Circulating Tumour Cells in Somatuline Autogel Treated NeuroEndocrine Tumours Patients

NCT02075606 | Completed Phase 4 Results

• 2 other identifiers: A-97-52030-2702013-002194-22
• Study Type: interventional
• Target: 50
• Locations: 1 country
• Sites: 14

Brief Summary

Circulating tumour cells (CTCs) are detectable in the blood in around 50% of patients with functioning NeuroEndocrine Tumours (NET) arising in the midgut area (tumours which are secreting hormones and are located in the area in the middle of the digestive system) and their presence usually means that the prognosis for the patient is poor. CTCs have also been shown to be valuable as predictive markers following treatment and there is increasing interest in using CTCs as 'liquid biopsies' that can help to inform treatment decisions. CTC analysis has the benefit of being relatively non- invasive and quick compared with a conventional CT scan and is therefore an attractive method of monitoring the tumour throughout the treatment period. The purpose of this study is to assess the clinical value that enumeration will have in predicting the clinical symptomatic response and progression free survival in patients receiving Somatuline Autogel for functioning midgut NETs over a one year period.

Conditions

NeuroEndocrine Tumours

Keywords

NET; Symptomatic response; Functioning NeuroEndocrine Tumours; midgut region

Outcome Measures

Primary Outcomes (2)

• Assessment of Clinical Symptomatic Response

  This endpoint was assessed using 2 efficacy variables: * CTCs, enumerated at baseline and Weeks 5, 17, 25, 53 * Clinical symptomatic response, assessed by the use of symptom reporting Subjects recorded 24-hour symptom frequency and severity for 7 days prior to first treatment (baseline), throughout the study, and up to 28 days following final drug administration. Symptoms were recorded by answering predetermined questions on the interactive voice response system (IVRS). Subjects were considered to have a clinical symptomatic response between baseline and last study visit if any 1 of the following criteria were fulfilled: the average number of episodes of diarrhoea decreased by at least 50%, the average number of episodes of flushing decreased by at least 50%, the mode severity of flushing decreased by at least 1 level. Clinical symptomatic response was assessed as a qualitative variable (Yes/No) and reported according to CTC presence at baseline and overall.

  From baseline up to Week 53.

• Percentage of Subjects With Time Point Responses According to Response Evaluation Criteria in Solid Tumours (RECIST) Assessments at Weeks 25 and 53

  Subjects underwent Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) scans at baseline, Visit 8 (Week 25) and Visit 15 (Week 53). Progression was assessed by investigators using RECIST v1.1, and classified as a complete response, partial response, stable disease, progressive disease or non evaluable. The time point responses at Week 25 and Week 53 were analysed by CTC presence at baseline and overall. The percentage of subjects within each response category are presented. Percentages are based on the number of subjects in the concerned population with available responses.

  Week 25 and Week 53.

Secondary Outcomes (5)

• Mean Change From Baseline in Number of Episodes of Diarrhoea and Flushing

  From baseline up to Week 53.

• Mode Symptom Severity of Episodes of Flushing

  From baseline up to Week 53.

• Quality of Life (QoL) Questionnaire: European Organisation for Research and Treatment of Cancer (EORTC) QoL Questionnaire (QLQ)-C30

  From baseline up to Week 53.

• QoL Questionnaire: EORTC QLQ-G.I.NET21

  From baseline up to Week 53.

• Percentage of Subjects Alive and Progression Free at One Year

  From baseline up to Week 53.

Study Arms (1)

Somatuline Autogel®

EXPERIMENTAL

Somatuline Autogel® to treat Functioning Midgut NeuroEndocrine Tumours (NET)

Drug: lanreotide acetate

Interventions

lanreotide acetate DRUG

Somatuline Autogel injection 120mg for first 3 months then 120, 90 or 60 mg administered via the deep subcutaneous route every 28 days

Somatuline Autogel®

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Provision of written informed consent prior to any study related procedures.
• Patients (either sex) must be 18 years or older.
• Patients must be suffering from symptoms of diarrhoea and/or flushing at the time of study enrolment.
• Patients must have a documented diagnosis of a functioning midgut NET.
• In order to avoid patients with rapidly progressing tumours, only patients with well or moderately differentiated tumours and with a Ki67 proliferation index of \<20% will be recruited.
• The clinically appropriate treatment for the patient must be therapy with a somatostatin analogue.
• Patients must have had either a positive somatostatin receptor scintigraphy result or a positive 68Gallium-DOTATATE PET imaging result.

You may not qualify if:

• If the patient is at risk of pregnancy or is breast feeding, unless treatment with Somatuline Autogel is clearly needed (as determined by the clinician).
• The patient is, in the opinion of the investigator, unable to comply fully with the protocol and the study instructions, or present any concomitant condition which could compromise the objectives of the study and/or preclude the protocol-defined procedures (e.g. severe medical conditions, brain metastases, psychiatric disorders, active or uncontrolled infection, known pituitary disease).
• The patient has been treated with any other unlicensed drug within the last 30 days before study entry or will require a concurrent treatment with any other experimental drugs or treatments.
• The patient has been treated with a somatostatin analogue prior to study entry, unless a washout period of at least 2 weeks for subcutaneous octreotide, or at least 6 weeks for a single dose of long acting somatostatin analogue has occurred.
• The patient has received interferon, chemotherapy, chemoembolisation or radionuclide therapy within 3 months prior to study entry.
• The patient has a history of hypersensitivity to drugs with a similar chemical structure.
• Females of childbearing potential must be using oral, double barrier or injectable contraception. Non childbearing potential is defined as being post-menopause for at least 1 year, surgical sterilisation or hysterectomy at least three months before the start of the study.
• The patient has abnormal baseline findings, any other medical condition(s) or laboratory findings that, in the opinion of the Investigator, might jeopardise the patient's safety or decrease the chance of obtaining satisfactory data needed to achieve the objective(s) of the study.

Sponsors & Collaborators

• Ipsen: lead

Study Sites (14)

Basingstoke & North Hampshire Hospital

Basingstoke, United Kingdom

Location

Queen Elizabeth Hospital

Birmingham, United Kingdom

Location

University Hospital Wales

Cardiff, United Kingdom

Location

Beatson West of Scotland Cancer Centre

Glasgow, United Kingdom

Location

St James's University Hospital

Leeds, United Kingdom

Location

University Hospital Aintree

Liverpool, United Kingdom

Location

Hammersmith Hospital

London, United Kingdom

Location

King's College Hospital

London, United Kingdom

Location

Royal Free Hospital

London, United Kingdom

Location

Maidstone Hospital

Maidstone, United Kingdom

Location

The Christie Hospital

Manchester, United Kingdom

Location

Norfolk & Norwich Hospital

Norwich, United Kingdom

Location

Royal Hallamshire Hospital

Sheffield, United Kingdom

Location

Southampton University Hospital

Southampton, United Kingdom

Location

Related Publications (2)

• Meyer T, Caplin M, Khan MS, Toumpanakis C, Shetty S, Ramage JK, Houchard A, Higgs K, Shah T. Circulating tumour cells and tumour biomarkers in functional midgut neuroendocrine tumours. J Neuroendocrinol. 2022 Apr;34(4):e13096. doi: 10.1111/jne.13096. Epub 2022 Feb 7.

  PMID: 35132704 DERIVED

• Childs A, Vesely C, Ensell L, Lowe H, Luong TV, Caplin ME, Toumpanakis C, Thirlwell C, Hartley JA, Meyer T. Expression of somatostatin receptors 2 and 5 in circulating tumour cells from patients with neuroendocrine tumours. Br J Cancer. 2016 Dec 6;115(12):1540-1547. doi: 10.1038/bjc.2016.377. Epub 2016 Nov 22.

  PMID: 27875519 DERIVED

MeSH Terms

Conditions

Neuroendocrine Tumors

Interventions

lanreotide

Condition Hierarchy (Ancestors)

Neuroectodermal Tumors; Neoplasms, Germ Cell and Embryonal; Neoplasms by Histologic Type; Neoplasms; Neoplasms, Nerve Tissue

Results Point of Contact

• Title: Medical Director
• Organization: Ipsen

clinical.trials@ipsen.com

00441753627777

Study Officials

• Matthew Hickling, MD

  Ipsen

  STUDY DIRECTOR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: phase 4
• Allocation: NA
• Masking: NONE
• Purpose: DIAGNOSTIC
• Intervention Model: SINGLE GROUP
• Sponsor Type: INDUSTRY
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: February 26, 2014
• First Posted: March 3, 2014
• Study Start: May 1, 2014
• Primary Completion: June 1, 2017
• Study Completion: June 1, 2017
• Last Updated: June 7, 2019
• Results First Posted: June 7, 2019

Record last verified: 2019-02

Locations

GB (14)