Zanzalintinib for Neuroendocrine Tumors

Not yet recruiting at 2 trial locations
NT
Overseen ByNikolaos Trikalinos, M.D.
Age: 18+
Sex: Any
Trial Phase: Phase 2
Sponsor: Washington University School of Medicine
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests whether zanzalintinib, a new potential drug, can slow the progression of neuroendocrine tumors, a type of cancer affecting certain hormone-producing cells, after initial chemotherapy. It targets individuals with confirmed high-grade cancer who have completed an initial chemotherapy course with stable results or partial improvement. Participants must have measurable disease and must not have previously received treatment with zanzalintinib or cabozantinib. As a Phase 2 trial, this research focuses on assessing the treatment's effectiveness in an initial, smaller group, offering participants a chance to contribute to the development of a potentially effective therapy.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications. However, you cannot take certain oral anticoagulants and must stop them at least 3 days or 5 half-lives before starting the trial. If you are on somatostatin analogue therapy for well-differentiated high-grade tumors, you can continue it.

Is there any evidence suggesting that zanzalintinib is likely to be safe for humans?

Previous studies have shown that zanzalintinib demonstrates promise in terms of safety when combined with other treatments. For instance, when used with atezolizumab, zanzalintinib lowered the risk of death compared to regorafenib, suggesting it can be relatively safe with other medications. Additionally, when combined with nivolumab, many patients experienced positive effects without serious health issues.

These findings offer some reassurance about its safety, but it's important to remember that zanzalintinib alone might have different effects. Always discuss potential side effects and safety concerns with healthcare providers before joining a trial.12345

Why do researchers think this study treatment might be promising?

Zanzalintinib is unique because it introduces a new approach to treating neuroendocrine tumors by targeting specific pathways involved in tumor growth. Unlike standard treatments like somatostatin analogs or chemotherapy, which focus on controlling symptoms or destroying rapidly dividing cells, Zanzalintinib directly inhibits tyrosine kinases, which play a crucial role in the development and spread of these tumors. Researchers are excited about Zanzalintinib's potential to offer a more targeted and potentially less toxic treatment option, with the convenience of oral administration once daily.

What evidence suggests that zanzalintinib might be an effective treatment for neuroendocrine tumors?

Research has shown that zanzalintinib may help treat neuroendocrine tumors. One study demonstrated that, when combined with nivolumab, it resulted in a 63% rate of significant tumor shrinkage and a 90% rate of halting tumor growth. These findings suggest that zanzalintinib could effectively control tumor growth. In this trial, participants will receive zanzalintinib alone to evaluate its effectiveness in treating hard-to-treat neuroendocrine tumors. These results indicate that zanzalintinib might be a strong option for slowing tumor progression.14678

Who Is on the Research Team?

NT

Nikolaos Trikalinos, M.D.

Principal Investigator

Washington University School of Medicine

Are You a Good Fit for This Trial?

This trial is for adults with high-grade neuroendocrine tumors, excluding lung and Merkel cell cancer. Participants must have stable disease or partial response after initial chemo, be able to consent, not pregnant, and agree to use contraception. They should have good organ function and performance status.

Inclusion Criteria

Measurable disease per RECIST 1.1
Ability to understand and willingness to sign an IRB approved written informed consent document
I am not pregnant and can have children.
See 7 more

Exclusion Criteria

Pregnant and/or breastfeeding
History of allergic reactions attributed to compounds of similar composition to zanzalintinib
Corrected QT interval calculated by the Fridericia formula (QTcF) > 480 ms within 14 days before C1D1
See 10 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Chemotherapy

Participants receive initial cytotoxic chemotherapy

Varies

Maintenance Treatment

Participants receive zanzalintinib maintenance therapy in 28-day cycles

Up to 3 years

Follow-up

Participants are monitored for progression-free survival and overall survival

Up to 4 years

What Are the Treatments Tested in This Trial?

Interventions

  • Zanzalintinib
Trial Overview The study tests if Zanzalintinib can extend the time patients live without their cancer getting worse after initial chemotherapy. Patients will receive Zanzalintinib as a maintenance therapy to see if it helps control tumor growth better than current standard care.
How Is the Trial Designed?
1Treatment groups
Experimental Treatment
Group I: ZanzalintinibExperimental Treatment1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Washington University School of Medicine

Lead Sponsor

Trials
2,027
Recruited
2,353,000+

Exelixis

Industry Sponsor

Trials
126
Recruited
20,500+
Michael M. Morrissey profile image

Michael M. Morrissey

Exelixis

Chief Executive Officer since 2010

PhD in Chemistry from Harvard University, BSc in Chemistry from the University of Wisconsin

Vicki L. Goodman profile image

Vicki L. Goodman

Exelixis

Chief Medical Officer since 2022

MD

Published Research Related to This Trial

In a phase II study involving 109 patients with advanced neuroendocrine tumors, sunitinib demonstrated a 16.7% objective response rate in pancreatic endocrine tumor patients and 2.4% in carcinoid patients, with a significant proportion of patients experiencing stable disease.
The treatment resulted in a median time to tumor progression of 7.7 months for pancreatic neuroendocrine tumors and 10.2 months for carcinoid tumors, with one-year survival rates of approximately 81% for pancreatic and 83% for carcinoid patients, indicating potential efficacy and safety for further investigation.
Activity of sunitinib in patients with advanced neuroendocrine tumors.Kulke, MH., Lenz, HJ., Meropol, NJ., et al.[2022]
Surufatinib, a tyrosine kinase inhibitor, is well-absorbed in both rats and humans, with a median time to peak concentration of 4 hours after oral dosing, and a significantly longer half-life in humans (23.3 hours) compared to rats (3.12-6.48 hours).
The primary route of elimination for surufatinib in both species is fecal excretion, accounting for about 87% of the dose, indicating that the drug is largely eliminated unchanged, with no single metabolite making up more than 10% of the total radioactivity in circulation.
Absorption, Metabolism and Excretion of Surufatinib in Rats and Humans.Li, K., Ma, S., Miao, L., et al.[2021]
In the KEYNOTE-028 study, pembrolizumab showed antitumor activity in patients with well-differentiated or moderately-differentiated neuroendocrine tumors (NETs), with objective response rates of 12% for carcinoid tumors and 6.3% for pancreatic NETs after a median follow-up of 20 to 21 months.
The treatment was generally well-tolerated, with 68% to 69% of patients experiencing treatment-related adverse events, the most common being diarrhea and fatigue, indicating that while effective, monitoring for side effects is important.
Pembrolizumab for the treatment of programmed death-ligand 1-positive advanced carcinoid or pancreatic neuroendocrine tumors: Results from the KEYNOTE-028 study.Mehnert, JM., Bergsland, E., O'Neil, BH., et al.[2021]

Citations

Press Release - Exelixis, Inc.Zanzalintinib in combination with nivolumab demonstrated an objective response rate of 63% and a disease control rate of 90%.
Zanzalintinib Maintenance in Patients With High Grade ...Histologically or cytologically confirmed high-grade poorly differentiated or well differentiated neuroendocrine tumor (with a Ki-67 of ≥20%), excluding small ...
Zanzalintinib for Neuroendocrine TumorsIn a phase II study involving 109 patients with advanced neuroendocrine tumors, sunitinib demonstrated a 16.7% objective response rate in pancreatic endocrine ...
Zanzalintinib Versus Everolimus in Participants With ...The primary purpose of this study is to assess the effectiveness of zanzalintinib compared to everolimus in participants with previously treated, unresectable, ...
Zanzalintinib Versus Everolimus in Participants With Locally ...The primary purpose of this study is to assess the effectiveness of zanzalintinib compared to everolimus in participants with previously treated, unresectable, ...
Exelixis Announces Zanzalintinib in Combination with an ...Zanzalintinib in combination with atezolizumab demonstrated a statistically significant reduction in risk of death versus regorafenib in ...
7.stellarnetstudy.comstellarnetstudy.com/
STELLAR-311 Clinical Trial (Exelixis) | US Patient WebsiteThis study will help researchers learn if the study drug is safe and if it works to treat neuroendocrine tumors in many different types of people. Image of ...
Exelixis Announces Detailed Results from Phase 3 ...Zanzalintinib in combination with atezolizumab improved median overall survival to 10.9 months versus 9.4 months with regorafenib, ...
Unbiased ResultsWe believe in providing patients with all the options.
Your Data Stays Your DataWe only share your information with the clinical trials you're trying to access.
Verified Trials OnlyAll of our trials are run by licensed doctors, researchers, and healthcare companies.
Terms of Service·Privacy Policy·Cookies·Security