Study Of Pasireotide Long Acting Release (LAR) In Patients With Metastatic Neuroendocrine Tumors (NETs)

Study Overview

Study of Pasireotide Long Acting Release (LAR) in Patients With Metastatic Neuroendocrine Tumors (NETs)

The goal of this clinical research study is to learn if the study drug, Pasireotide LAR can shrink or slow the growth of Metastatic Neuroendocrine Carcinomas. The safety of this drug will also be studied. The patient's physical state, changes in the size of the tumor, and laboratory findings taken while on-study will help us decide if Pasireotide LAR is safe and effective.

This is a multi-institutional, prospective phase II open-label trial. The investigational drug used in this study is pasireotide LAR 60 mg. Pasireotide will be administered as an intramuscular injection at the beginning of every cycle which is defined as 28 days (+/- 3 days). Study treatment should begin within 14 days following enrollment into the study and continue until disease progression, unacceptable toxicity, or withdrawal of consent. Safety and efficacy will be assessed throughout the treatment period.

Neuroendocrine Tumors
Carcinoid Tumors

DRUG: Pasireotide Long Acting Release (LAR)

MCC-16438
CSOM230DUS23T (OTHER Identifier) (OTHER: Novartis Pharmaceuticals)

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates	Results Reporting Dates	Study Record Updates
First Submitted 2010-11-30	Results First Submitted 2021-11-01	Last Update Submitted that met QC Criteria 2023-03-02
First Submitted that Met QC Criteria 2010-12-01	Results First Submitted that Met QC Criteria 2022-01-11	Last Update Posted (ACTUAL) 2023-03-06
First Posted (ACTUAL) 2010-12-03	Results First Posted 2022-01-18	Last Verified 2023-03

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

Design Details

Primary Purpose:
Treatment

Allocation:
Na

Interventional Model:
Single Group

Masking:
None

Arms and Interventions

Participant Group/Arm	Intervention/Treatment
EXPERIMENTAL: Pasireotide LAR Treatment The investigational drug used in this study is pasireotide long acting release (LAR) 60 mg.	DRUG: Pasireotide Long Acting Release (LAR) Pasireotide will be administered as an intramuscular injection at the beginning of every cycle which is defined as 28 days (+/- 3 days). Study treatment should begin within 14 days following enrollment into the study and continue until disease progression

Participant Group/Arm

Intervention/Treatment

EXPERIMENTAL: Pasireotide LAR Treatment

The investigational drug used in this study is pasireotide long acting release (LAR) 60 mg.

DRUG: Pasireotide Long Acting Release (LAR)

Pasireotide will be administered as an intramuscular injection at the beginning of every cycle which is defined as 28 days (+/- 3 days). Study treatment should begin within 14 days following enrollment into the study and continue until disease progression

Primary Outcome Measures	Measure Description	Time Frame
Progression-free Survival (PFS) at One Year	PFS: Defined as the time from the date of first study treatment to the date of the first documented disease progression, by Response Evaluation Criteria in Solid Tumors (RECIST 1.0) guidelines, or death due to any cause. Progressive Disease (PD): at least a 20% increase in the sum of the longest diameter of target lesions, taking as reference the smallest sum longest diameter recorded since the treatment started or the appearance of one or more new lesions.	12 months

Secondary Outcome Measures	Measure Description	Time Frame
Overall Radiographic Response Rate (ORR)	Complete response (CR): complete disappearance of all target lesions, confirmed by repeat assessments at no less than 4 weeks after the criteria for response are first met. Partial response (PR): at least a 30% decrease in the sum of the longest diameter of target lesions, taking as reference the baseline sum longest diameter. This must be confirmed by repeat assessment at no less than 4 weeks after the criteria for response are first met. Stable Disease (SD): neither sufficient decrease to qualify for partial response nor sufficient increase to qualify for progressive disease, taking as reference the smallest sum longest diameter since the treatment started.	Up to 48 months
Adverse Events Possibly Related to Study Treatment	Adverse Events (AEs) and Serious Adverse Events (SAEs) will be evaluated continuously throughout the study. Safety and tolerability will be assessed according to the NIH/NCI Common Terminology Criteria for Adverse Events version 4.0 (CTCAE v4.0).	Up to 48 months

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person’s general health condition or prior treatments.

Ages Eligible for Study:
ALL

Sexes Eligible for Study:
18 Years

Accepts Healthy Volunteers:

Locally unresectable or metastatic carcinoid or pancreatic neuroendocrine tumors
Tumors must be considered well or moderately differentiated (or low to intermediate grade). Patients with poorly differentiated neuroendocrine carcinomas or small cell carcinomas are excluded from the study.
No prior systemic antineoplastic neuroendocrine tumor treatment (including prior somatostatin analogs). However patients who have received a short course of subcutaneous (SQ) octreotide (<10 days) in the past are eligible if > 1 week has elapsed from their last octreotide injection.
Minimum of four weeks since any major surgery
Measureable disease by Response Evaluation Criteria in Solid Tumors (RECIST)
Eastern Cooperative Oncology Group (ECOG) performance status ≤1
Life expectancy 12 weeks or more
Adequate bone marrow function as shown by: absolute neutrophil count (ANC) ≥ 1.0 x 10^9/L, Platelets ≥ 75 x 10^9/L, hemoglobin (Hgb) > 8 g/dL
Adequate liver function as shown by: serum bilirubin ≤ 2.0 x upper limit of normal (ULN), and serum transaminases activity ≤ 2 x ULN, with the exception of serum transaminases (< 3 x ULN) if the patient has liver metastases
Adequate renal function as shown by serum creatinine ≤ 2.0 x ULN
Fasting serum cholesterol ≤300 mg/dL OR ≤7.75 mmol/L AND fasting triglycerides ≤ 2.5 x ULN. Note: In case one or both of these thresholds are exceeded, the patient can only be included after initiation of appropriate lipid lowering medication.
Women of childbearing potential (WOCBP) must have a negative serum pregnancy test within 14 days of the administration of the first study treatment. Women must not be lactating. Both men and WOCBP must be advised of the importance of using effective birth control measures during the course of the study.
Signed informed consent to participate in the study must be obtained from patients after they have been fully informed of the nature and potential risks by the investigator (or his/her designee) with the aid of written information.

Uncontrolled brain or leptomeningeal metastases, including patients who continue to require glucocorticoids for brain or leptomeningeal metastases
Patients with prior or concurrent malignancy except for the following: adequately treated basal cell or squamous cell skin cancer, or other adequately treated in situ cancer, or any other cancer from which the patient has been disease free for 5 years
Patients with uncontrolled diabetes mellitus or a fasting plasma glucose > 1.5 ULN or glycosylated hemoglobin (HbA1c) >8%. Note: At the principle investigator's discretion, non-eligible patients can be re-screened after adequate medical therapy has been instituted.
Patients with symptomatic cholelithiasis
Patients who have congestive heart failure: New York Heart Association (NYHA) Class III or IV, unstable angina, or a history of acute myocardial infarction within the 6 months preceding enrollment
Patients who have any severe and/or uncontrolled medical conditions or other conditions that could affect their participation in the study such as:

Severely impaired lung function
Any active (acute or chronic) or uncontrolled infection/ disorders
Nonmalignant medical illnesses that are uncontrolled or whose control may be jeopardized by the treatment with the study therapy
Known hypersensitivity to somatostatin analogues or any component of the pasireotide LAR formulation
Corrected QT interval (QTcF) of >470 msec on screening Electrocardiogram (ECG)
Risk factors for Torsades de Pointes such as cardiac failure, clinically significant/symptomatic bradycardia
Clinically significant hypokalemia or hypomagnesemia that are not correctable
History of sustained ventricular tachycardia, ventricular fibrillation, advanced heart block, or idiopathic syncope thought to be related to ventricular arrhythmia
Concomitant medication(s) known to increase the QT interval
History of noncompliance to medical regimens or unwillingness to comply with the protocol

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Novartis Pharmaceuticals
RECORDATI GROUP

Investigators

PRINCIPAL_INVESTIGATOR: Jonathan Strosberg, M.D., H. Lee Moffitt Cancer Center and Research Institute

Publications

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Cives M, Kunz PL, Morse B, Coppola D, Schell MJ, Campos T, Nguyen PT, Nandoskar P, Khandelwal V, Strosberg JR. Phase II clinical trial of pasireotide long-acting repeatable in patients with metastatic neuroendocrine tumors. Endocr Relat Cancer. 2015 Feb;22(1):1-9. doi: 10.1530/ERC-14-0360. Epub 2014 Nov 6.

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Clinical Trial Record