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Islet Cell CarcinomaPhase 2NCT00363051

Safety/Efficacy of Everolimus in Adults With Advanced Pancreatic Neuroendocrine Cancer Not Responsive to Chemotherapy

A Phase 2 study testing Everolimus 10 mg and Octreotide Depot in people with Islet Cell Carcinoma and Neuroendocrine Carcinoma, run by Novartis Pharmaceuticals at 54 sites in 11 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The purpose of this study was to assess the efficacy and safety of everolimus in the treatment of advanced pancreatic neuroendocrine tumor (NET) not responsive to cytotoxic chemotherapy. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Everolimus 10 mg and Octreotide Depot
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
160 participants
Where
54 sitesin 11 countries
Study dates
Jun 2006to Apr 2012
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Advanced (unresectable or metastatic) biopsy-proven pancreatic Neuroendocrine tumor (NET)
  • Confirmed low-grade or intermediate-grade neuroendocrine carcinoma
  • Objective disease progression by Response Evaluation Criteria in Solid tumors (RECIST) criteria while receiving cytotoxic chemotherapy or at any time after receiving an adequate course of cytotoxic chemotherapy (i.e., at least 3 consecutive cycles or months of treatment with the same cytotoxic drug or regimen)
  • Presence of at least one measurable disease using RECIST criteria at screening (computer tomography [CT] or Magnetic resonance imaging [MRI])
  • Adequate bone marrow, liver and kidney function
  • WHO Performance Status 0-2.
Show all 9Show fewer
  • Meet all inclusion criteria defined above for both strata.
  • Receiving treatment (at least 3 consecutive months) with Octreotide Depot.
  • In addition to documentation of progressive disease on or after chemotherapy, patients in stratum 2 must have documented objective progression of disease while receiving Octreotide Depot.

Who cannot join

  • Anticancer therapy within 3 weeks of enrollment.
  • Patients with poorly differentiated neuroendocrine carcinoma
  • Hepatic artery embolization within the last 6 months
  • Prior therapy with everolimus or other rapamycins (sirolimus, temsirolimus)
  • Other concurrent malignancy
  • Other serious intercurrent infections or nonmalignant uncontrolled medical illnesses
  • Received treatment with Octreotide Depot or any other long-acting somatostatin analogue in the 60 days prior to enrollment or any short-acting somatostatin analogue in the two weeks prior to enrollment.
  • Other protocol-defined inclusion/exclusion criteria applied.

Trial locations and contacts

54 sites in 11 countries.

54 sites in 11 countries

United States20 sites
  • Emory University Hospital

    Atlanta, Georgia, 30322

  • The University of Alabama at Birmingham

    Birmingham, Alabama, 35233

  • Dana Farber Cancer Institute

    Boston, Massachusetts, 02115

  • Arthur G. James Cancer Hospital/Ohio State University

    Columbus, Ohio, 43210

  • Duke University Medical Center

    Durham, North Carolina, 27710

  • M. D Anderson Cancer Center

    Houston, Texas, 77030

  • University of Iowa Hospitals and Clinics

    Iowa City, Iowa, 52242

  • Dartmouth Hitchcock Medical Center

    Lebanon, New Hampshire, 03756

  • USC Medical Center

    Los Angeles, California, 90033

  • Cedars-Sinai Outpatient Cancer Center/Samuel Oschin Comprehensive Cancer Inst.

    Los Angeles, California, 90048

  • UCLA Medical Center

    Los Angeles, California, 90073

  • University of Wisconsin Hospital & Clinics

    Madison, Wisconsin, 53792

  • University of Miami

    Miami, Florida, 33136

  • LSUHC Multispecialty Clinic

    New Orleans, Louisiana, 70115

  • Lynn Ratner, M.D.

    New York, New York, 10028

  • Oregon Health and Science University

    Portland, Oregon, 97239-3098

  • Mayo Clinic

    Rochester, Minnesota, 55905

  • UCSF Comprehensive Cancer Center

    San Francisco, California, 94115

  • H. Lee Moffit Cancer Center & Research Institute

    Tampa, Florida, 33612

  • Scott & White Memorial Hospital

    Temple, Texas, 76508

Other trials in United States

Germany7 sites
  • Novartis Investigative Site

    Berlin

  • Novartis Investigative Site

    Erlangen

  • Novartis Investigative Site

    Essen

  • Novartis Investigative Site

    Frankfurt

  • Novartis Investigative Site

    Heidelberg

  • Novartis Investigative Site

    Marburg

  • Novartis Investigative Site

    Ulm

Other trials in Germany

France6 sites
  • Novartis Investigative Site

    Billancourt, 92100

  • Novartis Investigative Site

    Clichy, 92118

  • Novartis Investigative Site

    Lyon, 03

  • Novartis Investigative Site

    Reims

  • Novartis Investigative Site

    Toulouse

  • Novartis Investigative Site

    Villejuif

Other trials in France

Canada5 sites
  • Novartis Investigative Site

    Halifax, Nova Scotia, B34 2Y9

  • Novartis Investigative Site

    London, Ontario, N6A 4L6

  • Novartis Investigative Site

    Montreal, Quebec, H1T 2M4

  • Novartis Investigative Site

    Toronto, Ontario, M5G 2M9

  • Novartis Investigative Site

    Vancouver, British Columbia, V5Z 4E6

Other trials in Canada

Italy5 sites
  • Novartis Investigative Site

    Milan, 20141

  • Novartis Investigative Site

    Modena

  • Novartis Investigative Site

    Pisa, 56126

  • Novartis Investigative Site

    Rome, 00189

  • Novartis Investigative Site

    Torrette Di Ancona, 60020

Other trials in Italy

Australia3 sites
  • Novartis Investigative Site

    Heidelberg

  • Novartis Investigative Site

    Herston

  • Novartis Investigative Site

    Kogarah

Other trials in Australia

Spain3 sites
  • Novartis Investigative Site

    Barcelona, 08035

  • Novartis Investigative Site

    L'Hospitalet de Llobregat

  • Novartis Investigative Site

    Madrid, 28040

Other trials in Spain

Argentina2 sites
  • Novartis Investigative Site

    Buenos Aires

  • Novartis Investigative Site

    Santa Fe

Other trials in Argentina

Belgium1 site
  • Novartis Investigative Site

    Leuven

Other trials in Belgium

Netherlands1 site
  • Novartis Investigative Site

    Gronigen

Other trials in Netherlands

Sweden1 site
  • Novartis Investigative Site

    Uppsala

Other trials in Sweden

About this study

Official title: An Open Label, Stratified, Single-arm Phase II Study of Everolimus in Patients With Advanced Pancreatic Neuroendocrine Tumor (NET) After Failure of Cytotoxic Chemotherapy

The purpose of this study was to assess the efficacy and safety of everolimus in the treatment of advanced pancreatic neuroendocrine tumor (NET) not responsive to cytotoxic chemotherapy. All patients were treated with everolimus until either tumor progression was documented using a standard criteria that measures tumor size called Response Evaluation Criteria in Solid tumors (RECIST), or until unacceptable toxicity occurred, or until the patient or investigator requested discontinuation of treatment.

Read the detailed description

This was a stratified two-stage, single-arm, phase 2 study of treatment with everolimus in patients with advanced (unresectable or metastatic) pancreatic neuroendocrine tumor (NET) after failure of cytotoxic chemotherapy.

Stratum 1, consisted of patients not receiving chronic Octreotide Depot therapy, will receive everolimus monotherapy at 10 mg/day.

Stratum 2, consisting of patients with tumors that have progressed during Octreotide Depot treatment will continue their entry dose of Octreotide Depot plus everolimus 10 mg/day.

Being tested
Everolimus 10 mg, Octreotide Depot
Keywords
Pancreatic, Tumor, Islet Cell, Carcinoma, Neuroendocrine, Endocrine, Atypical Carcinoid, RADIANT1, RADIANT-1
Medical subject headings
Carcinoma, Islet Cell, Carcinoma, Neuroendocrine, Neuroendocrine Tumors, Pancreatic Neoplasms, Neoplasms, Carcinoma

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Everolimus 10 mgDrug

    Also called RAD001

    Participants took two 5 mg tablets of Everolimus orally with a glass of water, once daily (preferably in the morning) in a fasting state or after no more than a light, fat-free meal. Dosing was to occur at the same time each day. If vomiting occurred, the vomited dose was not to be replaced.

  • Octreotide DepotDrug

Study groups in NCT00363051
Study groupRoleWhat they receive
Everolimus 10 mgExperimentalStratum 1 patients who were not receiving regular Octreotide Depot therapy. These patients were to receive everolimus monotherapy at 10 mg/day. Stratum 2 patients who were to receive everolimus 10 mg/day in addition to continuing their entry dose of Octreotide Depot therapy. Patients were instructed to take two 5 mg tablets of everolimus orally with a glass of water, once daily (preferably in the morning). Dosing was strongly recommended to occur at the same time every day.
Receives: Drug: Everolimus 10 mg; Drug: Octreotide Depot

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Objective Response Rate: Percentage of Participants With Best Over All Response of Complete Response or Partial Response by Central Radiology Review (Stratum 1) Based on Response Evaluation Criteria in Solid Tumors (RECIST)

    Objective response rate was defined by RECIST criteria: Partial response (PR) must have ≥ 30% decrease in the sum of longest diameter of all target lesions, from the baseline sum. Complete response (CR) must have disappearance of all target and non-target lesions. For CR or PR, tumor measurements must be confirmed by 2nd assessments within 4 weeks. Progression = 20% increase in the sum of longest diameter of all target lesions, from smallest sum of longest diameter of all target lesions recorded at or after baseline; or a new lesion; or progression of non-target lesions.

    Measured: from date of randomization/start of treatment until first documented response confirmed 4 weeks later( at least 3 months)

Secondary outcomes (11)
  1. Duration of Overall Response (Stratum 1) Based on Response Evaluation Criteria in Solid Tumors (RECIST)- Central Radiology Review

    Duration of overall response applies only to patients whose best overall response was complete response (CR) or partial response (PR):

    • Complete Response (CR) = at least two determinations of CR at least 4 weeks apart before progression.
    • Partial response (PR) = at least two determinations of PR or better at least 4 weeks apart before progression.

    Progression = 20% increase in the sum of the longest diameter of all target lesions, from the smallest sum of longest diameter of all target lesions recorded at or after baseline; or a new lesion; or progression of non-target lesions

    Measured: from date of first documented confirmed response to time to progression, at least 3 months

  2. Duration of Overall Response (Stratum 2) Based on Response Evaluation Criteria in Solid Tumors (RECIST)- Central Radiology Review

    Duration of overall response applies only to patients whose best overall response was complete response (CR) or partial response (PR):

    • Complete Response (CR) = at least two determinations of CR at least 4 weeks apart before progression.
    • Partial response (PR) = at least two determinations of PR or better at least 4 weeks apart before progression.

    Progression = 20% increase in the sum of the longest diameter of all target lesions, from the smallest sum of longest diameter of all target lesions recorded at or after baseline; or a new lesion; or progression of non-target lesions

    Measured: from date of first documented confirmed response to time to progression, at least 3 months

  3. Objective Response Rate: Percentage of Participants With Best Over All Response of Complete Response or Partial Response by Central Radiology Review (Stratum 2) Based on Response Evaluation Criteria in Solid Tumors (RECIST)

    Objective response rate was defined by RECIST criteria: Partial response (PR) must have ≥ 30% decrease in the sum of longest diameter of all target lesions, from the baseline sum. Complete response (CR) must have disappearance of all target and non-target lesions. For CR or PR, tumor measurements must be confirmed by 2nd assessments within 4 weeks. Progression = 20% increase in the sum of longest diameter of all target lesions, from smallest sum of longest diameter of all target lesions recorded at or after baseline; or a new lesion; or progression of non-target lesions.

    Measured: from date of randomization/start of treatment until first documented response confirmed 4 weeks later (at least 3 months)

  4. Number of Participants With Adverse Events (AEs), Death, Serious Adverse Events (SAEs)[Stratum 1]

    Adverse events are defined as any unfavorable and unintended diagnosis, symptom, sign (including an abnormal laboratory finding), syndrome or disease which either occurs during study, having been absent at baseline, or, if present at baseline, appears to worsen. Serious adverse events are any untoward medical occurrences that result in death, are life threatening, require (or prolong) hospitalization, cause persistent or significant disability/incapacity, result in congenital anomalies or birth defects, or are other conditions which in judgment of investigators represent significant hazards.

    Measured: on or after the day of the first intake of study treatment to starting no later than 28 days after study treatment discontinuation, at least every month

  5. Number of Participants With Adverse Events (AEs), Death, Serious Adverse Events (SAEs) [Stratum 2]

    Adverse events are defined as any unfavorable and unintended diagnosis, symptom, sign (including an abnormal laboratory finding), syndrome or disease which either occurs during study, having been absent at baseline, or, if present at baseline, appears to worsen. Serious adverse events are any untoward medical occurrences that result in death, are life threatening, require (or prolong) hospitalization, cause persistent or significant disability/incapacity, result in congenital anomalies or birth defects, or are other conditions which in judgment of investigators represent significant hazards.

    Measured: on or after the day of the first intake of study treatment to starting no later than 28 days after study treatment discontinuation, at least every month

  6. Time to Progression Free Survival (PFS) Per Central Radiology Review (Stratum 1)

    Progression free survival (PFS) is defined as the time from randomization to the date of first documented disease progression or death from any cause. The Kaplan-Meier estimate of the PFS survival function was constructed.

    Median PFS was obtained and displayed along with 95% confidence intervals.

    Measured: from randomisation to dates of disease progression, death from any cause or last tumor assessment, reported between day of first patient randomised, 26 June 2006, until cut-off date 13 September 2010

  7. Time to Progression Free Survival (PFS) Per Central Radiology Review (Stratum 2)

    Progression free survival (PFS) is defined as the time from randomization to the date of first documented disease progression or death from any cause. The Kaplan-Meier estimate of the PFS survival function was constructed.

    Median PFS was obtained and displayed along with 95% confidence intervals.

    Measured: from randomisation to dates of disease progression, death from any cause or last tumor assessment, reported between day of first patient randomised, 26 June 2006, until cut-off date 13 September 2010

  8. Time to Overall Survival (OS)(Stratum 1)

    Overall survival measures the time of survival , with any response or disease progression, until death. The OS is defined as the time from date of start of treatment to date of death due to any cause.

    If a patient is not known to have died, survival was censored at the date of last contact. In each treatment stratum, the Kaplan-Meier estimate of the overall survival function was constructed.

    Measured: from randomisation to dates of disease progression, death from any cause, reported between day of first patient randomised, 26 June 2006, until cut-off date 13 April 2012

  9. Time to Overall Survival (OS) (Stratum 2)

    Overall survival measures the time of survival , with any response or disease progression, until death. The OS is defined as the time from date of start of treatment to date of death due to any cause.

    If a patient is not known to have died, survival was censored at the date of last contact. In each treatment stratum, the Kaplan-Meier estimate of the overall survival function was constructed.

    Measured: from randomisation to dates of disease progression, death from any cause, reported between day of first patient randomised, 26 June 2006, until cut-off date 13 April 2012

  10. Everolimus Trough Level Determination by Pharmacokinetics Parameter in Both Strata (Stratum 1 and 2)

    For all patients in both strata, a blood sample for everolimus trough level determination will be collected immediately prior to the everolimus administration on Cycle 1 Day 15, Cycle 2 Day 1, and every month thereafter. A treatment cycle was defined as 28 days of consecutive daily treatment with everolimus and treatment continued until tumor progression. It is critical that patients not take their daily everolimus dose before the sample is drawn.

    Measured: Cycle 1 Day 15

  11. Effect of Octreotide Depot on the Trough Concentrations of Everolimus

    The effect of Octreotide Depot on the trough concentrations of everolimus was assessed at Cycle 1 Day 15.

    Measured: Cycle 1 Day 1, Cycle 2 Day 1

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted15 Aug 2006 (estimated)
  2. Study startJun 2006
  3. Primary completionJan 2008
  4. Study completionApr 2012

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
160 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00363051
Sponsor's protocol ID
CRAD001C2239
Status last verified
May 2013
First submitted
2 Aug 2006
Last updated
10 May 2013

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Everolimus 10 mg and Octreotide Depot in people with Islet Cell Carcinoma and Neuroendocrine Carcinoma, run by Novartis Pharmaceuticals at 54 sites in 11 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 9 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 10 May 2013. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 54 sites in United States, Germany, France, Canada, Italy and 6 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 30 Mar 2012). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Objective Response Rate: Percentage of Participants With Best Over All Response of Complete Response or Partial Response by Central Radiology Review (Stratum 1) Based on Response Evaluation Criteria in Solid Tumors (RECIST) (time frame: from date of randomization/start of treatment until first documented response confirmed 4 weeks later( at least 3 months)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 May 2013.

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