Recombinant Human Thyroid Stimulating Hormone for Radioiodine 131I Treatment

Radiotherapy; Complications Clinical Trial

Official title:

Safety and Efficacy of Recombinant Human Thyroid Stimulating Hormone for Radioiodine 131I Treatment in Patients With Locally Advanced/Metastatic Differentiated Thyroid Cancer

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT06405217
• Other study ID #: KY20240419-09
• Status: Recruiting
• Phase: N/A
• Start date: April 20, 2024
• Est. completion date: December 31, 2026

Study information

• Verified date: April 2024
• Source: Nanjing First Hospital, Nanjing Medical University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Subjects: patients with postoperative local recurrent or metastatic differentiated thyroid cancer .

Experimental group: Recombinant human thyroid stimulating hormone injection:

0.9mg/1.0mL/piece; intramuscular injection; once a day for two consecutive days. Control group: Thyroid hormone withdraw for 4-6 weeks.

The two groups were treated with radioiodine 131I after plasma thyroid stimulating hormone elevated (>30mU/L). The efficacy and adverse reactions were observed.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 30
• Est. completion date: December 31, 2026
• Est. primary completion date: March 31, 2026
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 75 Years

Eligibility

Inclusion Criteria:

• Age: 18~75 years old (including 18 and 75 years old);

• ECOG: 0-2 points;

• Expected survival of more than 3 months; Differentiated thyroid carcinoma undergoing total thyroidectomy or subtotal thyroidectomy and confirmed as locally recurrent or metastatic disease by imaging, serum tumor marker, biopsy pathology; at least one measurable lesion (diameter of the tumor =10 mm), and meets the requirements of RECIST 1.1.

• Hemoglobin =80g/L, neutrophil =1.5×109/L, platelet count =80×109/L, serum creatinine =1.5× upper limit of normal or creatinine clearance =60ml/min, Blood urea nitrogen =2.5× upper limit of normal (ULN); Total bilirubin =1.5×ULN; Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =2.5×ULN; If accompanied by liver metastasis, ALT and AST=5×ULN albumin =25 g/L;

• Women of childbearing potential must have taken reliable contraceptive measures or undergone a pregnancy test (serum or urine) within 7 days prior to enrollment, with a negative result, and be willing to use appropriate contraceptive methods during the trial and for 1 year after the last dose of 131I (for women), or for 6 months after the last dose of 131I (for men);

• Participants voluntarily joined the study and signed informed consent, with good compliance and follow-up.

Exclusion Criteria:

• Patients with severe and uncontrolled diseases, including: 1) Uncontrolled hypertension (despite optimal drug therapy, systolic blood pressure =140mmHg or diastolic blood pressure =90mmHg); 2) Poorly controlled arrhythmias of ischemic heart disease or myocardial infarction of grade II or above (including corrected QT interval male =450 ms, female =470 ms) and =2 congestive heart failures (New York Heart Association classification); 3) Poorly controlled diabetes (fasting blood sugar >10mmol/L); 4) Active or poorly controlled severe infections (according to Common Terminology Criteria for Adverse Events = grade 2); 5) Patients with active hepatitis B or hepatitis C (hepatitis B: positive HBsAg and hepatitis B virus (HBV) DNA =500 IU/mL; hepatitis C: positive hepatitis C virus RNA and abnormal liver function), or active infections requiring antimicrobial therapy (e.g., with antibiotics, antiviral drugs, antifungal drugs); 6) Renal insufficiency: urine routine shows urine protein =++ or confirmed 24-hour urine protein =1.0 g; 7) Patients with seizures requiring treatment.

• Received surgical treatment, incisional biopsy, or major trauma within 28 days prior to randomization;

• Unable to quit or with a history of psychiatric medication abuse;

• Allergic to the investigational drug (recombinant human thyroid stimulating hormone or 131I) or its excipients;

• Had an infection within 4 weeks prior to screening, including bacterial, viral, or fungal infections, with ongoing symptoms at the time of screening;

• Received lipophilic iodine contrast agents (such as iodized oil, iodized benzene, etc.) within the past 3 months or received water-soluble iodine contrast agents (such as iohexol, iodinated glycerol, etc.) within the past 1 month prior to screening;

• Pregnant or lactating women, or women who engaged in unprotected sexual intercourse within the two weeks prior to screening, or women with a positive blood pregnancy test at screening;

• Male subjects (or their partners) or female subjects who have plans for fertility or donation of sperm or ova during the entire study period and within 6 months after the end of the study, and who are unwilling to adopt contraceptive measures during the study period and within 6 months after the end of the study;

• Researchers believe that the presence of any condition may harm the subjects or prevent them from meeting or fulfilling the study requirements.

Related Conditions & MeSH terms

• Radiotherapy; Complications
• Thyroid Diseases
• Thyroid Neoplasms

Intervention

Drug:
• Recombinant Human Thyroid Stimulating Hormone
Recombinant human thyroid stimulating hormone injection: 0.9mg/1.0mL/piece; intramuscular injection; once a day for two consecutive days

Locations

Country	Name	City	State
China	Nanjing First Hospital	Nanjing	Jiangsu

Sponsors (1)

Lead Sponsor	Collaborator
Nanjing First Hospital, Nanjing Medical University

Country where clinical trial is conducted

China, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	The rate of hyroid stimulating hormone elevation	The proportion of patients with thyroid stimulating hormone>30 mIU/L	For patients in the experimental group: 24 hours after the second time of recombinant human thyroid stimulating hormone injection; For patients in the no intervention group: 4 to 6 weeks after thyroid hormone withdraw
Primary	Incidence of Treatment-Emergent Adverse Events	This study will utilize the CTCAE (NCI Common Terminology Criteria for Adverse Events) Version 4.0 for toxicity and Serious Adverse Event reporting	Time interval from start to 3 months after completion of the therapy
Secondary	Overall response rate	Number of patients achieving a complete response (CR) or partial response (PR) by Response Evaluation Criteria (RECIST v1.1 criteria) in Solid Tumors	4 month