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NCT00510068 · CITED IN SOURCE DOCUMENTS

Efficacy and Safety of Everolimus (RAD001) Compared to Placebo in Patients With Advanced Neuroendocrine Tumors

An NCI or FDA source cites this study. A citation does not establish that it applies to an individual diagnosis.

Phase
PHASE3
Status at capture
COMPLETED
Registry last update
2015-07-01

The purpose of this study was to evaluate progression free survival in those participants assigned everolimus 10 mg/day plus Best Supportive Care versus those assigned to placebo plus Best Supportive Care in Advanced Neuroendocrine Tumors of pancreatic origin.

Open the original ClinicalTrials.gov record → · Download preserved record

What did the study report?

Outcomes, safety and baseline populations are separate source sections. Quality-of-life measures appear under their original outcome titles.

flow

Participant flow

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baseline

Baseline characteristics

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outcome · POSTED

Time to Progression Free Survival (PFS) Based as Per Investigator Using Kaplan-Meier Methodology

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outcome · POSTED

Percentage of Participants With Objective Response Rate ( CR {Complete Response} OR PR {Partial Response})

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outcome · POSTED

Overall Survival

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outcome · POSTED

Progression Free Survival According to Ki-67 Levels Categorized as: Less Than or Equal to 2%, > 2% to Less Than or Equal to 5% and > 5%

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outcome · POSTED

Progression Free Survival According to Chromogramin A Tumor Marker (CgA) Baseline Level and According to CgA Early Response

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outcome · POSTED

Progression Free Survival According to Neuron Specific Enolase Tumor Marker (NSE) Baseline Level and According to NSE Early Response

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outcome · POSTED

Number of Participants With Adverse Events (AEs), Serious Adverse Events (SAEs)

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outcome · POSTED

Number of Participants With Adverse Events (AEs), Serious Adverse Events (SAEs) (Open-label Period)

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outcome · POSTED

Evaluation of Pharmacokinetics (PK) Parameter: AUC0-t Last

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outcome · POSTED

Evaluation of Pharmacokinetics (PK) Parameters: Cmax, Cmin

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outcome · POSTED

Evaluation of Pharmacokinetics (PK) Parameter: CL/F

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outcome · POSTED

Evaluation of Pharmacokinetics (PK) Parameter: Tmax -Time to Maximum (Peak) Drug Concentration

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outcome · POSTED

Analysis of Time to Definitive Deterioration of WHO Performance Status Using Kaplan-Meier

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outcome · POSTED

Plasma Angiogenesis Marker: Basic Fibroblast Growth Factor (bFGF)

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outcome · POSTED

Plasma Angiogenesis Marker: Placental Growth Factor (PLGF)

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outcome · POSTED

Plasma Angiogenesis Marker: Soluble Vascular Endothelial Growth Factor Receptor 1 (sVEGFR1)

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outcome · POSTED

Plasma Angiogenesis Marker: Soluble Vascular Endothelial Growth Factor Receptor 2 (sVEGFR2)

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outcome · POSTED

Plasma Angiogenesis Marker: Vascular Endothelial Growth Factor (VEGF)

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adverse events

Adverse events

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more info

Limitations, agreements, and source contact

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Who could take part
eligibility Criteria
Inclusion criteria: 1. Patients must have advanced (unresectable or metastatic) biopsy-proven pancreatic NET 2. Measurable disease by radiologic assessment 3. Adequate blood work 4. Performance Status 0-2 : Ability to be out of bed most of the time 5. Adult male or female patients ≥ 18 years of age 6. Women of childbearing potential must have a negative serum pregnancy test 7. Written informed consent from patients must be obtained in accordance to local guidelines Exclusion criteria: 1. Patients with severe kind of (poorly differentiated neuroendocrine carcinoma, high-grade neuroendocrine carcinoma, adenocarcinoid, goblet cell carcinoid and small cell carcinoma) cancer are not eligible 2. Other chemotherapy, immunotherapy or radiotherapy within 4 weeks prior to starting this trial 3. Hepatic artery procedure called embolization within the last 6 months (1 month if there are other sites of measurable disease), or cryoablation/ radiofrequency ablation of hepatic metastasis within 2 months of enrollment 4. Prior therapy with the same kind of medication (mTOR inhibitors: sirolimus, temsirolimus, everolimus). 5. Uncontrolled diabetes mellitus Patients who have any severe and/or uncontrolled medical conditions such as: 6. Patients receiving chronic treatment with corticosteroids or another immunosuppressive agent 7. Patients with a known history of HIV seropositivity 8. No other prior or concurrent cancer at the time enrolling to this trial Other protocol defined inclusion/ exclusion criteria applied
healthy Volunteers
false
minimum Age
18 Years
sex
ALL
std Ages
  1. ADULT
  2. OLDER_ADULT
Treatment arms and interventions
arm Groups
  1. description
    Participants received 10 mg per day of Everolimus plus best supportive care. Patients received their first dose of everolimus at Visit 2 (Cycle 1 Day 1).
    intervention Names
    1. Drug: Everolimus
    label
    Everolimus 10 mg/day
    type
    EXPERIMENTAL
  2. description
    Participants received matching placebo to everolimus daily plus best supportive care. Patients received their first dose of matching placebo at Visit 2 (Cycle 1 Day 1).
    intervention Names
    1. Drug: Everolimus Placebo
    label
    Placebo
    type
    PLACEBO_COMPARATOR
interventions
  1. arm Group Labels
    1. Everolimus 10 mg/day
    description
    A 10-mg dose of everolimus was given by continuous oral daily dosing of two 5-mg tablets.
    name
    Everolimus
    other Names
    1. RAD001
    type
    DRUG
  2. arm Group Labels
    1. Placebo
    description
    a 10-mg dose of matching placebo to Everolimus was given by continuous oral daily dosing of two 5-mg tablets.
    name
    Everolimus Placebo
    type
    DRUG
Study design
allocation
RANDOMIZED
intervention Model
PARALLEL
masking Info
masking
QUADRUPLE
who Masked
  1. PARTICIPANT
  2. CARE_PROVIDER
  3. INVESTIGATOR
  4. OUTCOMES_ASSESSOR
primary Purpose
TREATMENT
Enrollment
count
410
type
ACTUAL
Registered outcome plans (not posted results)
primary Outcomes
  1. description
    Progression of disease is defined as the time from study start to the date of first documented progression of disease or death due to any cause. Progression of disease is defined by RECIST criteria: Progression = 20% increase in the sum of the longest diameter of all target lesions, from the smallest sum of longest diameter of all target lesions recorded at or after baseline; or a new lesion; or progression of non-target lesions.
    measure
    Time to Progression Free Survival (PFS) Based as Per Investigator Using Kaplan-Meier Methodology
    time Frame
    Time from randomisation to dates of disease progression, death from any cause or last tumor assessment, reported between day of first patient randomised, 17 August 2007, until cut-off date 28 February 2010
secondary Outcomes
  1. description
    Objective Response defined by RECIST criteria: Partial response (PR) must have ≥ 30% decrease in the sum of the longest diameter of all target lesions, from the baseline sum. Complete response (CR) must have disappearance of all target and non-target lesions. For CR or PR, tumor measurements must be confirmed by 2nd assessments within 4 weeks . Progression = 20% increase in the sum of the longest diameter of all target lesions, from the smallest sum of longest diameter of all target lesions recorded at or after baseline; or a new lesion; or progression of non-target lesions
    measure
    Percentage of Participants With Objective Response Rate ( CR {Complete Response} OR PR {Partial Response})
    time Frame
    Time from randomisation to dates of disease progression, death from any cause or last tumor assessment, reported between day of first patient randomised, 17 August 2007, until cut-off date 28 February 2010
  2. description
    Overall survival (OS) was defined as the time from date of randomization to the date of death due to any cause. Analyses were performed using all deaths in the FAS population regardless of whether they were observed during the double-blind treatment period, the open-label treatment period, the post-treatment evaluations, or the survival follow-up period.
    measure
    Overall Survival
    time Frame
    Baseline, to death- no time limit
  3. description
    The level of Ki 67 expression for evaluable tumor samples were analyzed towards progression free survival (PFS) as per local investigator assessment. The Ki-67 protein is a cellular marker for proliferation. It is strictly associated with cell proliferation. During interphase, the Ki-67 antigen can be exclusively detected within the cell nucleus, whereas in mitosis most of the protein is relocated to the surface of the chromosomes. Baseline Ki 67 levels were categorized as: less than or equal to 2%, \> 2% to less than or equal to 5% and \> 5%.
    measure
    Progression Free Survival According to Ki-67 Levels Categorized as: Less Than or Equal to 2%, > 2% to Less Than or Equal to 5% and > 5%
    time Frame
    Time from randomisation to dates of disease progression, death from any cause or last tumor assessment, reported between day of first patient randomised, 17 August 2007, until cut-off date 28 February 2010
  4. description
    Baseline levels of serum CgA SE were characterized towards progression free survival (PFS) as per local investigator assessment, relative to the upper limited of normal (ULN). CgA levels exceeding 2 x ULN were considered to be 'Elevated' otherwise considered as "Non-elevated". An 'early response' (applicable to only those patients with elevated levels at baseline) was defined as a decrease of greater than or equal to 30% from baseline to Cycle 2 Day 1 or normalization by Cycle 2 Day 1. CgA is widely expressed in well-differentiated pancreatic NET. CgA is present in the secretory granules of neuroendocrine cells. Pancreatic NET patients often present with elevated circulating levels of CgA in their blood. Baseline levels of these biomarkers are considered as prognostic factors.
    measure
    Progression Free Survival According to Chromogramin A Tumor Marker (CgA) Baseline Level and According to CgA Early Response
    time Frame
    Time from randomisation to dates of disease progression, death from any cause or last tumor assessment, reported between day of first patient randomised, 17 August 2007, until cut-off date 28 February 2010
  5. description
    Baseline levels of serum NSE were characterized towards PFS as per local investigator assessment, relative to the upper limited of normal (ULN). NSE levels exceeding ULN were considered to be 'Elevated' otherwise considered as "Non-elevated". An 'early response' (applicable to only those patients with elevated levels at baseline) was defined as a decrease of greater than or equal to 30% from baseline to Cycle 2 Day 1 or normalization by Cycle 2 Day 1. NSE is widely expressed in well-differentiated pancreatic NET. NSE is usually expressed in the cytoplasm. Pancreatic NET patients often present with elevated circulating levels of NSE in their blood. Baseline levels of these biomarkers are considered as prognostic factors.
    measure
    Progression Free Survival According to Neuron Specific Enolase Tumor Marker (NSE) Baseline Level and According to NSE Early Response
    time Frame
    Time from randomisation to dates of disease progression, death from any cause or last tumor assessment, reported between day of first patient randomised, 17 August 2007, until cut-off date 28 February 2010
  6. description
    Adverse events are defined as any unfavorable and unintended diagnosis, symptom, sign (including an abnormal laboratory finding), syndrome or disease which either occurs during study, having been absent at baseline, or, if present at baseline, appears to worsen. Serious adverse events are any untoward medical occurrences that result in death, are life threatening, require (or prolong) hospitalization, cause persistent or significant disability/incapacity, result in congenital anomalies or birth defects, or are other conditions which in judgment of investigators represent significant hazards.
    measure
    Number of Participants With Adverse Events (AEs), Serious Adverse Events (SAEs)
    time Frame
    on or after the start of double-blind study medication until no later than 28 days after double-blind study medication discontinuation
  7. description
    Adverse events are defined as any unfavorable and unintended diagnosis, symptom, sign (including an abnormal laboratory finding), syndrome or disease which either occurs during study, having been absent at baseline, or, if present at baseline, appears to worsen. Serious adverse events are any untoward medical occurrences that result in death, are life threatening, require (or prolong) hospitalization, cause persistent or significant disability/incapacity, result in congenital anomalies or birth defects, or are other conditions which in judgment of investigators represent significant hazards.
    measure
    Number of Participants With Adverse Events (AEs), Serious Adverse Events (SAEs) (Open-label Period)
    time Frame
    on or after the start of open-label study medication until no later than 28 days after open-label study medication discontinuation
  8. description
    The PK parameters for a full PK profile at steady-state were determined in blood using non compartmental methods. This PK parameter is area under the concentration-time curve from time zero to the time of the last quantifiable concentration (AUC0-t last).
    measure
    Evaluation of Pharmacokinetics (PK) Parameter: AUC0-t Last
    time Frame
    Day 1 of every cycle (28 days/cycle) throughout the study
  9. description
    The PK parameters for a full PK profile at steady-state were determined in blood using non compartmental methods. The PK parameter: maximum (peak) drug concentration (Cmax) and minimum (trough) drug concentration (Cmin).
    measure
    Evaluation of Pharmacokinetics (PK) Parameters: Cmax, Cmin
    time Frame
    Day 1 of every cycle (28 days/cycle) throughout the study
  10. description
    The PK parameters for a full PK profile at steady-state were determined in blood using non compartmental methods. The PK parameter clearance of distribution expressed as a function of bioavailability (CL/F).
    measure
    Evaluation of Pharmacokinetics (PK) Parameter: CL/F
    time Frame
    Day 1 of every cycle (28 days/cycle) throughout the study
  11. description
    The PK parameters for a full PK profile at steady-state were determined in blood using non compartmental methods. Values for tmax where summarized in median (range).
    measure
    Evaluation of Pharmacokinetics (PK) Parameter: Tmax -Time to Maximum (Peak) Drug Concentration
    time Frame
    Day 1 of every cycle (28 days/cycle) throughout the study
  12. description
    Time to definitive worsening is defined as a definitive increase in performance status from a baseline of 0 or 1 to WHO \>= 2, or from a baseline value of 2 to WHO \>= 3. If no earlier deterioration, patients were censored at the end of follow-up or at the start of further antineoplastic therapy. Rates of patients with no deterioration at 3 and 6 months were computed using Kaplan-meier method. Grade 0: Able to carry out all activity without restriction; Grade 1: Restricted in physically strenuous activity but ambulatory \& able to do light work; Grade 2: Ambulatory \& capable of all self-care but unable to carry out any work. Up \& about more than 50% of waking hours; Grade 3: Capable of only limited self-care, confined to bed or chair more than 50% of waking hours; Grade 4: Completely disabled \& cannot carry on any self-care; totally confined to bed or chair.
    measure
    Analysis of Time to Definitive Deterioration of WHO Performance Status Using Kaplan-Meier
    time Frame
    3 months, 6 months
Full study description
brief Summary
The purpose of this study was to evaluate progression free survival in those participants assigned everolimus 10 mg/day plus Best Supportive Care versus those assigned to placebo plus Best Supportive Care in Advanced Neuroendocrine Tumors of pancreatic origin.
Source references
references
  1. citation
    Chan DL, Yao JC, Carnaghi C, Buzzoni R, Herbst F, Ridolfi A, Strosberg J, Kulke MH, Pavel M, Singh S. Markers of Systemic Inflammation in Neuroendocrine Tumors: A Pooled Analysis of the RADIANT-3 and RADIANT-4 Studies. Pancreas. 2021 Feb 1;50(2):130-137. doi: 10.1097/MPA.0000000000001745.
    pmid
    33560090
    type
    DERIVED
  2. citation
    Yao JC, Voi M, Lincy J, Pavel M. Reply to V. Amoroso et al. J Clin Oncol. 2017 May 1;35(13):1488-1489. doi: 10.1200/JCO.2017.71.3875. Epub 2017 Jan 23. No abstract available.
    pmid
    28113028
    type
    DERIVED
  3. citation
    Yao JC, Pavel M, Lombard-Bohas C, Van Cutsem E, Voi M, Brandt U, He W, Chen D, Capdevila J, de Vries EGE, Tomassetti P, Hobday T, Pommier R, Oberg K. Everolimus for the Treatment of Advanced Pancreatic Neuroendocrine Tumors: Overall Survival and Circulating Biomarkers From the Randomized, Phase III RADIANT-3 Study. J Clin Oncol. 2016 Nov 10;34(32):3906-3913. doi: 10.1200/JCO.2016.68.0702. Epub 2016 Sep 30.
    pmid
    27621394
    type
    DERIVED
  4. citation
    Lombard-Bohas C, Yao JC, Hobday T, Van Cutsem E, Wolin EM, Panneerselvam A, Stergiopoulos S, Shah MH, Capdevila J, Pommier R. Impact of prior chemotherapy use on the efficacy of everolimus in patients with advanced pancreatic neuroendocrine tumors: a subgroup analysis of the phase III RADIANT-3 trial. Pancreas. 2015 Mar;44(2):181-9. doi: 10.1097/MPA.0000000000000262.
    pmid
    25479584
    type
    DERIVED
  5. citation
    Yao JC, Shah MH, Ito T, Bohas CL, Wolin EM, Van Cutsem E, Hobday TJ, Okusaka T, Capdevila J, de Vries EG, Tomassetti P, Pavel ME, Hoosen S, Haas T, Lincy J, Lebwohl D, Oberg K; RAD001 in Advanced Neuroendocrine Tumors, Third Trial (RADIANT-3) Study Group. Everolimus for advanced pancreatic neuroendocrine tumors. N Engl J Med. 2011 Feb 10;364(6):514-23. doi: 10.1056/NEJMoa1009290.
    pmid
    21306238
    type
    DERIVED
Source notices and limitations
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        ve Breast Cancer in BOLERO-2 14.2 Neuroendocrine Tumors (NET) Pancreatic Neuroendocrine Tumors (PNET) A randomized, double-blind, multicenter trial (RADIANT-3, NCT00510068) of AFINITOR in combination with best supportive care (BSC) compared to placebo in combination with BSC was conducted in patients with locally advanced or meta
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    Preserved source evidence · Not medical advice