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177Lu-DOTA-TATE and Olaparib in Somatostatin Receptor Positive Tumours (LuPARP)

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ClinicalTrials.gov Identifier: NCT04375267
Recruitment Status : Recruiting
First Posted : May 5, 2020
Last Update Posted : May 5, 2020
Advanced Accelerator Applications
Information provided by (Responsible Party):
Vastra Gotaland Region

Brief Summary:
This is a phase I study of 177Lu-DOTA-TATE in combination with the PARP-inhibitor olaparib for treatment of patients with somatostatin receptor positive tumours detected by 68Ga-DOTA-TATE/TOC PET. The combination of a PARP inhibitor that will specifically target the repair mechanism, with ionising radiation causing SSB's might overcome the repair dependent survival of the tumour cells, making them more sensitive to β-emission and increase the probability of tumour cell death.

Condition or disease Intervention/treatment Phase
Clinical Trial, Phase I Neuroendocrine Tumors Thymoma Mesothelioma Drug: 177Lu-DOTA-TATE + olaparib Phase 1

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 18 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Phase I Trial With 177Lu-DOTA-TATE and Olaparib in Somatostatin Receptor Positive Tumours
Actual Study Start Date : April 23, 2020
Estimated Primary Completion Date : June 30, 2022
Estimated Study Completion Date : June 30, 2023

Arm Intervention/treatment
Experimental: 177Lu-DOTA-TATE and olaparib Drug: 177Lu-DOTA-TATE + olaparib
177Lu-DOTA-TATE in four cycles in combination with escalated doses of olaparib

Primary Outcome Measures :
  1. Number of participants with treatment-related adverse events as assessed by CTCAE v5.0 [ Time Frame: up to 6 months after last treatment cycle ]
    To assess the number of participants with toxicity of 177Lu-DOTA-TATE in combination with olaparib measured by NCI Common Toxicity Criteria v 5.0

Secondary Outcome Measures :
  1. TTP [ Time Frame: 3 years ]
    Time to progression

  2. Response rate [ Time Frame: 12 months after last treatment cycle ]
    Response rate (RECIST) at 3 and 12 months

  3. OS [ Time Frame: 3 years ]
    Overall survival

  4. DOR [ Time Frame: 3 years ]
    Duration of response

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Histological or cytological diagnosis of neoplasia (not mandatory for meningioma)
  • GEPNETs grade 3 or aggressive grade 2 tumours with a poor prognosis and a Ki67 > 15% OR neuroendocrine tumours NOS after standard therapy OR thymomas/tumours of other origin after standard therapy OR meningiomas after standard therapy not suitable for surgery or radiotherapy
  • Evidence of regional or distant metastases or localised disease not accessible for complete resection
  • Measurable disease according to RECIST 1.1
  • Evidence of somatostatin receptor positive disease detected by 68Ga-DOTA-TATE/TOC PET
  • Progressive disease during the last 14 months based on CT or new lesions detected by 68Ga-DOTA-TATE PET.
  • Performance status ECOG 0 - 1
  • Life expectancy > 6 months
  • Age >18 years, no upper age limit.
  • Neutrophil count >1,5 x 109/L
  • Platelet count >100 x 109/L
  • Normal liver function regarding transaminases, PK and albumin. A raised bilirubin which can be considered an isolated effect of liver metastases is not a contraindication as long as the levels remain <1.5 x ULN.
  • GFR > 50 ml/min
  • Written informed consent from patients
  • Evidence of post-menopausal status or negative urinary or serum pregnancy test for female pre-menopausal subjects. Women will be considered post-menopausal if they have been amenorrheic for 12 months without an alternative medical cause. The following age-specific requirements apply:

    • Women <50 years of age would be considered post-menopausal if they have been amenorrheic for 12 months or more following cessation of exogenous hormonal treatments and if they have luteinizing hormone and follicle-stimulating hormone levels in the post-menopausal range for the institution or underwent surgical sterilization (bilateral oophorectomy or hysterectomy).
    • Women ≥50 years of age would be considered post-menopausal if they have been amenorrheic for 12 months or more following cessation of all exogenous hormonal treatments, had radiation-induced menopause with last menses >1 year ago, had chemotherapy-induced menopause with last menses >1 year ago, or underwent surgical sterilization (bilateral oophorectomy, bilateral salpingectomy or hysterectomy).

Exclusion Criteria:

  • Performance Status ECOG > 1
  • Well differentiated GEPNETs grad 1 and 2 (except aggressive grade 2 tumours with a poor prognosis and a Ki67 > 15%)
  • Loco-regional treatment during the last 3 months involving all of the measurable lesions
  • Chemotherapy during the last 8 weeks or longer until no persisting toxicity exists. Earlier treatment with mTORi or TKI the last 4 weeks or until no persisting toxicity exists
  • Previous treatment with 177Lu-DOTA-TATE or cis-/carboplatin
  • Other concomitant nephrotoxic treatment
  • Serious heart disease (NYHA III-IV)
  • Previous radiotherapy including >25% of active bone marrow volume
  • Pregnancy and lactation
  • Extensive liver metastases combined with impaired liver function (i.e. abnormal laboratory parameters (> grad 1 CTCAE) or ascites)
  • Symptomatic CNS metastases (e.g. requiring corticosteroid treatment) Symptomatic treatment for meningiomas or corticosteroids due to treatment related swelling is however allowed
  • Ongoing treatment with interferon. This treatment should be suspended a minimum of 4 wees before treatment with 177Lu-DOTA-TATE, or longer if there is persisting signs of toxicity
  • Patients who have a another metastatic tumor diagnosis
  • Known or expected hypersensitivity to 177Lu-DOTA-TATE, 68Ga- DOTA-TATE/TOC or any of their excipients
  • History of psychiatric disease/condition that may interfere with the objectives and assessments of the study
  • Female subjects who are pregnant or breastfeeding or subjects of reproductive potential who are not willing to employ effective birth control methods (Pearl index <1) from screening to 6 months after the last dose of olaparib

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04375267

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Contact: Andreas Hallqvist, MD, PhD +46313421000 andreas.hallqvist@vgregion.se
Contact: Annika Baan +46313421000 annika.baan@vgregion.se

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Dept of Oncology Recruiting
Gothenburg, Sweden, 41345
Contact: Andreas Hallqvist       andreas.hallqvist@vgregion.se   
Sponsors and Collaborators
Vastra Gotaland Region
Advanced Accelerator Applications
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: Vastra Gotaland Region
ClinicalTrials.gov Identifier: NCT04375267    
Other Study ID Numbers: 2019-001700-37
First Posted: May 5, 2020    Key Record Dates
Last Update Posted: May 5, 2020
Last Verified: April 2020
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Undecided

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Product Manufactured in and Exported from the U.S.: No
Additional relevant MeSH terms:
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Neuroendocrine Tumors
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Neoplasms, Mesothelial
Thoracic Neoplasms
Neoplasms by Site
Neuroectodermal Tumors
Neoplasms, Germ Cell and Embryonal
Neoplasms, Nerve Tissue
Neoplasms, Complex and Mixed
Thymus Neoplasms
Lymphatic Diseases
Lutetium Lu 177 dotatate
Poly(ADP-ribose) Polymerase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents