Phase II Study of Everolimus Combined With Octreotide LAR to Treat Advanced GI NET (EVERLAR)

Grupo Espanol de Tumores Neuroendocrinos

Status and phase

Completed

Phase 2

Conditions

Gastrointestinal Neoplasms

Treatments

Drug: octreotide LAR

Drug: Everolimus

Study type

Interventional

Funder types

Other

Identifiers

NCT01567488

CRAD001KES08T (Other Grant/Funding Number)

GETNE 1003

Details and patient eligibility

About

The underlying hypothesis of the synergistic activity of octreotide and everolimus is based on the combination of a) a direct action of everolimus over mTOR (mammalian target of rapamycin), and b) the inhibitory effect of octreotide on the IGF-I (insulin like growth factor 1) system preventing the activation of the mTOR system by this factor. Both types of inhibition would completely cancel this signal transduction pathway, which is so important in neuroendocrine tumours.

Furthermore, the biological study proposed in this protocol will allow for better establishing the relationship between the activation of the IGFR-PI3K-mTOR signal transduction pathway (i.e., the mTOR pathway stimulated by IGFR) and treatment response; this information is relevant since the IGFR-PI3K-mTOR activation status could be a response prediction factor.

This study will provide significant additional information about the efficacy of the combination treatment of everolimus with octreotide LAR® in non-functioning GI NET.

Full description

Everolimus has been developed following two administration regimens: weekly and daily. Phase I pharmacodynamic studies recommend doses of 50 mg weekly and 10 mg/daily, based on its toxicity and inhibitory effect of the mTOR pathway in tumours; although the inhibition of this pathway has been demonstrated, the knowledge of response prediction factors has not been developed, in part due to the very low responses found in the population in phase I studies. These factors can be better outlined in a phase II study, where patients who have received fewer previous treatments can respond better, and where the profile of responders and non-responders can be identified more easily.

Enrollment

43 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Diagnosis of non-operable or metastatic non-functioning, well differentiated advanced GI NET, confirmed by cytology or histology. In case of liver metastasis, neuroendocrine tumours of unknown origin are accepted.
Confirmation of diagnosis of neuroendocrine carcinoma of low to intermediate histology grade
Radiologically documented disease progression within 12 months prior to inclusion in the study. If the patient received anticancer treatment within the past 12 months, disease progression must be documented by radiology during or after taking this medication
Adequate bone marrow. liver and renal function

Exclusion criteria

Previous treatment with mTOR inhibitors (sirolimus, temsirolimus, everolimus, deforolimus).
Patients with any serious disease and/or an uncontrolled clinical condition
Patients on chronic treatment with corticosteroids or any other immunosuppressive agent