Tarlatamab vs Standard of Care Chemotherapy in Patients With Pre-treated Advanced, Pulmonary or Gastroenteropancreatic Poorly Differentiated Neuroendocrine Carcinomas (NECs)

NCT ID: NCT06937905

Last Updated: 2025-04-22

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

PHASE3

Total Enrollment

129 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-09-01

Study Completion Date

2030-03-01

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Based on the efficacy of tarlatamab in patients with small-cell lung cancer, we aim to assess the efficacy of tarlatamab in patients with Advanced, pulmonary (large-cell only) or gastroenteropancreatic neuroendocrine carcinoma.

Related Clinical Trials

Explore similar clinical trials based on study characteristics and research focus.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Neuroendocrine Carcinoma

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Arm A : Standard of care chemotherapy

Study treatment in the arm A is left to the investigator appreciations. This may include immune checkpoint inhibitors, docetaxel, topotecan for primary lung tumors, and FOLFOX, FOLFIRI or alkylating-based chemotherapy in primary digestive tumors.

Group Type ACTIVE_COMPARATOR

Standard of Care Chemotherapy

Intervention Type DRUG

Study treatment in the arm A is left to the investigator appreciations. This may include immune checkpoint inhibitors, docetaxel, topotecan for primary lung tumors, and FOLFOX, FOLFIRI or alkylating-based chemotherapy in primary digestive tumors.

Arm B : Tarlatamab

Tarlatamab 10 mg every 2 weeks

Group Type EXPERIMENTAL

Tarlatamab

Intervention Type DRUG

Tarlatamab 10 mg every 2 weeks

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Standard of Care Chemotherapy

Study treatment in the arm A is left to the investigator appreciations. This may include immune checkpoint inhibitors, docetaxel, topotecan for primary lung tumors, and FOLFOX, FOLFIRI or alkylating-based chemotherapy in primary digestive tumors.

Intervention Type DRUG

Tarlatamab

Tarlatamab 10 mg every 2 weeks

Intervention Type DRUG

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

1. Signed Informed consent:

* Subjects must have signed and dated an IRB/IEC approved written informed consent form in accordance with regulatory and institutional guidelines. This must be obtained before the performance of any protocol related procedures that are not part of normal subject care.
* Subjects must be willing and able to comply with scheduled visits, treatment schedule, and laboratory testing
2. Age ≥ 18 years.
3. WHO Performance status 0 - 1.
4. Life expectancy \> 12 weeks.
5. Histologically proven and centrally confirmed poorly differentiated neuroendocrine carcinoma (NEC): large cells for lung NEC (WHO 2015 classification), and large and small cells for extra-gastroenteropancreatic (assessed on archived tissue, with possible pre-screening during first-line).
6. Expression of DLL3 in at least 1% of tumor cells (assessed on archived tissue, with possible pre-screening during first-line)
7. Tumor progression following one platinum based line of therapy.
8. Unresectable locally advanced or metastatic stage.
9. At least one measurable target lesion according to RECIST v1.1 per investigator assessment. The radiological assessment has to be done within the timelines indicated.
10. Adequate organ function: creatinine clearance \> 50 mL/min, Neutrophils count ≥ 1500/mm3; Platelets \> 100 000/mm3 ; Hemoglobin \> 9 g/dL; AST and ALT \< 3 x ULN (upper limit of normal) with total bilirubin ≤ 2 × ULN except subjects with documented Gilbert's syndrome or liver metastasis, who must have AST and ALT ≤ 5 x ULN and a baseline total bilirubin ≤ 3.0 mg/dL.
11. Full recovery from all toxicities associated with prior treatment, to acceptable baseline status, or a National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE v5.0) grade of 0 or 1, except for toxicities not considered a safety risk, such as alopecia or vitiligo.
12. Availability of tumor material for central review processes and translational research projects.
13. Absence of any unstable systemic disease and any psychological, familial, sociological or geographical factors potentially hampering compliance with the study protocol and follow-up schedule.
14. Females of childbearing potential who are sexually active with a non-sterilized male partner must use a highly effective method of contraception for 28 days prior to the first dose of investigational product, and must agree to continue using such precautions for 7 months after the final dose of investigational product; cessation of contraception after this point should be discussed with a responsible physician. Periodic abstinence, the rhythm method, and the withdrawal method are not acceptable methods of contraception. They must also refrain from egg cell donation for 7 months after the final dose of investigational product.
15. Men who are sexually active with women of childbearing potential will be instructed to adhere to contraception for a period of 6 months after the last dose of treatment.
16. Patient covered by a national health insurance.

Exclusion Criteria

1. Well-differentiated neuroendocrine tumor (NET G1, G2 and G3 according to digestive WHO 2017 classification or typical/atypical carcinoid tumor according to lung WHO 2015 classification)
2. Previous treatment targeting DLL3
3. More than one line of systemic therapy in the metastatic setting. Chemotherapy for non-metastatic stage is not considered as first-line if there is a time interval of at least 6 months between the last dose of chemotherapy for non-metastatic stage and the initiation of first-line chemotherapy for metastatic/recurrent disease.
4. Small cell lung NEC (except as a minor \<30% component in mixed tumors)
5. Known EGFR activating mutation or ALK or ROS1 rearrangement for lung NEC
6. Untreated or symptomatic central nervous system (CNS) metastases:

* Subjects with asymptomatic CNS metastases are eligible if clinically stable for at least 4 weeks and do not require intervention (including use of corticosteroids).
* Subjects with treated brain metastases are eligible provided the following criteria are met:

* Subject is asymptomatic from brain metastases
* Whole brain radiation or surgery was completed at least 2 weeks prior to first dose of study treatment (stereotactic radiosurgery completed at least 7 days prior to first dose of study treatment)
* Any CNS disease is clinically stable, subject is off steroids for CNS disease for at least 5 days (unless steroids are indicated for a reason unrelated to CNS disease), and subject is off or on stable doses of anti-epileptic drugs at least 14 days prior to first dose of study treatment
7. Leptomeningeal metastasis
8. Patients with a recent history of other malignancies except adequately treated non-melanoma skin cancer, and curatively treated in-situ cancer. Patients with history of solid tumors, including adenocarcinoma, treated in a curative way with or without chemotherapy and without any evidence of disease \>2 years before randomisation can be included as well.
9. Major surgery within 28 days prior to initiation of study treatment.
10. Myocardial infarction and/or symptomatic congestive heart failure (New York Head Association class \> class II) within 12 months prior to initiation of study treatment.
11. History of arterial thrombosis (e.g. stroke or transient ischemic attack) within 12 months prior to initiation of study treatment.
12. Symptoms and/or clinical and/or radiological signs suggestive of uncontrolled and/or acute active systemic infection within 7 days prior to first administration ofstudy treatment. Patient with active infection requiring parenteral antibiotic therapy. Upon completion of parental antibiotic therapy and resolution of symptoms, the patient may be considered eligible under the infection criterion.
13. Known sensitivity and/or immediate hypersensitivity to any component of study treatment.
14. History of primary immunodeficiency, history of organ transplant that requires therapeutic immunosuppression and the use of immunosuppressive agents within 28 days of randomization or a prior history of severe (grade 3 or 4) immune mediated toxicity from other immune therapy.
15. Patients with immune pneumonitis, pituitary or thyroid disorders, or pancreatitis under treatment with immuno-oncology agents.
16. Patients reporting infusion-related reactions or severe, life-threatening or recurrent immune-mediated adverse events (grade 2 or higher), including events leading to permanent discontinuation of immuno-oncology agents.
17. Presence of an indwelling line or drain (including the following: percutaneous nephrostomy tube, indwelling Foley catheter, biliary drain, peritoneal drain or catheter, pericardial drain or catheter, drain catheter or thoracic drain for pleural fluid collection).
18. Patient with a diagnosis of immunodeficiency or undergoing systemic corticotherapy or any other form of immunosuppressive therapy within 7 days prior to administration of the first dose of study treatment.
19. Known acute or chronic B or C hepatitis by serological evaluation. Patients with serological sequellae of hepatitis (antibodies test serologically positive for virus) without hepatitis could be included.
20. Known Human immunodeficiency virus infection
21. Patients who are pregnant or breast-feeding, or planning to become pregnant or breast-feed during the trial and within 7 months after the last dose of study treatment.
22. Male not wishing to abstain from sperm donation during the trial and within 6 months of the last study treatment.
23. Vaccination with live or attenuated virus vaccines is not permitted during the 28 days prior to administration of the first dose of treatment, and for the duration of the study. Vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) should be avoided during selection, at least 14 days before the first day of treatment. Live, non-replicating smallpox vaccines (such as Jynneos) against monkeypox infection are permitted during the study (except during cycle 1) in accordance with the center's standard of care and internal recommendations.
24. Active autoimmune disease requiring systemic therapy (except replacement therapy) within the last 2 years or any other disease requiring immunosuppressive therapy during the study.
25. Patients with other concurrent severe and/or uncontrolled medical disease which could compromise participation in the study.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Intergroupe Francophone de Cancerologie Thoracique

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Angers - CHU

Angers, , France

Site Status

Avignon - CH

Avignon, , France

Site Status

Besançon - CHU

Besançon, , France

Site Status

Boulogne - Ambroise Paré

Boulogne, , France

Site Status

Caen - CHU

Caen, , France

Site Status

Caen - CHU

Caen, , France

Site Status

Tours - CHU

Chambray-lès-Tours, , France

Site Status

Dijon - Centre Georges-François Leclerc

Dijon, , France

Site Status

Dijon - CHU Bocage

Dijon, , France

Site Status

Grenoble - CHU

Grenoble, , France

Site Status

Le Mans - CHG

Le Mans, , France

Site Status

Lille - Centre Oscar Lambret

Lille, , France

Site Status

Limoges - CHU

Limoges, , France

Site Status

Limoges - CHU

Limoges, , France

Site Status

Lyon - Centre Léon Bérard

Lyon, , France

Site Status

Lyon - Hôpital Edouard Herriot

Lyon, , France

Site Status

Lyon - Hôpital Privé Jean Mermoz

Lyon, , France

Site Status

Marseille - APHM

Marseille, , France

Site Status

Marseille - Institut Paoli-Calmettes

Marseille, , France

Site Status

Montpellier - CHU

Montpellier, , France

Site Status

Nice - Centre Antoine Lacassagne

Nice, , France

Site Status

Paris - Curie

Paris, , France

Site Status

Paris - Hôpital Cochin

Paris, , France

Site Status

Paris - Saint-Antoine

Paris, , France

Site Status

Paris - Tenon

Paris, , France

Site Status

Bordeaux - CHU

Pessac, , France

Site Status

Bordeaux - CHU

Pessac, , France

Site Status

Lyon - HCL

Pierre-Bénite, , France

Site Status

Poitiers - CHU

Poitiers, , France

Site Status

Reims - CHU

Reims, , France

Site Status

Rennes - CHU

Rennes, , France

Site Status

Rouen - CHU

Rouen, , France

Site Status

Nantes - Hôpital Laennec

Saint-Herblain, , France

Site Status

Nantes - Institut de Cancérologie de l'Ouest

Saint-Herblain, , France

Site Status

Strasbourg - Nouvel Hôpital Civil

Strasbourg, , France

Site Status

Toulon - CHI

Toulon, , France

Site Status

Toulouse - CHU

Toulouse, , France

Site Status

Tours - CHU

Tours, , France

Site Status

Vandoeuvre-lès-Nancy - Institut de Cancérologie de Lorraine

Vandœuvre-lès-Nancy, , France

Site Status

Villefranche sur Saône - CH

Villefranche-sur-Saône, , France

Site Status

Countries

Review the countries where the study has at least one active or historical site.

France

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Contact IFCT

Role: CONTACT

+33 1.56.81.10.45

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Guillaume ROQUIN

Role: primary

+33156811045

Malek ZOGHLAMI

Role: primary

+33 1.56.81.10.45

Hamadi ALMOTLAK

Role: primary

+331.56.81.10.45

Etienne GIROUX LEPRIEUR

Role: primary

Jeannick MADELAINE

Role: primary

+33 1.56.81.10.45

Karine BOUHIER-LEPORRIER

Role: primary

+33 1.56.81.10.45

Morgane CAULET

Role: primary

+33 1.56.81.10.45

François GHIRINGHELI

Role: primary

+33 1.56.81.10.45

Côme LEPAGE

Role: primary

+33 1.56.81.10.45

Denis MORO-SIBILOT

Role: primary

33 1.56.81.10.45

Camille GUGUEN

Role: primary

+33 1.56.81.10.45

Elisabeth GAYE

Role: primary

+33 1.56.81.10.45

homas EGENOD

Role: primary

+33 1.56.81.10.45

rédéric THUILLIER

Role: primary

+33 1.56.81.10.45

Aurélie SWALDUZ

Role: primary

+33 1.56.81.10.45

Thomas WALTER

Role: primary

+33 1.56.81.10.45

Jérôme DESRAME

Role: primary

+33 1.56.81.10.45

Laurent GREILLIER

Role: primary

+33 1.56.81.10.45

Patricia NICCOLI

Role: primary

+33 1.56.81.10.45

Patricia BARRE

Role: primary

+33 1.56.81.10.45

Claire JARAUDIAS

Role: primary

+33 1.56.81.10.45

Nicolas GIRARD

Role: primary

Anne PELLAT

Role: primary

+33 1.56.81.10.45

Pauline AFCHAIN

Role: primary

+33 1.56.81.10.45

Anthony CANELLAS

Role: primary

+33 1.56.81.10.45

Denis SMITH

Role: primary

+33 1.56.81.10.45

Maéva ZYSMAN

Role: primary

+33 1.56.81.10.45

Sébastien COURAUD

Role: primary

+33 1.56.81.10.45

Aurélie FERRU

Role: primary

+33 1.56.81.10.45

Maxime DEWOLF

Role: primary

+33 1.56.81.10.45

Charles RICORDEL

Role: primary

+33 1.56.81.10.45

Frédéric DI FIORE

Role: primary

+33 1.56.81.10.45

Alexandre LUGAT

Role: primary

+33 1.56.81.10.45

Hélène SENELLART

Role: primary

+33 1.56.81.10.45

Guillaume PAMART

Role: primary

+33 1.56.81.10.45

Clarisse AUDIGIER-VALETTE

Role: primary

+33 1.56.81.10.45

Julien MAZIERES

Role: primary

+33 1.56.81.10.45

Delphine CARMIER

Role: primary

+33 1.56.81.10.45

Christelle CLEMENT-DUCHENE

Role: primary

+33 1.56.81.10.45

Luc ODIER

Role: primary

+33 1.56.81.10.45

Other Identifiers

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

GCO-003

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.