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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT01563354
Other study ID # CSOM230DIC03
Secondary ID 2011-002872-17
Status Completed
Phase Phase 2
First received
Last updated
Start date August 16, 2013
Est. completion date February 10, 2020

Study information

Verified date March 2021
Source Novartis
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This was a multicenter, randomized, phase II study evaluating Everolimus or Pasireotide LAR alone or in combination in adult patients with advanced (unresectable or metastatic) neuroendocrine carcinoma of the lung and thymus


Description:

This was a prospective, multicenter, randomized, open-label, 3-arm, phase II study with a single-stage design in each arm. The purpose of this study was to test the effectiveness and safety of Everolimus or Pasireotide LAR alone or in combination in adult patients with advanced (unresectable or metastatic) neuroendocrine carcinoma (typical and atypical) of the lung and thymus. It was expected that a total of 120 patients with 40 patients in each arm were to be enrolled into this study. Patients were seen weekly for one month and monthly thereafter. Radiological and biochemical response assessments were performed every 3 months. Patients with disease control (stable disease or better) in the combination arm or monotherapy with pasireotide LAR and everolimus who had not experienced unacceptable toxicity were permitted to continue treatment in the extension phase of the study and were seen every 3 months. Patients could remain in the extension phase as long as they continued to have clinical benefit and had not fulfilled any of the study discontinuation criteria. All patients had a safety follow-up visit 56 days after last treatment dose.


Recruitment information / eligibility

Status Completed
Enrollment 124
Est. completion date February 10, 2020
Est. primary completion date February 10, 2020
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - Histological confirmed advanced well differentiated typical and atypical carcinoid tumors of the lung or thymus - Patients of all treatment lines including naive patients could have been enrolled - At least one measurable lesion of disease on CT scan or MRI - Radiological documentation of disease progression within 12 months prior to randomization - Adequate liver, renal and bone marrow function - WHO Performance Status 0-2 Exclusion Criteria: - Poorly differentiated neuroendocrine carcinoma - Non-neuroendocrine thymoma - Patients with severe functional disease who required symptomatic treatment with somatostatin analogs - Prior therapy with mTOR inhibitors - History of liver disease - Baseline QTcF> 470 msec - Uncontrolled diabetes mellitus despite adequate therapy

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
Pasireotide LAR
60 mg was administered as an intra muscular depot injection once every 28 days starting at Day 1
Everolimus
10 mg tables administered orally once a day
Pasireotide LAR and Everolimus Combination
Pasireotide LAR 60 mg i.m. injected once every 28 days + Everolimus 10 mg p.o. daily

Locations

Country Name City State
Denmark Novartis Investigative Site Aarhus
Denmark Novartis Investigative Site Copenhagen N
France Novartis Investigative Site Creteil
France Novartis Investigative Site Lille Cedex
France Novartis Investigative Site Lyon
France Novartis Investigative Site Rennes
France Novartis Investigative Site Strasbourg Cedex
France Novartis Investigative Site Toulouse Cedex 9
France Novartis Investigative Site Villejuif Cedex
Germany Novartis Investigative Site Bad Berka
Germany Novartis Investigative Site Berlin
Germany Novartis Investigative Site Mainz
Greece Novartis Investigative Site Athens GR
Italy Novartis Investigative Site Ancona AN
Italy Novartis Investigative Site Brescia BS
Italy Novartis Investigative Site Milano MI
Italy Novartis Investigative Site Napoli
Italy Novartis Investigative Site Orbassano TO
Italy Novartis Investigative Site Padova PD
Italy Novartis Investigative Site Parma PR
Italy Novartis Investigative Site Perugia PG
Italy Novartis Investigative Site Roma RM
Italy Novartis Investigative Site Viagrande CT
Netherlands Novartis Investigative Site Amsterdam
Netherlands Novartis Investigative Site Groningen
Spain Novartis Investigative Site Barcelona
Spain Novartis Investigative Site Granada Andalucia
Spain Novartis Investigative Site Madrid
Spain Novartis Investigative Site Oviedo Asturias
Spain Novartis Investigative Site Sevilla Andalucia
Spain Novartis Investigative Site Valencia Comunidad Valenciana
Sweden Novartis Investigative Site Lund
United Kingdom Novartis Investigative Site Glasgow
United Kingdom Novartis Investigative Site London
United Kingdom Novartis Investigative Site London
United Kingdom Novartis Investigative Site Withington Greater Manchester

Sponsors (1)

Lead Sponsor Collaborator
Novartis Pharmaceuticals

Countries where clinical trial is conducted

Denmark,  France,  Germany,  Greece,  Italy,  Netherlands,  Spain,  Sweden,  United Kingdom, 

Outcome

Type Measure Description Time frame Safety issue
Primary Percentage of Participants Progression-free at 9 Months Based on Response Evaluation Criteria In Solid Tumors v1.1 (RECIST v1.1) Patients with Complete Response (CR), Partial Response (PR), or Stable Disease (SD) at Month 9 were to be considered as "progression-free" based on RECIST v1.1. Patients with missing tumor assessment, or with overall lesion response "unknown" at Month 9 were considered as "non progression-free", unless any of the following assessments at Week 48 or Week 52 indicate CR, PR, or SD, in which case the patient was to be considered as progression-free at Month 9. Patients discontinuing the study for any reason prior to the 9 month assessment were to be considered as "non progression-free". Baseline up to 9 months
Secondary Summary of Progression-free Survival (PFS) Based on RECIST v1.1 Time from first study drug administration to objective tumor progression or death from any cause according to RECIST v1.1 Baseline, every 3 months up to 69 months
Secondary Kaplan-Meier Estimates of Progression-free Survival (PFS) Percent (%) event-free probability estimate is the estimated probability that a patient will remain event-free up to the specified time point. Percent event-free probability estimates are obtained from the Kaplan-Meier survival estimates. Events are time from first study drug administration to objective tumor progression or death from any cause according to RECIST v1.1. Baseline, every 3 months up to 69 months
Secondary Summary of Time to Response (Months) Time from start of treatment to the first observed objective tumor response (partial response or complete response) observed according to RECIST v1.1. Every 3 months up to Year 1
Secondary Summary of Duration of Response (Months) Date of first objective tumor response to date of tumor progression or death due to any cause. Every 3 months up to Year 1
Secondary 12-month Disease Control Rate (DCR) and Objective Response Rate (ORR) Objective response rate (ORR) was defined as the percentage of patients showing a best overall response (BOR) of CR or PR during the core study according to RECIST v1.1 criteria. The best overall response is interpreted as the best response recorded from the start of the treatment until disease progression/recurrence, death from any cause or until the patient withdraws consent, whichever is earliest. DCR was was defined as the percentage of participants with a best overall response of complete response, partial response or stable disease during 12 months of treatment according to RECIST v1.1. Baseline up to Month 12
Secondary Biochemical Response Rate (BRR) for Chromogranin A (CgA) Levels Percentage of patients showing normalization or a decrease of = 30% of serum CgA concentrations compared to baseline. Baseline up to Week 52
Secondary Duration of Biochemical Response (DBR), by Treatment (Full Analysis Set) Time from the first documentation of biochemical response to the first documentation of biochemical progression or to death due to any cause, whichever occurred first. Biochemical progression is defined as an increase of serum CgA levels = 25% compared to baseline. Baseline up to Month 18
Secondary Kaplan-Meier Event-free Probability Estimate Based on CgA Levels Kaplan Meier estimates are for Duration of biochemical response (DBR) outcome measure. Events are biochemical progressions i.e. an increase of CgA levels >= 25% compared to baseline or deaths due to any cause. Percent (%) Event-free probability estimate is the estimated probability that a patient will remain event-free up to the specified time point. Baseline, every 3 months up to Month 18
Secondary Summary of Biochemical Progression-free Survival Based on CgA Levels by Treatment Time from the first documentation of biochemical response to the first documentation of biochemical progression or to death due to any cause, whichever occurred first. Biochemical progression is defined as an increase of serum CgA levels = 25% compared to baseline. Baseline up Month 24
Secondary Kaplan-Meier Event-free Probability Estimate for Biochemical Progression-free Survival Based on CgA Levels Percent (%) Event-free probability estimate is the estimated probability that a patient will remain event-free up to the specified time point. Percent event-free probability estimates are obtained from the Kaplan-Meier survival estimates. Events are biochemical progressions, i.e., an increase of CgA levels >= 25% compared to baseline or deaths due to any cause. Baseline, every 3 months up to Month 24
Secondary Biochemical Response Rate (BRR) for 5HIAA Levels The percentages are the biochemical response rates i.e. percentage of patients showing normalization i.e. return to within normal ranges, or a decrease of >= 50% from baseline of 5HIAA concentrations. Baseline up Week 52