Overview

Study of Capecitabine-Temozolomide(CapTem) With Yttrium-90 in Patients With Unresectable Metastatic Grade 2 Neuroendocrine Tumors

Status:
Not yet recruiting
Trial end date:
2026-05-01
Target enrollment:
0
Participant gender:
All
Summary
This is a Phase 2 evaluation of hepatic-progression free survival among patients with Grade 2 liver-dominant NET metastases undergoing combination therapy with CapTem and Y90 radioembolization.The hypothesis is to confirm safety and to assess if disease control is improved relative to expectation from either therapy alone.
Phase:
Phase 2
Accepts Healthy Volunteers?
No
Details
Lead Sponsor:
University of Pennsylvania
Treatments:
Capecitabine
Temozolomide
Criteria
Inclusion Criteria:

- Patients with confirmed diagnosis of histologic grade 2 neuroendocrine tumor with
unresectable liver metastases (primary tumor or other extrahepatic disease may be
present)

- Patients with at least one measurable liver metastases, with size > 1cm (RECIST
criteria)

- Patients with liver dominant disease defined as ≥50% tumor body burden confined to the
liver

- Liver tumor burden does not exceed 50% of the liver volume

- Patent main portal vein

- At least 4 weeks since last administration of last chemotherapy and /or radiotherapy

- Age >18 years.

- Life expectancy of greater than 6 months.

- ECOG performance status 0-2.

- Adequate liver function as measured by: Total bilirubin ≤ 2.0mg/dl, ALT, AST ≤5 times
ULN, albumin ≥2.5g/dl.

- Patients must have adequate organ and marrow function as defined below:

- platelets >100,000/mcL (may be corrected by transfusion)

- serum creatinine < 2.0 mg/dl

- INR <1.6, (may be corrected by transfusion)

- Ability to understand and the willingness to sign a written informed consent document.

- Women of child bearing potential and fertile men are required to use effective
contraception (negative urine or serum βHCG for women of child-bearing age)

Exclusion Criteria:

- Contraindications to capecitibine or temozolomide

- Contraindicated for both contrast-enhanced MRI and CT

- Patients previously treated with transarterial embolization (with or without
chemotherapy) or with radioembolization (Y-90 microspheres)

- Contraindication for radioembolization procedures:

- excessive hepatopulmonary shunt as determined by the investigator

- inability to deliver Y90 microspheres without risk of non-target embolization of
extra-hepatic structures

- Subjects consenting to the trial who fail their simulation angiography will be removed
from the study and replaced.

- Patients may not be receiving any other investigational agents.

- Absolute contraindication to intravenous iodinated contrast (Hx of significant
previous contrast reaction, not mitigated by appropriate pre-medication).

- Choledochoenteric anastomosis, transpapillary stent or sphincterotomy of duodenal
papilla;

- Uncontrolled intercurrent illness including, but not limited to, ongoing or active
infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac
arrhythmia, or psychiatric illness/social situations that would limit compliance with
study requirements.

- Pregnant and lactating women are ineligible