E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
MALIGNANT PHEOCHROMOCYTOMA/PARAGANGLIOMA |
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MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 9.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10034876 |
E.1.2 | Term | Pheochromocytoma |
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E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
Phase I • To determine the maximum tolerated dose (MTD) of Ultratrace iobenguane I 131 in patients with malignant pheochromocytoma/paraganglioma
Phase II • To determine the objective tumor response rate and its 95% confidence interval at 9 months following treatment with Ultratrace iobenguane I 131 in patients with malignant pheochromocytoma/paraganglioma |
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E.2.2 | Secondary objectives of the trial |
Phase I • Estimate radiation absorbed doses to target lesions and to a standard set of normal organs following a 5.0 mCi tracer infusion of Ultratrace iobenguane I 131 in patients with malignant pheochromocytoma/paraganglioma • Assess objective tumor response at 3, 6, 9 & 12 months following treatment with Ultratrace iobenguane I 131 in patients with malignant pheochromocytoma/paraganglioma
Phase II • Assess the objective tumor response rate and its 95% confidence interval at 3, 6, and 12 months following treatment with Ultratrace iobenguane I 131 in patients with malignant pheochromocytoma/paraganglioma • Determine the biochemical response rate and its 95% confidence interval at 3, 6, 9, and 12 months following treatment with Ultratrace iobenguane I 131 in patients with malignant pheochromocytoma/paraganglioma
Only the first two secondary objectives are listed for each phase of the study. For the full list please refer to the protocol.
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
• Have a diagnosis of either adrenal pheochromocytoma or extra-adrenal paraganglioma by: o histological confirmation –OR-- o plasma-free metanephrines and 24-hour urine test for catecholamines/metanephrines • Disease is metastatic or has recurred following surgery • At least one measurable lesion seen by computed tomography (CT) or magnetic resonance (MR) scan performed with IV contrast within 4 weeks prior to the first dose of study drug • At least one measurable tumor site is also seen on Ultratrace iobenguane I 131 scan • Provide written informed consent and are willing to comply with protocol requirements • Are at least 18 years of age • If female, then not of childbearing potential as documented by history (e.g., tubal ligation or hysterectomy) or is post menopausal with a minimum 1 year without menses • If female of childbearing potential, has a negative serum βHCG pregnancy test within 48 hours prior to receiving iobenguane I 131 • Females who agree not to become pregnant and males who agree not to father a child during the 1 year period following the therapeutic dose of Ultratrace iobenguane I 131. Both females and males must use an acceptable method of birth control during the first year following the therapeutic dose of Ultratrace iobenguane I 131. |
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E.4 | Principal exclusion criteria |
• Females who are nursing • Active CNS lesions by CT/MR scanning within 3 months of study entry • New York Heart Association class III-IV heart failure • Received any previous systemic radiotherapy within 6 months of study entry [prior carrier-added iobenguane I 131 therapy is allowed if not within 6 months] • Administered prior whole-body radiation therapy • Received external beam radiotherapy to > 25% of bone marrow • Administered prior chemotherapy within 30 days of study entry • Karnofsky performance status is < 60 • Platelets ≤ 100,000/μL • Absolute neutrophil count (ANC) ≤ 1,500/μL • Serum creatinine ≥ 1.5 mg/dL • Total bilirubin ≥ 1.5 times the upper limit of normal • AST/SGOT or ALT/SGPT ≥ 2.5 times the upper limit of normal • Has a known allergy to iobenguane, iodine, or SSKI that has required medical intervention • Has received a therapeutic investigational compound and/or medical device within 30 days before admission into this study • Has any medical condition or other circumstances which would significantly decrease the chances of obtaining reliable data, achieving study objectives, or completing the study and/or post dose follow-up examinations • Has evidence of altered biodistribution of Ultratrace iobenguane I 131 • Has evidence of renal obstruction • Is determined by the Investigator that the patient is clinically unsuitable for the study. • Has received a medication which inhibits uptake of iobenguane I 131: - phenothiazines or decongestants within 2 weeks prior to the first dose of Ultratrace iobenguane I 131; - a tricyclic antidepressant within 6 weeks prior to the first dose of Ultratrace iobenguane I 131; or, - labetelol within 1 week prior to the first dose of Ultratrace iobenguane I 131. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Dosimetry [phase I only] - radiation absorbed doses to target lesions and to normal organs in accordance with MIRD Efficacy: - objective tumor response per Response Evaluation Criteria in Solid Tumors (RECIST) - dose-response [phase I only] - biochemical response Safety: - maximum tolerated dose [phase I only] - treatment emergent AEs - clinical laboratory measurements - vital signs measurements - ECG measurements - physical examination findings |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | Information not present in EudraCT |
E.6.2 | Prophylaxis | Information not present in EudraCT |
E.6.3 | Therapy | Information not present in EudraCT |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Information not present in EudraCT |
E.6.7 | Pharmacodynamic | Information not present in EudraCT |
E.6.8 | Bioequivalence | Information not present in EudraCT |
E.6.9 | Dose response | Yes |
E.6.10 | Pharmacogenetic | Information not present in EudraCT |
E.6.11 | Pharmacogenomic | Information not present in EudraCT |
E.6.12 | Pharmacoeconomic | Information not present in EudraCT |
E.6.13 | Others | Information not present in EudraCT |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | Yes |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | Yes |
E.7.1.3.1 | Other trial type description |
Dose finding, Safety & efficacy |
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E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | Information not present in EudraCT |
E.7.4 | Therapeutic use (Phase IV) | Information not present in EudraCT |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.3.1 | Comparator description |
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E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 4 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 14 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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Patients will be monitored from the time of signed informed consent through 12 months after the second (therapeutic) Ultratrace iobenguane I 131 infusion. Patients then enter long-term follow-up until 5 years posttreatment or death, to obtain objective response, biochemical response, overall survival, serious adverse events, and late radiation toxicity. |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 2 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 2 |
E.8.9.2 | In all countries concerned by the trial months | 0 |