Lu)-DOTATOC

Intervention Type RADIATION

5 cycles of 3,7 e 5,55 gigabequerel (GBq) of 177Lu-DOTATOC every 8-10 weeks. Cumulative activity: 18,5 e 27,75 GBq

Yttrium-90 (90Y)-DOTATOC

Intervention Type RADIATION

5 cycles of 1,85 e 2,775 GBq of 90Y-DOTATOC every 8-10 weeks. Cumulative activity: 9,25 e 13,875 GBq

177Lu-DOTATOC + 90Y-DOTATOC

Intervention Type RADIATION

3 cycles of 3,7 e 5,55 GBq of 177Lu-DOTATOC alternated with 2 cycles of 1,85 e 2,775 GBq of 90Y-DOTATOC every 8-10 weeks.

Cumulative activity: 18,5 e 27,75 GBq of 177Lu-DOTATOC and 9,25 e 13,875 GBq of 90Y-DOTATOC

Re-treatment 177Lu-DOTATOC

Intervention Type RADIATION

3 cycles of 3,7 e 5,55 GBq of 177Lu-DOTATOC every 8-10weeks. Cumulative activity: 11,1 e 16,65 GBq of 177Lu-DOTATOC

Re-treatment 90Y-DOTATOC

Intervention Type RADIATION

3 cycles of 1,85 e 2,775 GBq of 90Y-DOTATOC every 8-10 weeks Cumulative activity: 5,55 e 8,325 GBq of 90Y-DOTATOC

Bronchial NETs

25 patients affected by non-functional and functional Bronchial NETs.

Group Type EXPERIMENTAL

Lutetium-177 (177Lu)-DOTATOC

Intervention Type RADIATION

5 cycles of 3,7 e 5,55 gigabequerel (GBq) of 177Lu-DOTATOC every 8-10 weeks. Cumulative activity: 18,5 e 27,75 GBq

Yttrium-90 (90Y)-DOTATOC

Intervention Type RADIATION

5 cycles of 1,85 e 2,775 GBq of 90Y-DOTATOC every 8-10 weeks. Cumulative activity: 9,25 e 13,875 GBq

177Lu-DOTATOC + 90Y-DOTATOC

Intervention Type RADIATION

3 cycles of 3,7 e 5,55 GBq of 177Lu-DOTATOC alternated with 2 cycles of 1,85 e 2,775 GBq of 90Y-DOTATOC every 8-10 weeks.

Cumulative activity: 18,5 e 27,75 GBq of 177Lu-DOTATOC and 9,25 e 13,875 GBq of 90Y-DOTATOC

Re-treatment 177Lu-DOTATOC

Intervention Type RADIATION

3 cycles of 3,7 e 5,55 GBq of 177Lu-DOTATOC every 8-10weeks. Cumulative activity: 11,1 e 16,65 GBq of 177Lu-DOTATOC

Re-treatment 90Y-DOTATOC

Intervention Type RADIATION

3 cycles of 1,85 e 2,775 GBq of 90Y-DOTATOC every 8-10 weeks Cumulative activity: 5,55 e 8,325 GBq of 90Y-DOTATOC

Sympathetic-Adrenergic axis NEts

25 patients affected by non-functional and functional: Pheochromocytoma, Paraganglioma and Neuroblastoma

Group Type EXPERIMENTAL

Lutetium-177 (177Lu)-DOTATOC

Intervention Type RADIATION

5 cycles of 3,7 e 5,55 gigabequerel (GBq) of 177Lu-DOTATOC every 8-10 weeks. Cumulative activity: 18,5 e 27,75 GBq

Yttrium-90 (90Y)-DOTATOC

Intervention Type RADIATION

5 cycles of 1,85 e 2,775 GBq of 90Y-DOTATOC every 8-10 weeks. Cumulative activity: 9,25 e 13,875 GBq

177Lu-DOTATOC + 90Y-DOTATOC

Intervention Type RADIATION

3 cycles of 3,7 e 5,55 GBq of 177Lu-DOTATOC alternated with 2 cycles of 1,85 e 2,775 GBq of 90Y-DOTATOC every 8-10 weeks.

Cumulative activity: 18,5 e 27,75 GBq of 177Lu-DOTATOC and 9,25 e 13,875 GBq of 90Y-DOTATOC

Re-treatment 177Lu-DOTATOC

Intervention Type RADIATION

3 cycles of 3,7 e 5,55 GBq of 177Lu-DOTATOC every 8-10weeks. Cumulative activity: 11,1 e 16,65 GBq of 177Lu-DOTATOC

Re-treatment 90Y-DOTATOC

Intervention Type RADIATION

3 cycles of 1,85 e 2,775 GBq of 90Y-DOTATOC every 8-10 weeks Cumulative activity: 5,55 e 8,325 GBq of 90Y-DOTATOC

Other Nets

25 patients affected by non-functional and functional NETs arising from Skin, Thyroid (medullary thyroid and anaplastic cancer) and Parathyroids.

Group Type EXPERIMENTAL

Lutetium-177 (177Lu)-DOTATOC

Intervention Type RADIATION

5 cycles of 3,7 e 5,55 gigabequerel (GBq) of 177Lu-DOTATOC every 8-10 weeks. Cumulative activity: 18,5 e 27,75 GBq

Yttrium-90 (90Y)-DOTATOC

Intervention Type RADIATION

5 cycles of 1,85 e 2,775 GBq of 90Y-DOTATOC every 8-10 weeks. Cumulative activity: 9,25 e 13,875 GBq

177Lu-DOTATOC + 90Y-DOTATOC

Intervention Type RADIATION

3 cycles of 3,7 e 5,55 GBq of 177Lu-DOTATOC alternated with 2 cycles of 1,85 e 2,775 GBq of 90Y-DOTATOC every 8-10 weeks.

Cumulative activity: 18,5 e 27,75 GBq of 177Lu-DOTATOC and 9,25 e 13,875 GBq of 90Y-DOTATOC

Re-treatment 177Lu-DOTATOC

Intervention Type RADIATION

3 cycles of 3,7 e 5,55 GBq of 177Lu-DOTATOC every 8-10weeks. Cumulative activity: 11,1 e 16,65 GBq of 177Lu-DOTATOC

Re-treatment 90Y-DOTATOC

Intervention Type RADIATION

3 cycles of 1,85 e 2,775 GBq of 90Y-DOTATOC every 8-10 weeks Cumulative activity: 5,55 e 8,325 GBq of 90Y-DOTATOC

Cancers of Unknown Primary Origin (CUP) NETs

25 patients affected by non-functional and functional unknown primary NETs

Group Type EXPERIMENTAL

Lutetium-177 (177Lu)-DOTATOC

Intervention Type RADIATION

5 cycles of 3,7 e 5,55 gigabequerel (GBq) of 177Lu-DOTATOC every 8-10 weeks. Cumulative activity: 18,5 e 27,75 GBq

Yttrium-90 (90Y)-DOTATOC

Intervention Type RADIATION

5 cycles of 1,85 e 2,775 GBq of 90Y-DOTATOC every 8-10 weeks. Cumulative activity: 9,25 e 13,875 GBq

177Lu-DOTATOC + 90Y-DOTATOC

Intervention Type RADIATION

3 cycles of 3,7 e 5,55 GBq of 177Lu-DOTATOC alternated with 2 cycles of 1,85 e 2,775 GBq of 90Y-DOTATOC every 8-10 weeks.

Cumulative activity: 18,5 e 27,75 GBq of 177Lu-DOTATOC and 9,25 e 13,875 GBq of 90Y-DOTATOC

Re-treatment 177Lu-DOTATOC

Intervention Type RADIATION

3 cycles of 3,7 e 5,55 GBq of 177Lu-DOTATOC every 8-10weeks. Cumulative activity: 11,1 e 16,65 GBq of 177Lu-DOTATOC

Re-treatment 90Y-DOTATOC

Intervention Type RADIATION

3 cycles of 1,85 e 2,775 GBq of 90Y-DOTATOC every 8-10 weeks Cumulative activity: 5,55 e 8,325 GBq of 90Y-DOTATOC

Interventions

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Lutetium-177 (177Lu)-DOTATOC

5 cycles of 3,7 e 5,55 gigabequerel (GBq) of 177Lu-DOTATOC every 8-10 weeks. Cumulative activity: 18,5 e 27,75 GBq

Intervention Type RADIATION

Yttrium-90 (90Y)-DOTATOC

5 cycles of 1,85 e 2,775 GBq of 90Y-DOTATOC every 8-10 weeks. Cumulative activity: 9,25 e 13,875 GBq

Intervention Type RADIATION

177Lu-DOTATOC + 90Y-DOTATOC

3 cycles of 3,7 e 5,55 GBq of 177Lu-DOTATOC alternated with 2 cycles of 1,85 e 2,775 GBq of 90Y-DOTATOC every 8-10 weeks.

Cumulative activity: 18,5 e 27,75 GBq of 177Lu-DOTATOC and 9,25 e 13,875 GBq of 90Y-DOTATOC

Intervention Type RADIATION

Re-treatment 177Lu-DOTATOC

3 cycles of 3,7 e 5,55 GBq of 177Lu-DOTATOC every 8-10weeks. Cumulative activity: 11,1 e 16,65 GBq of 177Lu-DOTATOC

Intervention Type RADIATION

Re-treatment 90Y-DOTATOC

3 cycles of 1,85 e 2,775 GBq of 90Y-DOTATOC every 8-10 weeks Cumulative activity: 5,55 e 8,325 GBq of 90Y-DOTATOC

Intervention Type RADIATION

Other Intervention Names

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"MONO" "DUO"

Eligibility Criteria

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Inclusion Criteria

* 1\. Age ≥18 years, of both sexes, of any ethnicity;
* 2\. Cyto-histological and immunohistochemical diagnosis of NET;
* 3\. Evaluation of the cell proliferation index by studying Ki-67 and / or E3 ubiquitin-protein ligase (MIB-1).
* 4\. Illness measurable according to RECIST 1.1 criteria by imaging conventional (CT with contrast medium or MRI with contrast medium) not earlier than two months with respect to enrollment;
* 5\. Elevated expression of somatostatin receptors documented by PET-CT with 68Ga-DOTATOC in the target lesion (s). It is defined as "high expression of somatostatin receptors "a ratio of Maximum standardized uptake value (SUVmax) lesion / Mean standardized uptake value (SUVmean) muscle ≥ 4: 1 calculated with semi-quantitative analysis on examination PET-CT with 68Ga-DOTATOC;
* 6\. Dosage of Chromogranin A (and any other specific markers) not prior to two months of enrollment;
* 7\. Evaluation of glucose metabolism in the target lesion (s) by PET-CT with 18F-FDG;
* 8\. Preserved haematological, hepatic and renal parameters, in particular: white blood cells ≥2500 / μL; platelets ≥ 90000 / μL; hemoglobin ≥ 9 gr / dL; creatinine ≤ 2 mg / dL; bilirubin ≤ 2.5 mg / dL
* 9\. Eastern Cooperative Oncology Group (ECOG) performance status ≤2;
* 10\. Life expectancy ≥ 6 months;
* 11\. Stable or progressive disease, at any stage, both in operated patients that inoperable;
* 12\. Absence of standard treatments already documented and of equal effectiveness;
* 13\. Absence of surgical, chemotherapy and / or radiotherapy treatments for at least 30 days. On the other hand, patients in therapy with somatostatin analogues or biologics, such as mechanistic target of rapamycin (m-TOR) inhibitors;
* 14\. Voluntary participation in the study by signing the consent form informed, after reading and complete understanding of the information notes.

Exclusion Criteria

* 1\. Lack of the requirements listed above;
* 2\. State of pregnancy;
* 3\. Breastfeeding and relative refusal to suspend breastfeeding;
* 4\. Participation in another therapeutic experimental clinical protocol in the four weeks prior to the PRRT;
* 5\. Bone marrow invasion of disease\> 25% confirmed;
* 6\. Previous extensive radiotherapy treatments.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital of Ferrara

OTHER

Sponsor Role lead

Responsible Party

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Mirco Bartolomei

MD, Director of Nuclear Medicine Unit

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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University Hospital of Ferrara

Ferrara, , Italy

Site Status RECRUITING

Countries

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Italy

Central Contacts

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Mirco Bartolomei, MD

Role: CONTACT

0532236082

Licia Uccelli, PhD

Role: CONTACT

0532237462

Facility Contacts

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Mirco Bartolomei, MD

Role: primary

0532-236082

Role: backup

0532-236387

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Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

2016-005129-35

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

160990

Identifier Type: -

Identifier Source: org_study_id

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