Bevacizumab Plus Somatostatin Analogue and Metronomic Capecitabine in Patients With Advanced Neuroendocrine Tumors (XELBEVOCT)
Recruitment status was Recruiting
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Purpose
Well differentiated neuroendocrine (NE) carcinomas have low proliferative activity and conventional chemotherapy is not recommended. Metronomic chemotherapy, i.e. the frequent administration of cytotoxic drugs at low doses, has demonstrated antiangiogenetic properties. Since well differentiated NE carcinomas are highly vascular, there is a rationale for testing metronomic chemotherapy and antiangiogenetic drugs. This is a national, multicenter, phase II study.
| Condition | Intervention | Phase |
|---|---|---|
|
Neuroendocrine Carcinomas |
Drug: bevacizumab + octreotide LAR + capecitabine |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Phase II Study of the Combination of Bevacizumab Plus Somatostatin Analogue and Metronomic Capecitabine in Patients With Advanced Inoperable Well-Differentiated Neuroendocrine Tumors |
- time to progression [ Time Frame: 36 months ] [ Designated as safety issue: Yes ]
- Toxicity [ Time Frame: two years ] [ Designated as safety issue: Yes ]All adverse events encountered during the clinical study will be reported. The intensity of clinical adverse events will be graded according to the NCI Common Toxicity Criteria (CTC) version 3.0 grading system.
- Time to Treatment Failure (TTF) [ Time Frame: two years ] [ Designated as safety issue: Yes ]TTF is the time from first day of treatment to the first occurrence of any adverse events with withdrew prematurely the treatment.
- Overall survival (OS) [ Time Frame: 48 months ] [ Designated as safety issue: Yes ]Overall survival (OS) will be computed as the time between the first day of treatment and the date of death or the last date the patient was known to be alive.
| Estimated Enrollment: | 42 |
| Study Start Date: | January 2006 |
| Estimated Study Completion Date: | December 2010 |
| Estimated Primary Completion Date: | May 2009 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Drugs: bevacizumab + octreotide LAR + capecitabine
bevacizumab + octreotide + metronomic capecitabine
|
Drug: bevacizumab + octreotide LAR + capecitabine
long acting octreotide acetate at a dose of 20 or 30 mg administered intramuscularly every 4 weeks; Bevacizumab at a dose of 5 mg/kg every 2 weeks; orally capecitabine administered at a dose of 2000 mg/daily
Other Names:
|
Detailed Description:
Metastatic or locally advanced well differentiated neuroendocrine carcinoma will be treated with a combination of bevacizumab (5 mg/kg) plus octreotide LAR (long- acting release) 20/30 mg plus capecitabine administered on a metronomic schedule (2000 mg/day).
Patients with stable disease, complete or partial response will continue treatment until progressive disease or unacceptable toxicity.
Primary endpoint: the response to treatment, evaluated according to the RECIST criteria.
Secondary endpoint: - toxicity, graded according to the NCI-CTG criteria;
- symptomatic response: evaluated according to the changes in both the frequency and intensity of symptoms;
- biochemical response: evaluated considering the changes in the tumor marker levels (circulating Chromogranin A);
- relationship between vascular endothelial growth factor (VEGF) polymorphisms and response to treatment;
- time to progression and survival: measured from the date of treatment start to the date of progression and the date of last follow-up or death, respectively.
Eligibility| Ages Eligible for Study: | 18 Years to 80 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Histologically or cytologically diagnosis of well-differentiated neuroendocrine carcinoma
- Inoperable disease
- Age > 18
- ECOG Performance Status 0-2
- Life expectancy of at least 12 weeks
- Measurable and/or evaluable lesions according to RECIST criteria
- Radiological documentation of disease progression
- Adequate bone marrow reserve
- Adequate hepatic and renal function
- Urine dipstick of proteinuria < 2+
- Written informed consent
- Comply with the protocol procedures
Exclusion criteria:
- Serious non-healing wound or ulcer
- Evidence of bleeding diathesis or coagulopathy
- Uncontrolled hypertension
- Clinically significant cardiovascular disease for example cerebrovascular accidents (≤6 months), myocardial infarction (≤6 months), unstable angina, New York Heart Association (NYHA) grade II or greater congestive heart failure, serious cardiac arrhythmia requiring medication
- Current or recent ongoing treatment with anticoagulants for therapeutic purposes
- Chronic, daily treatment with high-dose aspirin (>325 mg/day) or other medications known to predispose to gastrointestinal ulceration
- Patients with severe renal impairment (creatinine clearance below 30 ml/min)
- Other co-existing malignancies or malignancies diagnosed within the last 5 years with the exception of basal cell carcinoma or cervical cancer in situ
- Major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to study treatment start, or anticipation of the need for major surgical procedure during the course of the study
- Pregnant or lactating women.
Contacts and Locations| Contact: Maria P Brizzi, MD, PhD | +39, 011-9026 ext 007 | mariapia.brizzi@email.it |
| Italy | |
| Lucia Tozzi | Completed |
| San Giovanni Rotondo, Foggia, Italy, 71013 | |
| Anna Ferrero | Recruiting |
| Orbassano, Turin, Italy, 10043 | |
| Contact: Anna Ferrero, MD +39 011 9026 ext 526 anna.ferrero80@libero.it | |
| Sub-Investigator: Maria P Brizzi, MD, PhD | |
| Elisabetta Nobili | Recruiting |
| Bologna, Italy, 40138 | |
| Contact: Elisabetta Nobili, MD 051 6363 ext 680 elisabetta.nobili3@unibo.it | |
| Principal Investigator: Guido Biasco, MD, PhD | |
| Nicola Fazio | Completed |
| Milan, Italy, 20121 | |
| Enrica Milanesi | Completed |
| Turin, Italy, 10126 | |
| Study Director: | Alfredo Berruti, MD, PhD | Medical Oncology, Department of Clinical and Biological Sciences, University of Turin |
More Information
Publications:
| Responsible Party: | Alfredo Berruti, Dipartimento di Scienze Cliniche e Biologiche - Università di Torino |
| ClinicalTrials.gov Identifier: | NCT01203306 History of Changes |
| Other Study ID Numbers: | EudraCT 2006-004748-22 |
| Study First Received: | September 9, 2010 |
| Last Updated: | September 15, 2010 |
| Health Authority: | Italy: AIFA - The Italian Medicines Agency |
Keywords provided by University of Turin, Italy:
|
bevacizumab somatostatin analogue metronomic capecitabine neuroendocrine tumors |
Additional relevant MeSH terms:
|
Carcinoma Carcinoma, Neuroendocrine Neuroendocrine Tumors Neoplasms, Glandular and Epithelial Neoplasms by Histologic Type Neoplasms Neuroectodermal Tumors Neoplasms, Germ Cell and Embryonal Adenocarcinoma Neoplasms, Nerve Tissue Octreotide Capecitabine Bevacizumab Fluorouracil Somatostatin |
Antineoplastic Agents, Hormonal Antineoplastic Agents Therapeutic Uses Pharmacologic Actions Gastrointestinal Agents Hormones Hormones, Hormone Substitutes, and Hormone Antagonists Physiological Effects of Drugs Antimetabolites, Antineoplastic Antimetabolites Molecular Mechanisms of Pharmacological Action Immunosuppressive Agents Immunologic Factors Angiogenesis Inhibitors Angiogenesis Modulating Agents |
ClinicalTrials.gov processed this record on May 22, 2013