A Study of Sunitinib Versus Placebo in Combination With Lanreotide in Patients With Progressive Advanced/Metastatic Midgut Carcinoid Tumors

NCT01731925

Last updated date
Study Location
Cliniques Universitaires Saint Luc
Brussels, , , Belgium
Contact
1-800-718-1021

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Eligibility Criteria
condition
The disease, disorder, syndrome, illness, or injury that is being studied.
Carcinoid Tumors
Sex
Females and Males
Age
Pediatric Trials: 0-17 Years
Adult Trials: 18+ Years
18 + years
Inclusion Criteria
The factors, or reasons, that allow a person to participate in a clinical study.
Show details

1. Patients with midgut well-differentiated Grade 1-2 endocrine tumor.

2. Local, locally advanced or metastatic disease documented as progressive by RECIST v1.1. on CT-scan or MRI at baseline and within 12 months prior to baseline.

3. 5HIAA levels superior to 1.5ULN as measured in each individual centre.

4. Disease that is not amenable to surgery with curative intent.

5. Presence of at least one measurable target lesion for further evaluation according to RECIST v1.1

6. Adequate organ function

7. ECOG Performance status 0 or 1.

8. Life expectancy superior or equal to 3 months.

9. Age superior or equal to 18 years.

10. Female patients must be surgically sterile or be postmenopausal, or must agree to use effective contraception during the period of therapy. All female patients with reproductive potential must have a negative pregnancy test (serum or urine) within 7 days prior to enrollment. Breast feeding is not allowed. Male patients must be surgically sterile or must agree to use effective contraception during the period of therapy. The definition of effective contraception will be based on the judgment of the principal investigator or a designated associate.

11. Able to swallow oral compound.

12. Signed and dated informed consent document indicating that the patient has been informed of all pertinent aspects of the trial prior to enrollment.

13. Willingness and ability to comply with scheduled visits, treatment plans, laboratory tests and other study procedures.

14. Registration in a national health care system (CMU included).

Exclusion Criteria
The factors, or reasons, that prevent a person from participating in a clinical study.
Show details


1. Patients with undifferentiated, poorly differentiated gastrointestinal neuroendocrine
tumors, pancreatic neuroendocrine tumors, bronchial carcinoid tumors.


2. Patients with carcinoid tumors with the presence of an obstructive intestinal tumor.


3. Patients with uncontrolled cardiac complication as part of their carcinoid syndrome.


4. Current treatment with any chemotherapy, chemoembolization therapy, immunotherapy, or
investigational anticancer agent


5. Current treatment with dose superior or equal to 120 mg per month of lanreotide


6. Prior treatment with any tyrosine kinase inhibitors or anti-VEGF angiogenic
inhibitors. Prior treatment with non-VEGF-targeted angiogenic inhibitors such as
everolimus or temsirolimus is permitted.


7. Patients who stopped everolimus treatment was less than 4 weeks prior to
randomization.


8. Patients with concomitant treatment with interferon.


9. Patients previously treated with chemotherapy, loco-regional therapy (e.g.,
chemoembolization) or interferon with last administration less than 6 weeks prior to
randomization or with toxicity not resolved to less or equal grade 1 at randomization.


10. Diagnosis of any second malignancy within the last 5 years, except for adequately
treated basal cell or squamous cell skin cancer, or in situ carcinoma of the cervix
uteri.


11. Treatment with potent CYP3A4 inhibitors and inducers within 7 and 12 days,
respectively prior to study drug administration.


12. Concomitant treatment with therapeutic doses of anticoagulants


13. Concomitant treatment with a drug having proarrhythmic potential


14. Unstable systemic diseases including uncontrolled hypertension or active uncontrolled
infections.


15. Current treatment on another clinical trial.


16. Any of the following within the 12 months prior to study drug administration:
myocardial infarction, severe/unstable angina, symptomatic congestive heart failure,
cerebrovascular accident or transient ischemic attack, or pulmonary embolism.


17. Ongoing cardiac dysrhythmias of NCI CTC grade superior or equal to 2, atrial
fibrillation of any grade, or prolongation of the QTc interval to more than 450 msec
for males or more than 470 msec for females.


18. Symptomatic brain metastases, spinal cord compression, or new evidence of brain or
leptomeningeal disease.


19. Left ventricular ejection fraction inferior or equal 50% as measured by either
multigated acquisition scan or echocardiogram.


20. Positive test for human immunodeficiency virus (HIV) or acquired immunodeficiency
syndrome (AIDS) related illness.


21. Patients with complicated, untreated lithiasis of the bile ducts


22. Other severe acute or chronic medical or psychiatric condition or laboratory
abnormality that may increase the risk associated with study participation or study
drug administration, or may interfere with the interpretation of study results, and in
the judgment of the investigator would make the patient inappropriate for entry into
this study.

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Carcinoid TumorsA Study of Sunitinib Versus Placebo in Combination With Lanreotide in Patients With Progressive Advanced/Metastatic Midgut Carcinoid Tumors
NCT01731925
  1. Brussels,
  2. Brussels,
  3. Brussels,
  4. Edegem,
  5. Gent,
  6. Leuven,
  7. Bordeaux,
  8. Clichy,
  9. Créteil,
  10. Lille,
  11. Lyon,
  12. Marseille,
  13. Paris,
  14. Paris,
  15. Paris,
  16. Paris,
  17. Reims,
  18. Rennes,
  19. Rouen,
  20. Tours,
ALL GENDERS
18 Years+
years
MULTIPLE SITES
Advanced Information
Descriptive Information
Brief Title  ICMJE A Study of Sunitinib Versus Placebo in Combination With Lanreotide in Patients With Progressive Advanced/Metastatic Midgut Carcinoid Tumors
Official Title  ICMJE A RANDOMIZED PHASE II DOUBLE-BLIND TRIAL OF SUNITINIB VERSUS PLACEBO IN COMBINATION WITH LANREOTIDE IN PATIENTS WITH PROGRESSIVE ADVANCED/METASTATIC MIDGUT CARCINOID TUMORS
Brief Summary Sunitinib may provide an opportunity for a novel therapeutic strategy for the treatment of subjects with neuroendocrine tumors.
Detailed Description

With the exception of surgery for localized disease, there is presently a lack of available therapies with proven survival benefit for patients with neuroendocrine tumors (NET). Available treatment options for unresectable disease include the use of somatostatin analogs, which may relieve symptoms related to hormonal hypersecretion. The efficacy of cytotoxic chemotherapy in patients with metastatic carcinoid tumors is also limited. Combinations of either streptozocin and cyclophosphamide, or streptozocin and 5-fluorouracil, appear to be inactive, and both regimens are associated with substantial toxicity.

Receptor tyrosine kinases (RTKs) are implicated in deregulated/ autocrine proliferation and survival of solid and hematologic cancer cells. Sunitinib malate is an orally administered small molecule that inhibits the tyrosine kinase enzymatic activities of the receptors for VEGF and PDGF, and also blocks signalling through the KIT, FLT3 and RET pathways.

Therefore, sunitinib malate may provide an opportunity for a novel therapeutic strategy for the treatment of subjects with NET.

Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 2
Study Design  ICMJE Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary Purpose: Treatment
Condition  ICMJE Carcinoid Tumors
Intervention  ICMJE
  • Drug: Lanreotide
    Lanreotide at the dose of 120 mg will be injected every 28 days as the reference treatment to control the carcinoid syndrome in both arms.
  • Drug: Placebo (for sunitinib)
  • Drug: Sunitinib
    Sunitinib 37.5 mg daily
Study Arms  ICMJE
  • Experimental: Sunitinib
    Sunitinib 37.5 mg daily. Lanreotide at the dose of 120 mg will be injected every 28 days as the reference treatment to control the carcinoid syndrome in both arms.
    Interventions:
    • Drug: Lanreotide
    • Drug: Sunitinib
  • Placebo Comparator: Placebo
    Placebo (for sunitinib). Lanreotide at the dose of 120 mg will be injected every 28 days as the reference treatment to control the carcinoid syndrome in both arms.
    Interventions:
    • Drug: Lanreotide
    • Drug: Placebo (for sunitinib)
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Unknown status
Actual Enrollment  ICMJE
 (submitted: December 21, 2016)
44
Original Estimated Enrollment  ICMJE
 (submitted: November 19, 2012)
104
Estimated Study Completion Date  ICMJE December 2017
Estimated Primary Completion Date December 2017   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  1. Patients with midgut well-differentiated Grade 1-2 endocrine tumor.
  2. Local, locally advanced or metastatic disease documented as progressive by RECIST v1.1. on CT-scan or MRI at baseline and within 12 months prior to baseline.
  3. 5HIAA levels superior to 1.5ULN as measured in each individual centre.
  4. Disease that is not amenable to surgery with curative intent.
  5. Presence of at least one measurable target lesion for further evaluation according to RECIST v1.1
  6. Adequate organ function
  7. ECOG Performance status 0 or 1.
  8. Life expectancy superior or equal to 3 months.
  9. Age superior or equal to 18 years.
  10. Female patients must be surgically sterile or be postmenopausal, or must agree to use effective contraception during the period of therapy. All female patients with reproductive potential must have a negative pregnancy test (serum or urine) within 7 days prior to enrollment. Breast feeding is not allowed. Male patients must be surgically sterile or must agree to use effective contraception during the period of therapy. The definition of effective contraception will be based on the judgment of the principal investigator or a designated associate.
  11. Able to swallow oral compound.
  12. Signed and dated informed consent document indicating that the patient has been informed of all pertinent aspects of the trial prior to enrollment.
  13. Willingness and ability to comply with scheduled visits, treatment plans, laboratory tests and other study procedures.
  14. Registration in a national health care system (CMU included).

Exclusion Criteria:

  1. Patients with undifferentiated, poorly differentiated gastrointestinal neuroendocrine tumors, pancreatic neuroendocrine tumors, bronchial carcinoid tumors.
  2. Patients with carcinoid tumors with the presence of an obstructive intestinal tumor.
  3. Patients with uncontrolled cardiac complication as part of their carcinoid syndrome.
  4. Current treatment with any chemotherapy, chemoembolization therapy, immunotherapy, or investigational anticancer agent
  5. Current treatment with dose superior or equal to 120 mg per month of lanreotide
  6. Prior treatment with any tyrosine kinase inhibitors or anti-VEGF angiogenic inhibitors. Prior treatment with non-VEGF-targeted angiogenic inhibitors such as everolimus or temsirolimus is permitted.
  7. Patients who stopped everolimus treatment was less than 4 weeks prior to randomization.
  8. Patients with concomitant treatment with interferon.
  9. Patients previously treated with chemotherapy, loco-regional therapy (e.g., chemoembolization) or interferon with last administration less than 6 weeks prior to randomization or with toxicity not resolved to less or equal grade 1 at randomization.
  10. Diagnosis of any second malignancy within the last 5 years, except for adequately treated basal cell or squamous cell skin cancer, or in situ carcinoma of the cervix uteri.
  11. Treatment with potent CYP3A4 inhibitors and inducers within 7 and 12 days, respectively prior to study drug administration.
  12. Concomitant treatment with therapeutic doses of anticoagulants
  13. Concomitant treatment with a drug having proarrhythmic potential
  14. Unstable systemic diseases including uncontrolled hypertension or active uncontrolled infections.
  15. Current treatment on another clinical trial.
  16. Any of the following within the 12 months prior to study drug administration: myocardial infarction, severe/unstable angina, symptomatic congestive heart failure, cerebrovascular accident or transient ischemic attack, or pulmonary embolism.
  17. Ongoing cardiac dysrhythmias of NCI CTC grade superior or equal to 2, atrial fibrillation of any grade, or prolongation of the QTc interval to more than 450 msec for males or more than 470 msec for females.
  18. Symptomatic brain metastases, spinal cord compression, or new evidence of brain or leptomeningeal disease.
  19. Left ventricular ejection fraction inferior or equal 50% as measured by either multigated acquisition scan or echocardiogram.
  20. Positive test for human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) related illness.
  21. Patients with complicated, untreated lithiasis of the bile ducts
  22. Other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or study drug administration, or may interfere with the interpretation of study results, and in the judgment of the investigator would make the patient inappropriate for entry into this study.
Sex/Gender  ICMJE
Sexes Eligible for Study:All
Ages  ICMJE 18 Years and older   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE Contact information is only displayed when the study is recruiting subjects
Listed Location Countries  ICMJE Belgium,   France
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT01731925
Other Study ID Numbers  ICMJE SUNLAND D12-01
2012-001098-94 ( EudraCT Number )
Has Data Monitoring Committee Yes
U.S. FDA-regulated Product Not Provided
IPD Sharing Statement  ICMJE Not Provided
Responsible Party GERCOR - Multidisciplinary Oncology Cooperative Group
Study Sponsor  ICMJE GERCOR - Multidisciplinary Oncology Cooperative Group
Collaborators  ICMJE
  • Pfizer
  • Ipsen
Investigators  ICMJE
Principal Investigator:Pascal HAMMEL, MDHôpital Beaujon
PRS Account GERCOR - Multidisciplinary Oncology Cooperative Group
Verification Date January 2017

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP