Clinical Trial: Lutathera and ASTX727 in Neuroendocrine Tumours (LANTana)

Whenever I post about a new trial or study, some people get excited without understanding that these new treatments and capabilities can very often take years to come to fruition and it’s also possible that clinical trials can be halted, or that national approval agencies will not approve the final product.  Please bear that in mind when reading studies/clinical trials posted on RonnyAllan.NET

What is the aim of this clinical trial?

The aim of this single location trial in Imperial College London is to determine whether pre-treatment with ASTX727 results in re-expression of SSTR2 in patients with metastatic NETs, using 68Ga-DOTA-TATE to image epigenetic modification of the SSTR2 locus allowing subsequent treatment with Lutathera(i.e. PRRT).  Patients entered into the study will receive ASTX727 orally up to 3 to 8 days prior to receiving Lutathera treatment. 

What is ASTX727?

Oral Decitabine and Cedazuridine (ASTX727) is a DNA methyltransferase (DNMT) inhibitor currently being used in a trial to facilitate oral treatment of certain drugs for adults with intermediate and high-risk myelodysplastic syndromes (MDS) including chronic myelomonocytic leukemia (CMML).

This is extremely technical, but from a study conducted by scientists at Imperial College London, they acknowledged that significant number of patients were unsuitable for (177Lu)DOTATATE due to limited SSTR2 expression.  In both in vitro and in vivo treatment of NET cell lines with decitabine not only resulted in re-expression of SSTR2 but importantly, also resulted in enhanced uptake of radiolabeled SSAs, showing functionality in receptor re-expression, a concept that was independently corroborated. The clinical trial would appear to be an extension of this concept for trial in humans who will receive ASTX727 to enhance SSTR2 expression, followed by PRRT, in which (68Ga) DOTA-PET is used to assess SSTR2 re-expression. Utilizing epigenetic modifiers to allow the re-expression of a receptor of interest has the potential to improve the clinical outcome in a significant number of GEP-NET patients who would otherwise not be suitable for PRRT (citation below).

Citation: Sharma, R.; Lythgoe, M.P.; Slaich, B.; Patel, N. Exploring the Epigenome in Gastroenteropancreatic Neuroendocrine Neoplasias. Cancers 2021, 13, 4181. https://doi.org/10.3390/cancers13164181

Further Reading

1.  See the clinical trial document “Lutathera and ASTX727 in Neuroendocrine Tumours (LANTana)”
click here

Note:
Always useful to check the inclusion and exclusion criteria in clinical trial documents. Amongst others, I think the key ones that might be on people’s minds are – prior PRRT not accepted, only for well-differentiated NETs less than Ki6755%, tumoural uptake on [68Ga]-DOTA-TATE greater than background liver. There are many more. 

2.  Somatostatin Receptor Primerclick here (or on the picture)

click the picture to read

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. It’s very important to check the trial inclusion and exclusion criteria before making any contact. 

Inclusion of any trial within this blog should not be taken as a recommendation by Ronny Allan. 

 
 

Subscribe to my newsletter

Thanks for reading.

Ronny

I’m also active on Facebook. Like my page for even more news. Help me build up my new site here – click here and ‘Like’

Sign up for my newsletters –  Click Here

Disclaimer

My Diagnosis and Treatment History

Follow me on twitter

Check out my online presentations

Check out my WEGO Health Awards

Remember ….. in the war on Neuroendocrine Cancer, let’s not forget to win the battle for better quality of life!

patients included

Please Share this post for Neuroendocrine Cancer awareness and to help another patient

 
 
 
Share on facebook
Facebook
Share on twitter
Twitter
Share on pinterest
Pinterest
Share on whatsapp
WhatsApp
Share on email
Email

I love comments - feel free!

%d bloggers like this: