Health Condition 1: C17- Malignant neoplasm of small intestine Health Condition 2: C7A8- Other malignant neuroendocrine tumors
Conditions
Interventions
Intervention1: Targeted Alpha therapy: Targeted Alpha therapy using 212Pb-VMT-a-peptide in Subjects With Somatostatin Receptor Expressing Neuroendocrine Tumors. The patients will be administered with
Sponsors
B J Madan and Company
Eligibility
Inclusion criteria
Inclusion criteria: 1) Male or female =18 years old with unresectable or metastatic histologically confirmed NET 2) Documented progression of disease following previous therapy within 12 months prior to enrollment and the presence of at least 1 site of measurable disease per RECIST 1.1; 3) Subjects must have received and progressed following somatostatin analog administration. 4) Confirmed presence of somatostatin receptors on all lesions including the non-target and measurable lesions documented by CT/MRI scans, based on positive 68Ga- DOTANOC or Pb203-VMT-a-peptide SSTR PET/CT imaging within 6 weeks prior to enrollment. Follow up imaging will be performed with the same agent or modality used at baseline; 5) Target lesions must be positive (greater than grade 2 uptake Krenning Score) or must have an SUV of more than the normal liver background. 6) Lytic bone lesions, with an identifiable soft tissue component, evaluated by CT or MRI, can also be considered measurable lesions if the soft tissue component otherwise meets the definition of measurability according to RECIST 1.1. In any case, osteoblastic bone lesions are not measurable. 7) Eastern Cooperative Oncology Group (ECOG) status 0-2. 8) Life expectancy of at least 12 weeks in the opinion of the investigator at the time of screening; 9) Be willing to practice the following medically acceptable methods of birth control (both women of childbearing potential (WOCBP) and men who have partners of childbearing potential) from the Screening Visit through 3 months after the final administration 212Pb- VMT-a-peptide. 10) Sufficient bone marrow capacity and organ function in the recent blood tests within 3 weeks prior to Day 1, as defined by: a) White blood cell (WBC) =2,500/ mm3; b) Absolute neutrophil count (ANC) =1000/mm3; c) Platelets =100,000/mm3; d) Hemoglobin (HgB) =9.0 g/dL; e) Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) =3 X upper limit of normal (ULN); f) Total Bilirubin: =2 X ULN; g) Serum creatinine =1.7 mg/dL; h) Serum albumin =3.0 g/L; if lower than 3.0 g/L requires normal range prothrombin time (PT) and international normalized ratio (INR)
Exclusion criteria
Exclusion criteria: 1) Prior whole-body radiotherapy or PRRT using 177Lu/90Y/111In-DOTATATE/ DOTATOC or TAT. 2) Prior regional hepatic radionuclide therapy within 4 months prior to enrollment or prior nonradioactive regional hepatic therapy within 6 months prior to enrollment. 3) Known hypersensitivity to somatostatin analogues, AA infusion, or 212Pb-VMT-a-peptide; 4) Therapeutic use of any somatostatin analogue, including Sandostatin® LAR (within 28 days) and Sandostatin® (within 1 day) prior to administration of study drug; 5) History of myelodysplastic syndrome (MDS); 6) Female subjects who are pregnant or lactating; 7) Indication for surgical lesion removal with curative potential; 8) Known brain metastases, unless these metastases have been treated and/or stable for 6 months prior to enrollment; 9) Experimental cancer treatments or other investigational therapies within 6 weeks or five half-lives of the investigational medication prior to Day 1; 10) Uncontrolled congestive heart failure (NYHA II, III, IV); 11) Uncontrolled diabetes mellitus as defined by a hemoglobin A1C >10.0; 12) Evidence of renal obstruction based on Tc-99m DTPA or TER for MAG3 renal scintigraphy or renal ultrasound. 13) Known or active human immunodeficiency virus (HIV) or hepatitis B or C virus unless cured; 14) Known or suspected active drug or alcohol abuse; 15) Participation in other interventional clinical studies within 30 days prior to Day 1; 16 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; 16) Any somatic or psychiatric disease/condition or abnormal laboratory test that in the opinion of the investigator, may interfere with the objectives and assessments of the study; or 17) Unable to comply with the requirements of the study protocol or be unsuitable for the study for any reason, in the opinion of the investigator.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| •Measurement of the objective response rate by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria. [ Time Frame: 24 months after last dose administration ] •The morphological imaging (CT/MRI) will be done before therapy and selected time points before therapy cycle to determine changes in the size of target lesions. •Number of patients with treatment-related adverse events as assessed by CTCAE v.4.0 [ Time Frame: 24 months after last dose administration ] Timepoint: Every 6 months | — |
Secondary
| Measure | Time frame |
|---|---|
| • Measurement of the Median Progression free survival (mPFS) [ Time Frame: 24 months after last dose administration ] • PFS will be defined as the number of days from the first dose of 212Pb- VMT-a-peptide to documented tumor progression per RECIST 1.1 criteria or death due to any cause. • Measurement of Overall Survival (OS) [ Time Frame: 24 months after last dose administration ] • OS will be defined as the number of days from the first dose of 212Pb-212Pb- VMT-a-peptide to the date of death due to any cause or the date of last contact (censored observations) at the data cut-off date. • Measurement of Time to Tumor Progression (TTP) [ Time Frame: 24 months after last dose administration ] • This measurement will determine the time from start of treatment with 212Pb- 212Pb- VMT-a-peptide until disease progression. Timepoint: 6 months | — |
Countries
India
Contacts
Public ContactDr Ishita Sen
Fortis Memorial Research Institute
Outcome results
None listed