Ronny Allan
In the News. On the heels of the approval of PRRT in USA and UK and elsewhere, here’s news of a new PRRT compound undergoing a phase 3 clinical trial. ITM Isotope Technologies Munich SE, a specialized radiopharmaceutical company, today (7th Dec 2017) announced the enrolment of the first patient recruited in Europe for the COMPETE phase III clinical trial at the University Hospital Marburg, Germany. The CEO of ITM said “This marks the starting point of COMPETE in Europe, whereby we expect a rapid increase in the number of recruits.”
What is the COMPETE TRIAL?
COMPETE is led as an international pivotal multi-center phase III clinical trial evaluating the efficacy and safety of (no-carrier-added) n.c.a.177Lu-Edotreotide (Solucin®) and the trial is comparing it to Everolimus (Afinitor). The trial runs until Dec 2020. The enrolment requires patients with inoperable, progressive, somatostatin-receptor positive neuroendocrine tumors of gastroenteric or pancreatic origin (GEP-NET). The primary endpoint is progression-free survival (PFS). The study will be conducted predominantly in Europe, North America, South Africa and Australia. The first patient to be enrolled and treated was in Australia. The clinical trial document (see references below) indicates it’s for non-functional GI tumours but for non-functional and functional pNETs. The list of locations can also be found in the clinical trial document. The usual inclusion/exclusion rules apply but the most notable would appear to be an exclusion for those with prior exposure to any PRRT or mTor inhibitor such as Everolimus (Afinitor).
What is 177Lu-Edotreotide (Solucin®)?
The compound under investigation, Solucin®, is known as a Targeted Radionuclide Therapy (TRT) agent, which consists of the targeting molecule Edotreotide, an octreotide-derived somatostatin analogue and ITM´s EndolucinBeta® (no-carrier-added Lutetium-177). EndolucinBeta® is a synthetic, low-energy beta-emitting isotope of Lutetium which is a recently EMA approved pharmaceutical precursor. The radiopharmaceutical Solucin® is administered as an intravenous infusion, specifically targeting and destroying the tumor cells with ionizing radiation. Solucin® received an Orphan Designation (EMA/OD/196/13) for the treatment of GEP-NET, based on early clinical experience, which has demonstrated a substantial clinical benefit with increased PFS and quality of life.
From ITM’s website … “Edotreotide contains DOTA which functions as a chelator for radioisotopes and TOC, a synthetic Somatostatin receptor ligand” (chelator and ligand are just fancy names for ‘bonding’ or ‘binding’). “The compound Edotreotide binds with high affinity Somatostatin receptors and retains both its receptor binding properties and its physiological function when labeled with 177Lu. Somatostatin receptors are predominantly overexpressed by neuroendocrine tumors. 177Lu-Edotreotide, upon binding to Somastotatin receptors in vivo is internalized and retained by tumor cells.”
“Compared to 90Y-Edotreotide, 177Lu-Edotreotide Targeted Radionuclide Therapy in NET was found to be less haematotoxic and associated with a longer median overall survival. That was highly significant for patients with low tumor uptake as well as for patients with extra hepatic and solitary metastases. In a retrospective Phase II trial 177Lu-Edotreotide showed a low uptake/dose delivered to normal organs and very high tumor-to-kidney ratio.”
Theranostic pairing from ITM – TOCscan®
68Ga-Edotreotide is the Ga68 PET radionuclide from ITM for true theranostic pairing with the SOLUCIN PRRT. See here.
Bonus read – my interview with ITM for their staff newsletter – click here
References:
1. ITM Website – click here
2. Clinical Trials Document – click here
3. Phase 2 results – click here
There’s also a Phase 3 trial known as COMPOSE designed for Grade 2 and 3 NETs – read more here.
Clinical Trials Disclaimer
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided in the clinical trials document. Inclusion of any trial within this blog should not be taken as a recommendation by Ronny Allan.
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Remember ….. in the war on Neuroendocrine Cancer, let’s not forget to win the battle for better quality of life!
Off tomorrow for my second PRT treatment at BU Medical Boston, Ma. Rather painless wit no nausea because of a specific amino acids they use to protect the kidneys.
Excellent article again Ronny. How does one access the ‘waiting list’ to be considered for trials on Compete?
Contact the trial coordinator for advice, they will have a view on suitability (normally driven by the inclusion/exclusion criteria I guess). Locations in UK, at Royal Free or Liverpool. I guess one way is to go via your specialist. He/she might have a view on suitability and that would be something useful to know in any case.
Thanks, The Christie doesn’t seem to be participating, which is surprising considering its reputation. Will investigate further!
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