Clinical trial • Phase III • Oncology|Rare Disease
LUTETIUM (177LU) OXODOTREOTIDE for Gastroenteropancreatic neuroendocrine tumour (GEP-NET)|Neuroendocrine tumour
Phase III trial of LUTETIUM (177LU) OXODOTREOTIDE for Gastroenteropancreatic neuroendocrine tumour (GEP-NET)|Neuroendocrine tumour.
Overview
- Trial Therapeutic Area
- Oncology|Rare Disease
- Trial Disease
- Gastroenteropancreatic neuroendocrine tumour (GEP-NET)|Neuroendocrine tumour
- Trial Stage
- Phase III
- Drug Modality
- Radiopharmaceutical|Peptide/protein/enzyme|Other
- Paediatric Trial
- Yes
- Orphan Drug
- Yes
Key dates
- Initial CTIS Submission Date
- 02-05-2024
- First CTIS Authorization Date
- 13-06-2024
Trial design
Randomised, open-label, high-dose octreotide long-acting (sandostatin lar) 60 mg every 4 weeks (comparator arm); octreotide long-acting (sandostatin lar) 30 mg used as best supportive care: 30 mg every 8 weeks during lutathera treatment and every 4 weeks after last lutathera treatment.-controlled, crossover Phase III trial across 20 sites in Spain, Netherlands, Germany and others.
- Randomised
- Yes
- Open Label
- Yes
- Comparator
- High-dose octreotide long-acting (Sandostatin LAR) 60 mg every 4 weeks (comparator arm); Octreotide long-acting (Sandostatin LAR) 30 mg used as best supportive care: 30 mg every 8 weeks during Lutathera treatment and every 4 weeks after last Lutathera treatment.
- Crossover
- Yes
- Target Sample Size
- 132
Eligibility
Recruits 132 paediatric patients.
- Pregnancy Exclusion
- Pregnancy or lactation
- Vulnerable Population
- Vulnerable population selected. Participants may include adolescents (inclusion allows patients ≥15 years of age). Consent: "Patients who have provided a signed informed consent form to participate in the study, obtained prior to the start of any protocol related activities". No specific assent procedures for minors are described in the available documents.
Inclusion criteria
- {"criterion_text":"- Presence of metastasized or locally advanced, inoperable (curative intent) histologically proven, well differentiated Grade 2 or Grade 3 gastroenteropancreatic neuroendocrine (GEP-NET) tumor diagnosed within 6 months prior to screening.\n- Ki67 index ≥10 and ≤ 55%\n- Patients ≥15 years of age and a body weight of >40 kg at screening\n- Expression of somatostatin receptors on all target lesions documented by CT/MRI scans, assessed by any of the following somatostatin receptor imaging (SRI) modalities within 3 months prior to randomization: [68Ga]-DOTA-TOC (e.g. Somakit-TOC®) PET/CT (or MRI when applicable based on target lesions) imaging, [68Ga]-DOTA-TATE PET/CT (or MRI when applicable based on target lesions) imaging (e.g. NETSPOT®), Somatostatin Receptor scintigraphy (SRS) with [111In]- pentetreotide (Octreoscan® SPECT/CT), SRS with [99mTc]-Tektrotyd, [64Cu]-DOTA-TATE PET/CT (or MRI when applicable based on target lesions)\n- The tumor uptake observed in the target lesions must be > normal liver uptake\n- Karnofsky Performance Score (KPS) ≥60\n- Presence of at least 1 measurable site of disease\n- Patients who have provided a signed informed consent form to participate in the study, obtained prior to the start of any protocol related activities"}
Exclusion criteria
- {"criterion_text":"- Creatinine clearance <40 mL/min calculated by the Cockroft Gault method\n- Hb concentration <5.0 mmol/L (<8.0 g/dL); WBC <2x10^9/L (2000/mm^3); platelets <75x10^9/L (75x10^3/mm^3)\n- Any previous therapy with Interferons, Everolimus (mTOR-inhibitors), chemotherapy or other systemic therapies of GEP-NET administered for more than 1 month or within 12 weeks prior to randomization in the study\n- Any previous radioembolization, chemoembolization and radiofrequency ablation for GEP-NET\n- Any surgery within 12 weeks prior to randomization in the study\n- Known brain metastases, unless these metastases have been treated and stabilized for at least 24 weeks, prior to screening in the study. Patients with a history of brain metastases must have a head CT or MRI with contrast to document stable disease prior to randomization in the study\n- Uncontrolled congestive heart failure (NYHA II, III, IV). Patients with history of congestive heart failure who do not violate this exclusion criterion will undergo an evaluation of their cardiac ejection fraction prior to randomization via echocardiography. The results from an earlier assessment (not exceeding 30 days prior to randomization) may substitute the evaluation at the discretion of the Investigator, if no clinical worsening is noted. The patient's measured cardiac ejection fraction in these patients must be >40% before randomization\n- QTcF > 470 msec for females and QTcF > 450 msec for males or congenital long QT syndrome\n- Uncontrolled diabetes mellitus as defined by hemoglobin A1c value > 7.5%\n- Hyperkaleamia >6.0 mmol/L (CTCAE Grade 3) which is not corrected prior to study enrolment\n- Any patient receiving treatment with short-acting octreotide, which cannot be interrupted for 24 h before and 24 h after the administration of Lutathera, or any patient receiving treatment with SSAs (eg octreotide long-acting), which cannot be interrupted for at least 6 weeks before the administration of Lutathera\n- Patients with any other significant medical, psychiatric, or surgical condition, currently uncontrolled by treatment, which may interfere with the completion of the study\n- Prior external beam radiation therapy to more than 25% of the bone marrow\n- Current spontaneous urinary incontinence\n- Other known co-existing malignancies except non-melanoma skin cancer and carcinoma in situ of the uterine cervix, unless definitively treated and proven no evidence of recurrence for 5 years\n- Patient with known incompatibility to CT Scans with I.V. contrast due to allergic reaction or renal insufficiency. If such a patient can be imaged with MRI, then the patient would not be excluded\n- Hypersensitivity to any somatostatin analogues, the IMPs active substance or to any of the excipients\n- Patients who have participated in any therapeutic clinical study/received any investigational agent within the last 30 day\n- Total bilirubin >3 x ULN\n- Serum albumin <3.0 g/dL unless prothrombin time is within the normal range\n- Pregnancy or lactation\n- A) Women of child-bearing potential, defined as all women physiologically capable of becoming pregnant, are not allowed to participate in this study UNLESS they are using highly effective methods of contraception throughout the study treatment period (including cross- over and re-treatment, if applicable) and for 7 months after study drug discontinuation. B) Sexually active male patients, unless they agree to remain abstinent (refrain from heterosexual intercourse) or be willing to use condoms and highly effective methods of contraception with female partners of childbearing potential or pregnant female partners during the treatment period (including cross-over and re-treatment, if applicable) and for 4 months after study drug discontinuation. In addition, male patients must refrain from donating sperm during this same period\n- Peptide receptor radionuclide therapy (PRRT) at any time prior to randomization in the study\n- Documented RECIST progression to previous treatments for the current GEP-NET at any time prior to randomization\n- Patients for whom in the opinion of the investigator other therapeutic options (eg chemo-, targeted therapy) are considered more appropriate than the therapy offered in the study, based on patient and disease characteristics"}
Endpoints
Primary endpoints
- {"endpoint_text":"- Progression Free Survival (PFS): Time from randomization to the first line progression (centrally assessed according to RECIST 1.1) or death due to any cause","definition_or_measurement_approach":"Time from randomization to first documented progression or death; progression centrally assessed according to RECIST 1.1."}
Secondary endpoints
- {"endpoint_text":"- ORR: Rate of patients with best overall response of partial response (PR) or complete response (CR) (centrally assessed according to RECIST 1.1)","definition_or_measurement_approach":"Objective response rate assessed centrally according to RECIST 1.1 (PR or CR)."}
- {"endpoint_text":"- Time to decline (TTD) by 10 points from baseline in the following scores measured by the EORTC QLQ-C30 questionnaire: global health status, diarrhea, fatigue and pain","definition_or_measurement_approach":"Time from baseline to a 10-point decline from baseline in specified EORTC QLQ-C30 scores (global health status, diarrhea, fatigue, pain)."}
Recruitment
- Planned Sample Size
- 132
- Recruitment Window Months
- 97
- Consent Approach
- Signed informed consent is required from participants prior to the start of any protocol-related activities: "Patients who have provided a signed informed consent form to participate in the study, obtained prior to the start of any protocol related activities". Subject information and informed consent forms are available in country/language-specific documents (examples in the file list include Dutch, German, Italian, French and English versions). No specific assent procedures for minors are provided in the available materials.
Geography
- Total Number Of Sites
- 20
- Total Number Of Participants
- 90
Spain
- Earliest CTIS Part Ii Submission Date
- 26-03-2024
- Latest Decision Or Authorization Date
- 13-06-2024
- Processing Time Days
- 79
- Number Of Sites
- 2
- Number Of Participants
- 35
Sites
- Site Name
- Hospital Universitario Ramon Y Cajal
- Department Name
- 72402: Oncología
- Contact Person Name
- Teresa Alonso Gordoa
- Contact Person Email
- talonso@oncologiahrc.com
- Site Name
- Hospital Universitari Vall D Hebron
- Department Name
- 72404: Oncología Médica
- Contact Person Name
- Jaume Capdevila Castillón
- Contact Person Email
- jcapdevila@vhio.net
Netherlands
- Earliest CTIS Part Ii Submission Date
- 26-03-2024
- Latest Decision Or Authorization Date
- 13-02-2025
- Processing Time Days
- 324
- Number Of Sites
- 2
- Number Of Participants
- 9
Sites
- Site Name
- Erasmus Universitair Medisch Centrum Rotterdam (Erasmus MC)
- Department Name
- 52801: Endocrinology
- Contact Person Name
- Johannes Hofland
- Contact Person Email
- j.hofland@erasmusmc.nl
- Site Name
- Universitair Medisch Centrum Utrecht
- Department Name
- 52802: Oncology
- Contact Person Name
- Marnix Lam
- Contact Person Email
- M.Lam@umcutrecht.nl
Germany
- Earliest CTIS Part Ii Submission Date
- 26-03-2024
- Latest Decision Or Authorization Date
- 13-02-2025
- Processing Time Days
- 324
- Number Of Sites
- 2
- Number Of Participants
- 16
Sites
- Site Name
- Universitaetsklinikum Erlangen AöR
- Department Name
- 27601: Medizinische Klinik 1
- Contact Person Name
- Marianne Pavel
- Contact Person Email
- marianne.pavel@uk-erlangen.de
- Site Name
- Universitaetsklinikum Essen AöR
- Department Name
- 27603: Klinik für Nuklearmedizin
- Contact Person Name
- Ken Herrmann
- Contact Person Email
- ken.herrmann@uk-essen.de
Italy
- Earliest CTIS Part Ii Submission Date
- 26-03-2024
- Latest Decision Or Authorization Date
- 13-02-2025
- Processing Time Days
- 324
- Number Of Sites
- 8
- Number Of Participants
- 18
Sites
- Site Name
- Istituto Europeo Di Oncologia S.r.l.
- Department Name
- 38002: Divisione di Oncologia Medica Gastrointestinale e Tumori Neuroendocrini
- Contact Person Name
- Nicola Fazio
- Contact Person Email
- nicola.fazio@ieo.it
- Site Name
- Azienda Ospedaliero-Universitaria Di Bologna IRCCS Istituto Di Ricerca E Di Cura A Carattere Scientifico
- Department Name
- 38003: Dipartimento Oncologia ed Ematologia U.O.C di Oncologia Medica
- Contact Person Name
- Davide Campana
- Contact Person Email
- davide.campana@unibo.it
- Site Name
- Azienda Ospedaliero-Universitaria Sant Andre
- Department Name
- 38004: U.O.C. Malattie dell'Apparato Digerente e del Fegato
- Contact Person Name
- Francesco Panzuto
- Contact Person Email
- francesco.panzuto@ospedalesantandrea.it
- Site Name
- Fondazione IRCCS Istituto Nazionale Dei Tumori
- Department Name
- 38005: S.C. di Medicina Nucleare Dipartimento Diagnostica per mmagini e Radioterapia
- Contact Person Name
- Marco Maccauro
- Contact Person Email
- marco.maccauro@istitutotumori.mi.it
- Site Name
- IRCCS Istituto Nazionale Tumori Fondazione Pascale
- Department Name
- 38001:OncSperSarcomi Tumori RariDip.Corp-s RicAssistOnco-Emat,Neop.Mesenc.Muscolo-Schel.adulto diagn
- Contact Person Name
- Salvatore Tafuto
- Contact Person Email
- s.tafuto@istitutotumori.na.it
- Site Name
- Azienda USL IRCCS Di Reggio Emilia
- Department Name
- 38006: S.C. Medicina Nucleare Dip Oncologico e Tecnologie Avanzate
- Contact Person Name
- Angelina Filice
- Contact Person Email
- Angelina.Filice@ausl.re.it
- Site Name
- Istituto Romagnolo Per Lo Studio Dei Tumori Dino Amadori IRST S.r.l.
- Department Name
- 38007: S.C. Medicina Nucleare e Terapia Metabolica
- Contact Person Name
- Maddalena Sansovini
- Contact Person Email
- maddalena.sansovini@irst.emr.it
- Site Name
- IRCCS Ospedale Policlinico San Martino
- Department Name
- 38008: U.O. Clinica Endocrinologica Dipartimento di Medicina Interna e Specialità Mediche (DIMI)
- Contact Person Name
- Diego Ferone
- Contact Person Email
- ferone@unige.it
France
- Earliest CTIS Part Ii Submission Date
- 26-03-2024
- Latest Decision Or Authorization Date
- 21-03-2025
- Processing Time Days
- 360
- Number Of Sites
- 6
- Number Of Participants
- 12
Sites
- Site Name
- Hospital Edouard Herriot
- Department Name
- 25003
- Contact Person Name
- Laura GERARD
- Contact Person Email
- laura.gerard@chu-lyon.fr
- Site Name
- Hopital Beaujon
- Department Name
- 25001
- Contact Person Name
- Louis De Mestier
- Contact Person Email
- louis.demestier@aphp.fr
- Site Name
- Hospital Hotel Dieu
- Department Name
- 25005
- Contact Person Name
- Catherine Ansquer
- Contact Person Email
- catherine.ansquer@chu-nantes.fr
- Site Name
- Institut Gustave Roussy
- Department Name
- 25002: Méd.Nuclé Et Cancér Et Endo
- Contact Person Name
- Eric Baudin
- Contact Person Email
- eric.baudin@gustaveroussy.fr
- Site Name
- Hospices Civils De Lyon
- Department Name
- 25003: "Service de de Médecine Nucléaire "
- Contact Person Name
- Laura GERARD
- Contact Person Email
- laura.gerard@chu-lyon.fr
- Site Name
- Institut Regional Du Cancer De Montpellier
- Department Name
- 25004: Oncologie Medicale - Cancerolo
- Contact Person Name
- Emmanuel Deshayes
- Contact Person Email
- emmanuel.deshayes@icm.unicancer.fr
Sponsor
Primary sponsor
- Full Name
- Advanced Accelerator Applications
- Organisation Type
- Pharmaceutical company
- Country Of Registered Address
- France
Contract research organisations
- Name
- Eresearchtechnology Inc.
- Responsibilities
- sponsorDuties codes: 13
- Name
- Parexel International (IRL) Limited
- Responsibilities
- sponsorDuties codes: 1,12,2,3,5,6,7
- Name
- Voiant LLC
- Responsibilities
- sponsorDuties codes: 13
- Name
- Charles River Laboratories Montreal ULC
- Responsibilities
- Central Pharmacokinetic assessment (determination of Octreotide in Human Plasma)
Third parties
- {"country":"United States","full_name":"Eresearchtechnology Inc.","duties_or_roles":"sponsorDuties codes: 13","organisation_type":"Pharmaceutical company"}
- {"country":"Ireland","full_name":"Parexel International (IRL) Limited","duties_or_roles":"sponsorDuties codes: 1,12,2,3,5,6,7","organisation_type":"Pharmaceutical company"}
- {"country":"United States","full_name":"Voiant LLC","duties_or_roles":"sponsorDuties codes: 13","organisation_type":"Pharmaceutical company"}
- {"country":"Canada","full_name":"Charles River Laboratories Montreal ULC","duties_or_roles":"Central Pharmacokinetic assessment (determination of Octreotide in Human Plasma)","organisation_type":"Pharmaceutical company"}
Investigational products
- Investigational Product Name
- Lutathera 370 MBq/mL solution for infusion
- Active Substance
- LUTETIUM (177LU) OXODOTREOTIDE
- Modality
- Radiopharmaceutical
- Routes Of Administration
- Intravenous
- Route
- Intravenous
- Authorisation Status
- Authorised (EU/1/17/1226/001)
- Orphan Designation
- Yes
- Starting Dose
- 7.4 GBq
- Dose Levels
- 7.4 GBq x 4 administrations (cumulative dose: 29.6 GBq)
- Frequency
- 4 administrations every 8±1 weeks
- Maximum Dose
- 59.2 GBq (max total per product entry)
- Investigational Product Name
- SANDOSTATIN LAR 30 mg powder and solvent for suspension for injection
- Active Substance
- OCTREOTIDE
- Modality
- Peptide/protein/enzyme
- Routes Of Administration
- Intramuscular
- Route
- Intramuscular
- Authorisation Status
- Authorised (MA1249/00605)
- Starting Dose
- 30 mg
- Dose Levels
- 30 mg (also available in 10 mg and 20 mg formulations)
- Frequency
- As used in study: 30 mg every 8 weeks during Lutathera treatment and every 4 weeks after last Lutathera treatment
- Maximum Dose
- Max daily dose 60 mg; max total dose 1950 mg (product entries)
- Investigational Product Name
- SANDOSTATIN LAR 10 mg powder and solvent for suspension for injection
- Active Substance
- OCTREOTIDE
- Modality
- Peptide/protein/enzyme
- Routes Of Administration
- Intramuscular
- Route
- Intramuscular
- Authorisation Status
- Authorised (MA1249/00603)
- Starting Dose
- 10 mg
- Dose Levels
- 10 mg formulation
- Maximum Dose
- Max daily dose 60 mg; max total dose 1950 mg (product entries)
- Investigational Product Name
- SANDOSTATIN LAR 20 mg powder and solvent for suspension for injection
- Active Substance
- OCTREOTIDE
- Modality
- Peptide/protein/enzyme
- Routes Of Administration
- Intramuscular
- Route
- Intramuscular
- Authorisation Status
- Authorised (MA1249/00604)
- Starting Dose
- 20 mg
- Dose Levels
- 20 mg formulation
- Maximum Dose
- Max daily dose 60 mg; max total dose 1950 mg (product entries)
- Investigational Product Name
- LysaKare 25 g/25 g solution for infusion
- Active Substance
- L-LYSINE HYDROCHLORIDE, L-ARGININE HYDROCHLORIDE
- Modality
- Other
- Routes Of Administration
- Intravenous
- Route
- Intravenous
- Authorisation Status
- Authorised (EU/1/19/1381/001)
- Maximum Dose
- 8 DF dosage form (max total per product entry)
- Combination Treatment
- Yes
Related trials
Other published trials that may interest you.
- LISOCABTAGENE MARALEUCEL for Follicular lymphoma | Marginal zone lymphoma | Relapsed or refractory indolent B-cell non-Hodgkin lymphoma
- MIRDAMETINIB for Neurofibromatosis type 1 associated plexiform neurofibroma
- (12M)-(1S,2S)-N-((63S,4S,Z)-11-ETHYL-12-(2-((S)-1-METHOXYETHYL)-5-(4-METHYLPIPERAZIN-1-YL)PYRIDIN-3-YL)-10,10-DIMETHYL-5,7-DIOXO-61,62,63,64,65,66-HEXAHYDRO-11H-8-OXA-2(4,2)-THIAZOLA-1(5,3)-INDOLA-6(1,3)-PYRIDAZINACYCLOUNDECAPHANE-4-YL)-2-METHYLCYCLOPROPANE-1-CARBOXAMIDE for Resected pancreatic ductal adenocarcinoma (PDAC)
- REVUMENIB for Acute Myeloid Leukemia
- N-[[(2S)-4-[(4-METHYL-1H-IMIDAZOL-5-YL)METHYL]-3-OXO-2-(PHENYLMETHYL)-1-PIPERAZINYL]CARBONYL]-L-LEUCINE TRIHYDRATE for Cutaneous T-cell lymphoma