The MetNET-2 Trial

Neuroendocrine Tumors Clinical Trial

— MetNET-2  

Official title:

Safety of Lanreotide 120 mg ATG in Combination With Metformin in Patients With Progressive Advanced Well-differentiated Gastro-intestinal (GI) or Lung Carcinoids: A Pilot, One-arm, Open-label, Prospective Study: the MetNET-2 Trial

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT02823691
• Other study ID #: NationalCIMilan
• Status: Active, not recruiting
• Phase: Early Phase 1
• Start date: April 2016
• Est. completion date: December 2021

Study information

• Verified date: June 2021
• Source: Fondazione IRCCS Istituto Nazionale dei Tumori, Milano
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This is a Pilot, One-arm, Open-label, Prospective Study to evaluate Safety of Lanreotide 120 mg ATG in combination with Metformin in patients with advanced progressive GI or lung carcinoids. The patient population will include patients with a histologically documented diagnosis of Well differentiated NET, G1-G2 according to the last WHO Classification criteria for GI and lung NET carcinoids.

Description:

This study is strategically positioned in the medical treatment safety and efficacy context, that is Lanreotide can be safely and effectively used in combination with other agents, like Metformin. Aim of this study is to verify the safety of a concomitant administration of Lanreotide 120 mg ATG with Metformin in advanced, progressing gastro-intestinal or lung carcinoids patients, by accurately monitor patients from a tolerability point of view during all study long.

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 20
• Est. completion date: December 2021
• Est. primary completion date: December 2021
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Adult patients (male or female, age > 18 years)
• Patient with advanced disease, not resectable. The evaluation of unresectable disease will be performed by surgeon of multidisciplinary Milan ENETS Center of Excellence tumour board of Fondazione IRCCS Istituto Nazionale dei Tumori Milano.
• Patients with a histologically documented diagnosis of advanced well differentiated (G1 and G2) GI or lung carcinoids, defined according to the last WHO Classification criteria for NET
• Tumor tissue available for analysis
• Measurable disease and disease progression in the 6 months before study inclusion (according to RECIST vs 1.1), documented and appropriate imaging
• Patient who has received prior treatment with surgery or chemotherapy or somatostatin analogues or m-TOR inhibitors or other systemic antineoplastic/target therapies
• Functioning or non-functioning NETs
• Type-2 Diabetic or normoglycaemic patient
• Documented Octreoscan/PET Ga68 uptake/IHC stain of SSTR2 receptor, within 6 months before study entry
• Basal blood tests:
• Counts of neutrophils in absolute value> 1.5 x 103 / L
• Platelet count> 100 x 103 / L
• Hemoglobin> 9 g/dl
• Total Bilirubin <1.5 times the upper limit of normal
• AST, ALT <2.5 times the upper limit of normal
• Alkaline phosphatase <2.5 times the upper limit of normal
• Values of serum creatinine <1.5 mg / dl. - CCr = 60 mL / min
• ECOG performance status = 2
• Life expectancy > 12 months
• Written informed consent
• Female subjects of childbearing potential (not surgically sterile or 2 years postmenopausal) must use a medically accepted method of contraception and must agree to continue use of this method for the duration of the study and for at least 60 days after participation in the study. Acceptable methods of contraception include double barrier method [i.e. condom and occlusive cap (diaphragm or cervical/vault caps)] spermicide, intrauterine device (IUD), or steroidal contraceptive (oral, transdermal, implanted, and injected) in conjunction with a barrier method.
• Male subjects with female partners of childbearing potential must use a medically accepted method of contraception and must agree to continue use of this method for the duration of the study and for 60 days after participation in the study. Exclusion Criteria
• Surgery performed within 28 days prior to the beginning of study treatment
• Brain metastasis or spinal cord compression
• Type-1 Diabetes
• Clinically significant cardiovascular disease, such as cardiovascular accidents occurred in less than 6 months, unstable angina, congestive heart failure grade greater than or equal to II (according to the classification of the New York Heart Association NYHA) series cardiac arrhythmias that require treatment
• Uncontrolled high blood pressure, atrial fibrillation
• Cardio-vascular, lung, kidney or hepatic disorders not treated/controlled
• Cirrhosis, acute hepatitis or chronic active hepatitis
• Metabolic disorders, clinical examination or laboratory investigations which contraindicate the use of drugs to study, or patients at high risk of complications from the treatment
• Active or uncontrolled severe infections
• Patients with a condition of metabolic acidosis, acute or chronic, including ketoacitosi
• History of POTUS (alcohol abuse), or habitual intake of alcohol (= 3 glasses of alcoholic drinks / day) sufficient to cause hepatotoxicity
• Severe states of dehydration
• Prolonged fasting
• History of immunosuppression, including positive HIV test
• Previous or concomitant oncological pathology, except: basal cell skin cancer, in situ, as long as every other cancer patient disease-free for at least 5 years
• Serious neurological or psychiatric disorders
• Pregnancy or lactation
• Patients that do not use appropriate methods of contraception as specified in the inclusion criteria

Related Conditions & MeSH terms

• Neuroendocrine Tumors

Intervention

Drug:
• Lanreotide and Metformin
Lanreotide and Metformin

Locations

Country	Name	City	State
Italy	NationalCIMilan	Milan

Sponsors (1)

Lead Sponsor	Collaborator
Fondazione IRCCS Istituto Nazionale dei Tumori, Milano

Country where clinical trial is conducted

Italy, 

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* Note: There are 38 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	incidence of SAEs and AEs		1 year
Secondary	time to progression (TTP) to Lanreotide ATG 120 mg in combination with Metformin	This is a pilot study. This endpoints should be considered an exploratory evaluation	3 years
Secondary	symptomatic responses to Lanreotide ATG 120 mg in combination with Metformin in symptomatic patients	Answers will be based on a 5 point Likert scale (1=completely satisfied, 2= rather satisfied, 3= unchanged, 4= rather dissatisfied, 5= completely dissatisfied).	1 year
Secondary	biochemical responses to Lanreotide ATG 120 mg in combination with Metformin	Biochemical progression will be evaluated testing Chromogranin A, NSE, 5-HIAA (only if functioning tumours) at each 4th month	1 year