Clinical Trial · NCT03246659

Radiolabelled CCK-2/Gastrin Receptor Analogue for Personalized Theranostic Strategy in Advanced MTC

Overview

The study is a phase I multicentre randomized, open, parallel-arm clinical trial conducted to investigate the IMP, namely 111In-CP04. The study consists of preclinical (to establish a clinically useful formulation for the radiolabelled peptide CP04), and a clinical step. The main objective of the clinical part of the project is to establish the safety of i.v. administration of a high peptide amount and to assess the tracer biodistribution and dosimetry in MTC and normal tissues and to determine critical organs as well as the evaluation of the potential of CCK2 receptor scintigraphy to detect cancer lesions for both low (10ug) and high (50ug) peptide amount and the decrease of kidney dose after co-administration of gelofusine /gelaspan as a nephroprotective agent. To achieve this, the following study design has been accepted: the first 4 patients will receive 2 peptide amount of CP04: low peptide amount (for diagnostic purpose) and high peptide amount (for therapeutic purpose) of CP04. If no SAE is present, the remaining pts will be randomized for 2 arms: high peptide amount of 111In-CP04 with and without gelofusine/gelaspan infusion. It is expected that CCK-2/gastrin receptor imaging will become a valid diagnostic method for a specific non-invasive staging and follow-up of patients with MTC, and treatment of recurrent and disseminated disease will be more efficient with minimized nephro- and myelotoxicity (if 111In labelled).

Sponsor

Azienda Ospedaliero-Universitaria Careggi

Phase

Phase 1

Contacts

Paola Anna Erba, Professor (PRINCIPAL_INVESTIGATOR)

ClinicalTrials.gov

NCT03246659

Drug / Compound

CP04

Isotope(s):
Target(s):
  • Cholecystokinin-2 (CCK2R)
Ligand Class: Peptides
Chelator: DOTA

Eligibility

Inclusion

  • Histologically documented medullary cancer of the thyroid.
  • Related to the medullary cancer of the thyroid:
  • Karnofsky performance status \> 50%.
  • Presence of more than one distant or nodal, surgically untreatable metastases confirmed with either 18F-FDG PET/CT or enhanced-CT or MRI OR
  • Life expectancy of more than 6 months. Related to the patient:
  • Doubling time (DT) of serum calcitonin level less than two years prior to study entry and negative imaging.

Exclusion

  • Related to the MTC:
  • Patients with surgically treatable medullary thyroid cancer.
  • Clinical diagnosis of disseminated intravascular coagulation.
  • Serum creatinine \>170 μmol/L, GFR \< 40 mL/min
  • Patients with history of second malignancy other than basal cell carcinoma of the skin. Related to previous or concomitant therapies :
  • Known history of hypersensitivity to gelofusine /gelaspan or any other contraindications to gelofusine/gelaspan infusion
  • Participation in any other investigational trial within 3 months of study entry.
  • Known hypersensitivity to gastrin analogues.
  • Patients with bladder outflow obstruction or unmanageable urinary incontinence.
  • Organ allograft requiring immunosuppressive therapy. Related to the patient:
  • Previous external beam radiation therapy within two years.
  • Pregnancy, breast-feeding.
  • Patients with concurrent illnesses that might preclude study completion or interfere with study results.