Phase 3
Completed N=302
Everolimus Plus Best Supportive Care vs Placebo Plus Best Supportive Care in the Treatment of Patients With Advanced Neuroendocrine Tumors (GI or Lung Origin)
Advanced NET of GI Origin · Advanced NET of Lung Origin · Neuroendocrine Tumor
Source: ClinicalTrials.gov NCT01524783 ↗
Enrolled (actual)
302
Serious AEs
40.7%
Results posted
Dec 2016
Primary outcomePrimary: Probability of Participants Remaining Event-Free in Progression-Free Survival (PFS) Based on Central Radiology Assessment — 90.1; 74.6; 81.2; 49.1 Percent event-free probability in PFS — p=<0.001
◆ Published Evidence
Highly cited
1,268citations · ~127 / year
Everolimus for the treatment of advanced, non-functional neuroendocrine tumours of the lung or gastrointestinal tract (RADIANT-4): a randomised, placebo-controlled, phase 3 study.
Summary
The purpose of this study is to compare the antitumor activity of everolimus plus best supportive care versus placebo plus best supportive care in patients with progressive nonfunctional neuroendocrine tumor (NET) of gastrointestinal (GI) or lung origin without a history of, or current symptoms of carcinoid syndrome.
Linked Publications (5)
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Everolimus for the treatment of advanced, non-functional neuroendocrine tumours of the lung or gastrointestinal tract (RADIANT-4): a randomised, placebo-controlled, phase 3 study.
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Everolimus in advanced, progressive, well-differentiated, non-functional neuroendocrine tumors: RADIANT-4 lung subgroup analysis.
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Health-related quality of life for everolimus versus placebo in patients with advanced, non-functional, well-differentiated gastrointestinal or lung neuroendocrine tumours (RADIANT-4): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial.
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Impact of prior therapies on everolimus activity: an exploratory analysis of RADIANT-4.
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Markers of Systemic Inflammation in Neuroendocrine Tumors: A Pooled Analysis of the RADIANT-3 and RADIANT-4 Studies.
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Probability of Participants Remaining Event-Free in Progression-Free Survival (PFS) Based on Central Radiology Assessment |
90.1; 74.6; 81.2; 49.1; 72.1; 40.1 | <0.001 sig |
| SECONDARY Overall Survival (OS) |
43.1; 41.76 | 0.259 |
| SECONDARY Overall Response Rate (ORR) as Per Modified RECIST 1.0 According to Central Evaluation |
2.0; 1.0 | — |
| SECONDARY Disease Control Rate (DCR) Based on Modified RECIST 1.0 and as Per Central Radiology Assessment |
82.4; 64.9 | — |
| SECONDARY Time to Definitive Deterioration in Functional Assessment of Cancer Therapy - General (FACT-G) Questionnaire Total Score |
13.01; 9.23 | 0.073 |
| SECONDARY Change From Baseline in Chromogranin A (CgA) Levels |
434.8; 1154.3; 162.3; 2697.6; 396.7; 1176.0 | — |
| SECONDARY Change From Baseline in Neuron Specific Enolase (NSE) Levels |
0.1; -2.2; 0.3; -4.2; -0.3; 15.5 | — |
| SECONDARY Time to Definitive Deterioration in World Health Organization (WHO) Performance Status (PS) Change |
24.08; 24.15 | 0.539 |
| SECONDARY Pharmacokinetics (PK): Predose Concentration (Cmin) of Everolimus at Day 29 |
16.382; 4.700 | — |
Eligibility Criteria
Inclusion Criteria
- Pathologically confirmed, well differentiated (G1 or G2), advanced (unresectable or metastatic), neuroendocrine tumor of GI or lung origin
- No history of and no active symptoms related to carcinoid syndrome
- In addition to treatment-naive patients, patients previously treated with SSA, Interferon (IFN), one prior line of chemotherapy, and/or PRRT were allowed into the study. Pretreated patients had to have progressed on or after the last treatment
- Radiological documented disease progression within 6 months prior to randomization
- Measurable disease
- WHO performance status ≤1
- Adequate bone marrow, liver and renal function
Exclusion Criteria
- Patients with poorly differentiated neuroendocrine carcinoma, high-grade neuroendocrine carcinoma, adenocarcinoid, pancreatic islet cell carcinoma, insulinoma, glucagonoma, gastrinoma, goblet cell carcinoid, large cell neuroendocrine carcinoma and small cell carcinoma
- Patients with pancreatic NET or NET of origins other than GI or Lung
- Patients with history of or active symptoms of carcinoid syndrome (e.g. flushing, diarrhea)
- Patients with more than one line of prior chemotherapy
- Prior targeted therapy
- Hepatic intra-arterial embolization within the last 6 months. Cryoablation or radiofrequency ablation of hepatic metastases within 2 months of randomization
- Prior therapy with mTOR inhibitors (e.g. sirolimus, temsirolimus, deforolimus)
- Known intolerance or hypersensitivity to everolimus or other rapamycin analogs (e.g. sirolimus, temsirolimus)
- Known impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of oral everolimus
- Uncontrolled diabetes mellitus as defined by HbA1c >8% despite adequate therapy
- Patients who had any severe and/or uncontrolled medical conditions such as:
- unstable angina pectoris, symptomatic congestive heart failure, myocardial infarction ≤6 months prior to randomization, serious uncontrolled cardiac arrhythmia
- active or uncontrolled severe infection
- liver disease such as cirrhosis, decompensated liver disease, and chronic hepatitis (i.e. quantifiable HBV-DNA and/or positive HbsAg, quantifiable HCV-RNA)
- Chronic treatment with corticosteroids or other immunosuppressive agents
- Known history of HIV seropositivity
- Pregnant or nursing (lactating) women
Other protocol-defined inclusion/exclusion criteria might apply.
Data sourced from ClinicalTrials.gov (NCT01524783) and the linked publication. Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication. Informational only — not medical advice.