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    Clinical Trial Results:
    Estudio en fase II de everolimus, un inhibidor mTOR (de formulación oral), junto con OcteotrideLAR®, en pacientes adultos con tumores neuroendocrinos gastrointestinales avanzados no funcionales y bien diferenciados (TNE GI).

    Summary
    EudraCT number
    2010-023422-20
    Trial protocol
    ES  
    Global end of trial date
    07 Jun 2017

    Results information
    Results version number
    v1(current)
    This version publication date
    22 May 2022
    First version publication date
    22 May 2022
    Other versions
    Summary report(s)
    Phase II Study of Everolimus and Octreotide LAR in Patients with Nonfunctioning Gastrointestinal Neuroendocrine Tumors: The GETNE1003_EVERLAR Study

    Trial information

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    Trial identification
    Sponsor protocol code
    GETNE1003
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01567488
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Grupo Español de Tumores Neuroendocrinos
    Sponsor organisation address
    C/ Velázquez nº 7, piso 3, Madrid, Spain, 28001
    Public contact
    GETNE secretariat desk, GETNE, getne@getne.org
    Scientific contact
    Secretaría Técnica de GETNE , Grupo Españolde Tumores Neuroendocrinos (GETNE), getne@getne.org
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    08 Mar 2016
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    07 Jun 2017
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    El objetivo principal del estudio es evaluar la eficacia de 10 mg/día de everolimus en combinación con 30 mg de octeotride LAR® i.m. cada 28 días, en el tratamiento de TNE GI avanzado
    Protection of trial subjects
    None out of clinical practice.
    Background therapy
    -
    Evidence for comparator
    No comparator is used. This is a one arm study.
    Actual start date of recruitment
    08 Jun 2011
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Spain: 44
    Worldwide total number of subjects
    44
    EEA total number of subjects
    44
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    24
    From 65 to 84 years
    18
    85 years and over
    2

    Subject disposition

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    Recruitment
    Recruitment details
    Los pacientes se incluyeron entre el 08/06/2011 y el 17/04/2013 en España.

    Pre-assignment
    Screening details
    Enfermedad medible según los criterios RECIST 1.0, mediante una valoración radiológica de TAC trifásico o RM de fase múltiple. Progresión de la enfermedad en los 12 meses anteriores a su inclusión en el estudio, documentada de forma radiológica. Estado funcional 0-2 (OMS), función adecuada de la médula ósea, hepática y renal, colesterol.

    Period 1
    Period 1 title
    Treatment (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    Treatment subject disposition
    Arm description
    Tratamiento combinado de dos principios activos: Everolimus y Octreorida LAR
    Arm type
    One arm study

    Investigational medicinal product name
    Everolimus
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    10 mg daily in combination with Octreotida LAR

    Investigational medicinal product name
    Octreotida LAR
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Powder and solvent for solution for injection/infusion
    Routes of administration
    Intramuscular use
    Dosage and administration details
    30mg i.m. each 28 days

    Number of subjects in period 1
    Treatment subject disposition
    Started
    44
    Completed
    44

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Treatment
    Reporting group description
    -

    Reporting group values
    Treatment Total
    Number of subjects
    44 44
    Age categorical
    Pacientes mayores o de 18 años.
    Units: Subjects
        In utero
    0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0
        Newborns (0-27 days)
    0 0
        Infants and toddlers (28 days-23 months)
    0 0
        Children (2-11 years)
    0 0
        Adolescents (12-17 years)
    0 0
        Adults (18-64 years)
    24 24
        From 65-84 years
    18 18
        85 years and over
    2 2
    Age continuous
    Se han reclutado pacientes mayores o de 18 años.
    Units: years
        arithmetic mean (standard deviation)
    61 ± 12 -
    Gender categorical
    Units: Subjects
        Female
    20 20
        Male
    24 24
    Subject analysis sets

    Subject analysis set title
    Treatment baseline characteristics
    Subject analysis set type
    Full analysis
    Subject analysis set description
    This is a one arm study. 43 patients of 44 included were analyzed.

    Subject analysis sets values
    Treatment baseline characteristics
    Number of subjects
    43
    Age categorical
    Pacientes mayores o de 18 años.
    Units: Subjects
        In utero
        Preterm newborn infants (gestational age < 37 wks)
        Newborns (0-27 days)
        Infants and toddlers (28 days-23 months)
        Children (2-11 years)
        Adolescents (12-17 years)
        Adults (18-64 years)
    12
        From 65-84 years
    9
        85 years and over
    1
    Age continuous
    Se han reclutado pacientes mayores o de 18 años.
    Units: years
        arithmetic mean (standard deviation)
    ±
    Gender categorical
    Units: Subjects
        Female
        Male

    End points

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    End points reporting groups
    Reporting group title
    Treatment subject disposition
    Reporting group description
    Tratamiento combinado de dos principios activos: Everolimus y Octreorida LAR

    Subject analysis set title
    Treatment baseline characteristics
    Subject analysis set type
    Full analysis
    Subject analysis set description
    This is a one arm study. 43 patients of 44 included were analyzed.

    Primary: Supervivencia libre de progresión 12 meses

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    End point title
    Supervivencia libre de progresión 12 meses
    End point description
    La tasa de supervivencia libre de progresión (SLP), variable de resultado principal del estudio, se describirá a partir de los resultados obtenidos en el ensayo tras 12 meses de tratamiento, hasta el registro de una progresión objetiva de la enfermedad o fallecimiento por cualquier causa.
    End point type
    Primary
    End point timeframe
    A los 12 meses de tratamiento.
    End point values
    Treatment subject disposition Treatment baseline characteristics
    Number of subjects analysed
    1
    43
    Units: Progresiones
    43
    43
    Statistical analysis title
    Análisis principal
    Statistical analysis description
    Porcentaje de pacientes sin signos de enfermedad progresiva después de 12 meses de tratamiento, incluyendo intervalos de confianza (IC) del 95%. La variable supervivencia libre de progresión (SLP) se analiza con un modelo de supervivencia de Kaplan Meier, estimando la proporción de SLP acumulada a un año con ICs de 95% bilateral.
    Comparison groups
    Treatment subject disposition v Treatment baseline characteristics
    Number of subjects included in analysis
    44
    Analysis specification
    Pre-specified
    Analysis type
    other
    Method
    Parameter type
    porcentage
    Point estimate
    62
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    47
         upper limit
    76

    Secondary: Supervivencia global

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    End point title
    Supervivencia global
    End point description
    Porcentage de eventos (muerte) observados desde la fecha de inclusión del paciente en el estudio hasta la fecha de la muerte por cualquier causa. Se describe la sobrevivencia a los 24 meses de iniciado el tratamiento, mediante un modelo de supervivencia de Kaplan-Meier.
    End point type
    Secondary
    End point timeframe
    A los 24 meses de iniciado el tratamiento.
    End point values
    Treatment subject disposition Treatment baseline characteristics
    Number of subjects analysed
    43
    43
    Units: eventos
    43
    43
    Statistical analysis title
    Análisis secundario
    Statistical analysis description
    Modelo de supervivencia de Kaplan Meier a los 24 meses.
    Comparison groups
    Treatment subject disposition v Treatment baseline characteristics
    Number of subjects included in analysis
    86
    Analysis specification
    Pre-specified
    Analysis type
    other [1]
    Method
    Parameter type
    tiempo (meses)
    Point estimate
    71
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    58
         upper limit
    85
    Notes
    [1] - Modelo de supervivencia de Kaplan Meier estimando la mediana y la media. Si se desconoce si un paciente ha fallecido, la supervivencia global será censurada con la fecha del último contacto.

    Secondary: Supervivencia libre de progresión 24 meses

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    End point title
    Supervivencia libre de progresión 24 meses
    End point description
    Tasa de supervivencia libre de progresión (SLP) observada desde el inicio del tratamiento hasta el registro de una progresión objetiva de la enfermedad o fallecimiento por cualquier causa.
    End point type
    Secondary
    End point timeframe
    24 meses de tratamiento
    End point values
    Treatment subject disposition Treatment baseline characteristics
    Number of subjects analysed
    43
    43
    Units: progresiones
    43
    43
    Statistical analysis title
    Supervivencia libre de progresion 24 meses
    Statistical analysis description
    Porcentaje de pacientes sin signos de enfermedad progresiva después de 24 meses de tratamiento. Se utiliza un modelo de supervivencia de Kaplan Meier, estimando la proporción de SLP acumulada a un año con ICs de 95% bilateral. Estudio de un solo brazo. One arm study.
    Comparison groups
    Treatment subject disposition v Treatment baseline characteristics
    Number of subjects included in analysis
    86
    Analysis specification
    Pre-specified
    Analysis type
    other [2]
    Method
    Parameter type
    porcentaje de pacientes
    Point estimate
    43
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    28
         upper limit
    58
    Notes
    [2] - Supervivencia de Kaplan Meier

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Hasta los 24 meses de tratamiento del último paciente incluido y hasta 30 días después de la última dosis.
    Adverse event reporting additional description
    Se utiliza estadística descriptiva, mediante tablas de frecuencia, de todos los acontecimientos adversos indicando la gravedad valorada según los criterios Common Terminology Criteria for Adverse Events (CTCAE) versión 4.0.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    17.0
    Reporting groups
    Reporting group title
    Terapia combinada
    Reporting group description
    Brazo de tratamiento

    Serious adverse events
    Terapia combinada
    Total subjects affected by serious adverse events
         subjects affected / exposed
    16 / 44 (36.36%)
         number of deaths (all causes)
    11
         number of deaths resulting from adverse events
    0
    General disorders and administration site conditions
    Uncontrolled pain
         subjects affected / exposed
    1 / 44 (2.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pericardial effusion
    Additional description: Un hombre hipertenso acude a urgencias con fatiga y palpitaciones. Se le realiza un análisis de sangre, una radiografía de tórax y una ecocardiografía y se diagnostica un derrame pericárdico asintomático.
         subjects affected / exposed
    1 / 44 (2.27%)
         occurrences causally related to treatment / all
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    Fever (focus unknown)
         subjects affected / exposed
    1 / 44 (2.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Vomiting
         subjects affected / exposed
    1 / 44 (2.27%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Absceso perineal
    Additional description: El paciente es hospitalizado y se realiza un drenaje.
         subjects affected / exposed
    1 / 44 (2.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Abdominal perforation
    Additional description: Posiblemente secundario a una isquemia intestinal relacionada con el tumor. Complicación secundaria a fibrosis extensiva y posible progresión. El paciente muere debido a una perforación secundaria a progresión local de la enfermedad.
         subjects affected / exposed
    1 / 44 (2.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Intestinal suboclusion
         subjects affected / exposed
    2 / 44 (4.55%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    Abdominal pain
         subjects affected / exposed
    3 / 44 (6.82%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Neumonitis
         subjects affected / exposed
    3 / 44 (6.82%)
         occurrences causally related to treatment / all
    2 / 3
         deaths causally related to treatment / all
    0 / 0
    Dyspnoea
         subjects affected / exposed
    1 / 44 (2.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Insuficiencia renal
         subjects affected / exposed
    1 / 44 (2.27%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Cólico nefrítico derecho
    Additional description: El paciente es atendido en el hospital, por dolor lumbar derecho. Es diagnosticado un cólico nefrítico derecho.
         subjects affected / exposed
    1 / 44 (2.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Endocrine disorders
    Ectopic ACTH syndrome
    Additional description: Es diagnosticado de síndrome ACTH ectópico relacionado con progresión de la enfermedad, y es ingresado en el hospital.
         subjects affected / exposed
    1 / 44 (2.27%)
         occurrences causally related to treatment / all
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Bacteremia
    Additional description: Due to E.Coli
         subjects affected / exposed
    1 / 44 (2.27%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hickman infection
    Additional description: La infección se produce tras su manipulación, y se comprueba tras su análisis.
         subjects affected / exposed
    1 / 44 (2.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Terapia combinada
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    39 / 44 (88.64%)
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    29 / 44 (65.91%)
         occurrences all number
    82
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    39 / 44 (88.64%)
         occurrences all number
    100
    Mucositis
         subjects affected / exposed
    29 / 44 (65.91%)
         occurrences all number
    60

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    07 Oct 2015
    1/ Modificar el formulario para definir correctamente el final del ensayo. 2/ Comunicar una ampliación del seguimiento de los pacientes. 3/ Incluir un nuevo Manual del investigador versión 14 que sustituye a la versión 13. 4/ Nuevos datos de contacto de la secretaría del promotor.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported

    Online references

    http://www.ncbi.nlm.nih.gov/pubmed/29794066
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