Clinical trial · Interventional
Ziv-Aflibercept for Advanced Progressive Carcinoid Tumors
Phase II Study of Ziv-aflibercept in Patients With Advanced, Progressive Carcinoid Tumors
- Source
- ClinicalTrials.gov
- Retrieved
- Sep 8, 2026
- Layer
- normalized (units and labels harmonized; values unchanged)
- Run
- ING-CLINICALTRIALS-20260908-000001
Summary
Brief summary (as posted)
This research study is a Phase II clinical trial, which tests the safety and effectiveness of an investigational drug to learn whether the drug works in treating a specific cancer. "Investigational" means that the drug, Ziv-aflibercept, is being studied. It also means that the FDA has not yet approved Ziv-aflibercept for use in patients with your type of cancer. Every person has molecules in their bloodstream called vascular endothelial growth factors (VEGFs). These molecules help grow and sustain new blood vessels needed by the human body. Cancer tumors hijack this mechanism because they need new blod vessels and oxygen to grow. Ziv-aflibercept is an antibody. Antibodies are proteins that are produced naturally in our bodies and help to recognize foreign substances in our body. Ziv-aflibercept is a "targeted therapy" called a "VEGF Trap", that "traps" (binds) these VEGFs and prevents the cancer from using them to grow. Though Ziv-aflibercept has not yet been FDA approved for the treatment of carcinoid tumors, it has recently been approved for patients with treatment-resistant colorectal cancer. In this research study, we will use Ziv-aflibercept in combination with standard octreotide therapy to see if it slows the growth or spread of your carcinoid tumor. Standard octreotide (sandostatin) therapy is currently approved for treating symptoms of carcinoid tumors, such as those caused by carcinoid syndrome. Carcinoid syndrome is caused by hormones and other substances released by carcinoid tumors into the bloodstream. One of these secreted substances is serotonin, one of the body's natural chemical messengers. When excess serotonin secreted by the carcinoid tumors reaches the body's tissues, it is thought to cause diarrhea and redness (flushing) of the face, chest or back. Excess serotonin may also cause changes in the structure of the heart valves, which can impair the heart's function. Octreotide works by binding to receptors found on carcinoid tumors and prevents the release of hormones from the tumor.
Conditions
Conditions (1)
Free-text conditions as registered, with the CancerIndex entity they were reconciled to and the match type.
| Condition (as posted) | Mapped entity | Match | Confidence |
|---|---|---|---|
| Carcinoid Tumor | Neuroendocrine Tumor | ALIAS | 0.90 |
Interventions
Interventions (1)
| Intervention | Type | Mapped drug | Match |
|---|---|---|---|
| Ziv-aflibercept | Drug | Aflibercept | ALIAS |
Design
Arms and outcomes
Arms (1)
- type
- EXPERIMENTAL
- label
- Experimental Treatment Arm
- description
- Ziv-aflibercept IV every 2 weeks, 4 mg/kg
- interventionNames
- Drug: Ziv-aflibercept
Primary outcomes (1)
- measure
- Progression Free Survival
- timeFrame
- 2 years
- description
- To evaluate the progression-free survival (PFS) duration of patients with metastatic, unresectable, progressive carcinoid tumors treated with Ziv-aflibercept. Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1) was used. Progressive Disease (PD) is defined as at least a 20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study with at least a 5 mm absolute increase in the sum of all lesions. The appearance of one or more new lesions denotes disease progression. Partial Response (PR) is defined as at least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline sum diameters.
Secondary outcomes (3)
Eligibility
Eligibility (as posted)
- Sex
- All
- Minimum age
- 18 Years
Show eligibility criteria text
Inclusion Criteria: * Histologically confirmed well differentiated or moderately differentiated neuroendocrine tumor from either a primary or metastatic site * Must have disease that is not amenable to curative resection * Must have evidence of disease progression within 12 months prior to study entry * Must have measurable disease (RECIST 1.1) * Prior chemoembolization of local ablative therapies are allowed, provided there is measurable disease outside of the area treated, or documented evidence of progression at the site of prior treatment * No limit to number of prior treatments. Prior bevacizumab allowed unless discontinued due to unacceptable toxicity. Prior TKI targeting VEGF receptors allowed * Treatment with a somatostatin analog required for all subjects * Subjects with history of hypertension must be adequately controlled * Therapeutic anticoagulation is allowed. Must be on a stable dose of anticoagulant medication * Must agree to use adequate contraception prior to study entry, for the duration of study participation and for 3 months after last administration of study drug Exclusion Criteria: * Prior treatment including chemoembolization within 4 weeks of study entry * Major surgery within 4 weeks of study entry or minor surgery within 2 weeks of study entry * Pregnant or breastfeeding * Poorly differentiated carcinoma, high grade neuroendocrine tumor or small cell carcinoma * Prior treatment with Ziv-aflibercept * Pancreatic neuroendocrine tumor (islet cell carcinoma)will be excluded from this study. All non functional and functional islet cell carcinomas such as insulinoma, glucagonoma, gastrinoma, VIPoma will be excluded. * Not adequately recovered from toxicity of previous therapy * Known untreated brain or other central nervous system metastases * Known allergy to any of the study agents or to compounds of similar chemical or biologic composition * History of congestive heart failure * Symptomatic peripheral arterial disease * Unhealed wounds, ulcers or bone fractures * HIV positive or active Hepatitis infection * History of abdominal fistula, GI perforation, intra abdominal abscess, uncontrolled GI bleeding, diverticulitis within 6 months of study entry * History of arterial thrombotic events such as myocardial infarction, unstable angina pectoris or any ischemic or hemorrhagic cerebrovascular accident within the past 6 months * No history of pulmonary embolism, DVT or vascular access related thrombosis if not also receiving adequate anticoagulation at a stable dose. * No history of prior or synchronous malignancy except if treated with curative intent at least 3 years prior to study entry, or adequately treated non-melanoma skin cancer, cervical carcinoma in situ, or prostate intraepithelial neoplasia without evidence of prostate cancer * Uncontrolled non-malignant illness that may increase the risks associated with study participation or may interfere with the conduct of the study or interpretation of study results * Uncontrolled psychiatric illness or social situations that would limit compliance with study requirements
References
Publications (1)
- DERIVEDPerez K, Kulke MH, Horick NK, Regan E, Graham C, Scheutz S, Stonely D, Enzinger PC, Fuchs CS, Allen JN, Enzinger AC, Clark JW, Chan JA. A Phase II Study of Ziv-Aflibercept in Patients With Advanced Extrapancreatic Neuroendocrine Tumors. Pancreas. 2022 Aug 1;51(7):763-768. doi: 10.1097/MPA.0000000000002099. PMID 36395401