Status:

WITHDRAWN

177Lu-DOTATOC for the Treatment of Patients With Somatostatin Receptor Positive NETs

Lead Sponsor:

British Columbia Cancer Agency

Conditions:

Neuroendocrine Tumors

Carcinoid Tumor

Eligibility:

All Genders

19+ years

Phase:

PHASE2

Brief Summary

This study is to assess if personalized peptide receptor radionuclide therapy (PRRT) with 177Lu-DOTATOC results in fewer adverse events than standard PRRT. Subjects will be randomized to either receiv...

Detailed Description

Overall, 200 subjects will be randomized (1:1 randomization ratio) to receive standard injected activities of 177Lu-DOTATOC PRRT or personalized injection of 177Lu-DOTATOC PRRT. Randomization will be ...

Eligibility Criteria

Inclusion

  • Able to provide written informed consent
  • Age greater than or equal to 19 years
  • Biopsy-proven, well-differentiated grade 1 - 3 NET
  • Gastroenteropancreatic tumors (e.g. carcinoids, gastrinoma, insulinoma, glucagonoma, VIPoma, etc.), functioning and non-functioning
  • Sympathoadrenal system tumors (phaeochromocytoma, paraganglioma)
  • Pulmonary NET, functioning and non-functioning
  • Easter Cooperative Oncology Group (ECOG) ≤ 2
  • Ki67 ≤ 55%
  • Progressive disease demonstrated by RECIST 1.1 criteria within the 6 months preceding the study.
  • Patients with other evidence of progressive disease that is not demonstrated on CT (like rising biomarkers) may be included, at the discretion of the Tumour Review Board.
  • If response to other treatments is considered adequate according to other criteria, the Tumour Review Board may consider excluding the patient from participation in the study.
  • Tumour Review Board confirmation of suitability to proceed to PRRT treatment and enrollment in this trial.
  • Positive PET SSR imaging (Krenning score 2 or higher) in previous 6 months (68Ga-DOTATOC, 68Ga-DOTATATE, 18F-AmBF3-TATE). If PET SSR imaging is not available 111In-penetreotide scintigraphy (Octreotide scan) is acceptable.
  • Adequate laboratory parameters within two weeks of enrollment
  • Kidneys
  • Serum creatinine ≤ 150 µmol/L
  • GFR ≥ 40 ml/min (using plasma clearance values)
  • Marrow
  • Hemoglobin ≥ 80 g/L
  • WBC ≥ 2 x 109/L
  • Platelets ≥ 75 x 109/L
  • Liver
  • Total bilirubin ≤ 3 x upper limit of normal (ULN)
  • ALT ≤ 3 x ULN or ≤ 5 x ULN if liver metastasis
  • Alkaline phosphatase ≤ 3 x ULN or ≤ 5 x ULN if liver metastasis
  • Subject's ability to comply with scheduled visits, treatment plans, laboratory tests, imaging tests, and other procedures required as detailed in the protocol.

Exclusion

  • Women and men of childbearing potential Procreation
  • Women: pregnancy test done before enrollment before each treatment cycle. And subject must use adequate contraception for the duration of therapy, be surgically sterile, or post-menopausal.
  • Men: must be surgically sterile or use adequate contraception for the duration of the therapy.
  • Patient with another non-cutaneous (excluding melanoma) active cancer requiring therapeutic intervention.
  • Curative medical or surgical treatment, local liver embolization, or debulking are appropriate options.
  • Life expectancy is less than 12 weeks.
  • Radiotherapy to target lesions ≤ 12 weeks ago or to more than 25% of bone marrow.
  • PRRT at any time prior to randomization in this study.
  • Systemic therapy (chemotherapy) within 4 weeks of PRRT and other locoregional therapies (radioisotope, embolization) within 12 weeks prior to enrollment. Ongoing use of somatostatin analogs for control of symptoms is allowed.
  • Known brain metastases (unless treated and stable for more than 3 months).
  • Co-morbidities that could, in the opinion of the PI, interfere with safe delivery of PRRT (like urinary incontinence, psychiatric illness), uncontrolled congestive heart failure (NYHA II, III, IV)
  • Breastfeeding (if patients elect to discontinue breast feeding, they can participate in the trial).

Key Trial Info

Start Date :

January 15 2023

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

December 31 2031

Estimated Enrollment :

Patients enrolled

Trial Details

Trial ID

NCT04915144

Start Date

January 15 2023

End Date

December 31 2031

Last Update

February 21 2023

Active Locations (1)

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BC Cancer

Vancouver, British Columbia, Canada, V5Z 4E6