Neuroendocrine Tumors Clinical Trial
Official title:
Evaluation of (68)Gallium- DOTATATE PET/CT for Detecting Primary and Metastatic Neuroendocrine Tumors
Verified date | November 2019 |
Source | National Institutes of Health Clinical Center (CC) |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
Background:
- Neuroendocrine tumors (NETs) are rare but have been more common over the past decade. The
only treatment for NETs is surgery, but most are found when they are too advanced for
surgery. Researchers are looking for the best way to find NETs earlier, so that surgery can
be successful. They want to test if the study drug can be used along with imaging devices to
detect NETs.
Objectives:
- To see how well a new experimental imaging agent, 68Gallium-DOTATATE, detects unknown
primary and metastatic NETs in the gastrointestinal system and pancreas.
Eligibility:
- Adults over 10 years old with a suspected NET or family history of NET.
Design:
- Participants will be screened with a medical history and physical exam, and have a blood
test.
- Participants will undergo three scans. For all of these, a substance is injected into
their body, they lie on a table, and a machine takes images.
- A standard computed tomography (CT) scan of the chest, abdomen, and pelvis.
- An octreotide scintigraphy Single photon emission computed tomography (SPECT)/CT.
- A 68Gallium-DOTATATE positron emission tomography (PET)/CT. The study drug is injected
into a vein, usually in the arm. Low-dose X-rays go through the body. For about 40
minutes a large, donut-shaped device takes images of the body. The entire session takes
90 to 120 minutes.
- Researchers will compare images from the three scans.
- Participants will have 1 follow-up visit each year for 5 years. At this visit, they will
have a medical exam, blood taken, and a CT scan.
Status | Completed |
Enrollment | 341 |
Est. completion date | March 12, 2018 |
Est. primary completion date | December 17, 2017 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 10 Years to 99 Years |
Eligibility |
- INCLUSION CRITERIA: - Patients with (any one of #1, #2, and/or #3): 1. Suspicion of neuroendocrine tumors (NET) on axial imaging (computed tomography (CT)/magnetic resonance imaging (MRI)/fluorodeoxyglucose (FDG) positron emission tomography (PET) and/or 2. biochemical evidence of neuroendocrine tumor (serum/urinary) based on elevated levels of chromogranin A, pancreatic polypeptide, neuron-specific enolase, vasoactive intestinal polypeptide, serotonin (urinary 5-HIAA), gastrin, somatostatin, catecholamines, metanephrines, calcitonin, fasting insulin, C-peptide (proinsulin), glucagon and/or 3. familial predisposition to NET in patients with multiple endocrine neoplasia type 1 (MEN1) and Von Hippel-Lindau (VHL) (symptomatic and/or asymptomatic cases; with biochemical or anatomic imaging evidence of disease). - Age greater than or equal to 10 years of age. - For females: Negative urine pregnancy test OR post-menopausal for at least 2 years OR patient has had a hysterectomy. - Patients must be willing to return to National Institutes of Health (NIH) for follow-up. - Ability of subject or Legally Authorized Representative (LAR) (if the patient is deemed by the treating physician to be cognitively impaired or questionably impaired in such a way that the ability of the patient to give informed consent is questionable) to understand and the willingness to sign a written informed consent document indicating that they are aware of the investigational nature of this study. EXCLUSION CRITERIA: - Patients unwilling to undergo serial non-invasive imaging. - Pregnant or lactating women: Pregnant women are excluded from this study because the effects of (68)Ga-DOTATATE in pregnancy are not known. Because there is an unknown but potential risk for adverse events in nursing infants secondary to administration of (68)Ga-DOTATATE in the mother, breastfeeding should be discontinued for at least one day if the mother receives (68)Ga-DOTATATE. - Patients that have recognized concurrent active infection, - Patients with the use of any investigational product or device, excluding 18F-dihydroxyphenylalanine (F-DOPA) scans, within 30 days prior to dosing. |
Country | Name | City | State |
---|---|---|---|
United States | National Institutes of Health Clinical Center | Bethesda | Maryland |
Lead Sponsor | Collaborator |
---|---|
National Cancer Institute (NCI) |
United States,
Lawrence B, Gustafsson BI, Chan A, Svejda B, Kidd M, Modlin IM. The epidemiology of gastroenteropancreatic neuroendocrine tumors. Endocrinol Metab Clin North Am. 2011 Mar;40(1):1-18, vii. doi: 10.1016/j.ecl.2010.12.005. Review. — View Citation
Modlin IM, Lye KD, Kidd M. A 5-decade analysis of 13,715 carcinoid tumors. Cancer. 2003 Feb 15;97(4):934-59. — View Citation
Tsikitis VL, Wertheim BC, Guerrero MA. Trends of incidence and survival of gastrointestinal neuroendocrine tumors in the United States: a seer analysis. J Cancer. 2012;3:292-302. doi: 10.7150/jca.4502. Epub 2012 Jul 1. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Number of Lesions Detected Using the 68Gallium-DOTATATE Positron Emission Tomography (PET/Computed Tomography (CT)) Scan | Patients with neuroendocrine tumors (NETs) were scanned with the 68Gallium-DOTATATE Positron Emission Tomography (PET/Computed Tomography (CT)) and the number of lesions detected are collected. | During PET Scan, up to 2 hours annually for up to 5 years | |
Secondary | Mean Radiation Activity Between Low Grade and Intermediate Grade Neuroendocrine Tumor | The radioactivity was assessed using intraoperative radiation detector following the 68Gallium-DOTATATE injection. Low grade neuroendocrine tumors is defined as tumors with slow cell division determined in histology. Low grade tumors is associated with the best outcome. Intermediate grade tumor is defined as the tumor with medium (3-20%) rate of actively dividing cells and is associated with less favorably outcome. | During radioguided surgery, up to 2 hours | |
Secondary | Tumor Volume of Neuroendocrine Tumors Assessed by the 68Gallium-DOTATATE Scan | Participants were scanned using the 68Gallium-DOTATATE Scan. Tumor volume more than 7ml is associated with shorter time to disease progression. Tumor volume more than 36 ml is associated with shorter disease specific survival. | During radioguided surgery, up to 2 hours | |
Secondary | Median Radioactivity of Tumors With High Expression of Somatostatin Receptor 2 Compared to Tumors With Intermediate Expression of Somatostatin Receptor 2 | High expression of somatostatin receptor 2 (SSTR2) is based on the intensity grading on immunohistochemistry. High SSTR2 expression may be associated with well-differentiated tumor and high avidity on DOTATATE scan, compared to intermediate or low expression of SSTR that can be seen in poorly differentiated and often aggressive neuroendocrine tumors. Because the correlation can only be from the comparison of preoperative DOTATATE and the tumors that were removed, it is a one time analysis. Subsequent DOTATATE studies are for surveillance and follow up for disease progression or recurrence. | During PET Scan, up to 2 hours annually | |
Secondary | The Number of Tumors Identified in Participants by the Radiation Detector During Radio-guided Surgery Using 68Gallium-DOTATATE | Radio-guided surgery in neuroendocrine tumors using 68Gallium-DOTATATE was performed to detect tumors in the stomach and small bowel neuroendocrine tumors, pancreas, metastatic sites to lymph nodes and liver, and pheochromocytoma or paraganglioma. The number of tumors identified by the radiation detector were assessed. | Radio-guided surgery, up to 2 hours | |
Secondary | Count of Participants With Serious and Non-serious Adverse Events Assessed by the Common Terminology Criteria in Adverse Events (CTCAE v4.0) | Here is the count of participants with serious and non-serious adverse events assessed by the Common Terminology Criteria in Adverse Events (CTCAE v4.0). A non-serious adverse event is any untoward medical occurrence. A serious adverse event is an adverse event or suspected adverse reaction that results in death, a life threatening adverse drug experience, hospitalization, disruption of the ability to conduct normal life functions, congenital anomaly/birth defect or important medical events that jeopardize the patient or subject and may require medical or surgical intervention to prevent one of the previous outcomes mentioned. | Date treatment consent signed to date off study, approximately 50 months and 17 days. |
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