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Comparing DLL3 PET/CT to Standard Scans in Neuroendocrine Cancer (DSC-NEC)

28 июля 2026 г. обновлено: Tingting Yuan

A Prospective, Multi-Center, Self-Controlled Phase IIa Clinical Trial Evaluating the Diagnostic Performance and Clinical Impact of [⁶⁸Ga]Ga-DLL3 Nanobody PET/CT Compared to [¹⁸F]FDG or [⁶⁸Ga]Ga-PSMA PET/CT in Patients With Metastatic Neuroendocrine Neoplasms

This study is testing a new PET/CT scan that uses a special tracer called [⁶⁸Ga]Ga-DLL3 nanobody to see if it can better detect cancer spread (metastases) in people with neuroendocrine tumors than the standard scans currently used (FDG PET/CT or PSMA PET/CT). DLL3 is a protein found on the surface of many neuroendocrine tumor cells, and the new tracer is designed to stick to this protein, making tumors visible on the scan. The goal is to find out whether this new imaging method can give doctors more accurate information about where the cancer has spread and help them choose the most appropriate treatment for each patient.

The study is prospective, multi-center, and self-controlled, meaning each participant will receive both the new scan and the standard scan, allowing a direct side-by-side comparison in the same person. Depending on the type of neuroendocrine tumor, participants will be assigned to one of two groups: one group will be compared with FDG PET/CT and the other with PSMA PET/CT. The two scans will be performed within two weeks of each other, and all images will be read by independent experts who do not know the patient's clinical history, to ensure objective and unbiased results.

The investigators plan to enroll about 180-200 patients aged 18 or older who have confirmed neuroendocrine tumors with at least two metastatic sites. The total duration of participation is approximately 6 months, consisting of a screening period of up to 14 days, two imaging scans completed within 2 days, and a final follow-up visit at 6 months to evaluate participants' health and disease progression. Participation is entirely voluntary, and participants may withdraw at any time without affecting participants' standard medical care.

Обзор исследования

Статус

Еще не набирают

Условия

Вмешательство/лечение

Тип исследования

Интервенционный

Регистрация (Оцененный)

200

Фаза

  • Фаза 2

Контакты и местонахождение

В этом разделе приведены контактные данные лиц, проводящих исследование, и информация о том, где проводится это исследование.

Контакты исследования

  • Имя: Tingting Yuan, MD
  • Номер телефона: +86 13051707479
  • Электронная почта: biluohtt@163.com

Места учебы

  • Китай
    • Beijing Municipality
      • Beijing, Beijing Municipality, Китай, 100034
        • Peking University First Hospital

Критерии участия

Исследователи ищут людей, которые соответствуют определенному описанию, называемому критериям приемлемости. Некоторыми примерами этих критериев являются общее состояние здоровья человека или предшествующее лечение.

Критерии приемлемости

Возраст, подходящий для обучения

  • Взрослый
  • Пожилой взрослый

Принимает здоровых добровольцев

Нет

Описание

Inclusion Criteria:

  • Age ≥ 18 and ≤ 80 years at the time of signing the informed consent form, male or female.
  • Histologically or cytologically confirmed neuroendocrine neoplasms (NENs), including but not limited to small cell lung cancer (SCLC), neuroendocrine prostate cancer (NEPC), gastroenteropancreatic neuroendocrine tumors (GEP-NENs), or other NEN subtypes.
  • Patients with strong clinical and radiological suspicion of NENs based on imaging (CT/MRI/conventional PET/CT) and clinical presentation.
  • At least 2 evaluable metastatic lesions (multiple metastases) confirmed by conventional imaging (CT/MRI/PET/CT).
  • Eastern Cooperative Oncology Group (ECOG) performance status 0-2. Life expectancy > 3 months.
  • Voluntarily agrees to participate and provides written informed consent.
  • Females of childbearing potential and male participants agree to use reliable contraceptive methods for 6 months after the last study drug administration.
  • Willing and able to comply with scheduled visits, diagnostic procedures, clinical laboratory tests, and other study procedures.

Exclusion Criteria:

  • Known severe immediate-type hypersensitivity or anaphylactic reaction to DLL3-targeted tracers, nanobody proteins, chelators, buffer components, or excipients.
  • Pregnant or breastfeeding women.
  • Estimated glomerular filtration rate (eGFR) < 30 mL/min/1.73m².
  • Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) > 3 × upper limit of normal (ULN).
  • Total bilirubin > 1.5 × ULN.
  • Inability to tolerate or cooperate with PET/CT imaging procedures, including but not limited to: severe claustrophobia, inability to remain supine and still for at least 30 minutes, or inability to establish adequate intravenous access.
  • Received chemotherapy, biological therapy, endocrine therapy, molecular targeted therapy, or investigational drug therapy within 4 weeks prior to enrollment.
  • Currently participating in another interventional clinical trial.
  • Prior exposure to any DLL3-targeted therapeutic agent (e.g., Tarlatamab, bispecific T-cell engagers, or DLL3-targeted radioimmunotherapy) or DLL3-targeted radiotracer.
  • Prior radionuclide therapy or diagnostic scan with an interval of less than 10 physical half-lives of the administered radionuclide prior to study tracer administration.
  • History of any other malignancy within 5 years prior to screening, except for adequately treated non-melanoma skin cancer, carcinoma in situ of the cervix, or other malignancies with negligible risk of recurrence in the investigator's opinion.
  • Clinically significant abnormalities on physical examination, electrocardiogram (ECG), or clinical laboratory tests during screening that, in the investigator's opinion, may compromise safety or study compliance.
  • Any other condition that, in the investigator's opinion, makes the patient unsuitable for study participation (e.g., severe psychiatric disorders, substance abuse, poor compliance).

Учебный план

В этом разделе представлена ​​подробная информация о плане исследования, в том числе о том, как планируется исследование и что оно измеряет.

Как устроено исследование?

Детали дизайна

  • Основная цель: Диагностика
  • Распределение: Н/Д
  • Интервенционная модель: Одногрупповое задание
  • Маскировка: Нет (открытая этикетка)

Оружие и интервенции

Группа участников / Армия
Вмешательство/лечение
Экспериментальный: [⁶⁸Ga]Ga-DLL3 Nanobody PET/CT
Participants receive a single intravenous injection of [⁶⁸Ga]Ga-DLL3 nanobody (a novel radiotracer targeting Delta-like ligand 3 [DLL3]), followed by whole-body PET/CT imaging at approximately 2 hours post-injection. DLL3 is a protein aberrantly expressed on the surface of neuroendocrine tumor cells. The nanobody is engineered for high-affinity and specificity binding to DLL3, enabling non-invasive visualization of DLL3-expressing tumor lesions. The total injected protein mass and molar activity are controlled according to the study protocol to ensure consistent imaging quality. PET/CT images are acquired from skull base to mid-thigh (extended to feet if clinically indicated) using a standardized acquisition protocol. Image reconstruction is performed with consistent algorithms across all participants. Each subject serves as their own control, with the DLL3 PET/CT results compared to their conventional imaging (FDG PET/CT or PSMA PET/CT) performed within 2 weeks. The scan is performed
Лекарство: 68Ga-PFD3

[⁶⁸Ga]Ga-PFD3 is a novel PET tracer constructed by conjugating a DLL3-specific nanobody (single-domain antibody, ~15 kDa) with a chelator for ⁶⁸Ga radiolabeling. DLL3 (Delta-like ligand 3) is a cell-surface protein that is rarely expressed in healthy adult tissues but is overexpressed in over 80% of small cell lung cancer and in other high-grade neuroendocrine tumors, making it an attractive target for molecular imaging. The nanobody platform offers advantages over conventional monoclonal antibody-based tracers (e.g., [⁸⁹Zr]Zr-DFO-SC16.56): smaller size (~15 kDa vs. ~150 kDa) enables superior tissue penetration, rapid blood clearance, and shorter in vivo residence time, allowing same-day PET/CT imaging within hours post-injection.

Participants receive a single intravenous injection of [⁶⁸Ga]Ga-PFD3 (activity: 111-185 MBq; protein mass and molar activity controlled per protocol), followed by whole-body PET/CT acquisition at approximately 2 hours post-injection. Images are acquired from

Другие имена:
  • 68Ga-DLL3

Что измеряет исследование?

Первичные показатели результатов

Мера результата
Мера Описание
Временное ограничение
Diagnostic Accuracy of [⁶⁸Ga]Ga-DLL3 Nanobody PET/CT in Detecting Metastatic Lesions
Временное ограничение: Baseline (within 14 days of enrollment) and Month 6
Sensitivity and specificity of [⁶⁸Ga]Ga-DLL3 nanobody PET/CT for detecting metastatic lesions in patients with neuroendocrine neoplasms, using a composite reference standard (incorporating histopathology, conventional imaging [FDG/PSMA PET/CT, diagnostic CT/MRI], and 6-month clinical/imaging follow-up) as the truth standard.
Baseline (within 14 days of enrollment) and Month 6

Вторичные показатели результатов

Мера результата
Мера Описание
Временное ограничение
Lesion Detection Rate
Временное ограничение: Baseline (within 14 days of enrollment)
Per-lesion detection rate of [⁶⁸Ga]Ga-DLL3 PET/CT compared to FDG or PSMA PET/CT, stratified by anatomical location (e.g., liver, bone, lung, brain, lymph nodes).
Baseline (within 14 days of enrollment)
Clinical Management Change Rate
Временное ограничение: Baseline (at time of image interpretation, within 14 days of enrollment)
Proportion of patients whose clinical management (e.g., staging, treatment selection, or biopsy site decision) is altered based on [⁶⁸Ga]Ga-DLL3 PET/CT results compared to conventional imaging.
Baseline (at time of image interpretation, within 14 days of enrollment)
Safety and Tolerability
Временное ограничение: Up to 24 hours post-injection
Incidence, severity, and causality of adverse events (graded per CTCAE v5.0) following single intravenous injection of [⁶⁸Ga]Ga-DLL3 nanobody, including injection site reactions, allergic reactions, and any serious adverse events.
Up to 24 hours post-injection
Correlation with DLL3 Expression
Временное ограничение: At study completion (expected at Month 6)
Correlation between [⁶⁸Ga]Ga-DLL3 PET/CT uptake (SUVmax, SUVmean) and DLL3 expression level by immunohistochemistry (IHC) in biopsied tumor specimens (where available).
At study completion (expected at Month 6)
Target-to-Background Ratio (TBR)
Временное ограничение: Baseline (within 14 days of enrollment)
Quantitative comparison of TBR between [⁶⁸Ga]Ga-DLL3 PET/CT and standard scans (FDG or PSMA PET/CT) in identified lesions, with background regions pre-defined as liver, blood pool, and muscle.
Baseline (within 14 days of enrollment)

Другие показатели результатов

Мера результата
Мера Описание
Временное ограничение
Baseline SUVmax of [⁶⁸Ga]Ga-DLL3 PET/CT as a Predictor of Clinical Benefit
Временное ограничение: Baseline (within 14 days of enrollment)
The maximum standardized uptake value (SUVmax) derived from baseline [⁶⁸Ga]Ga-DLL3 nanobody PET/CT imaging, measured within 14 days prior to enrollment. The optimal cut-off value for SUVmax will be determined using receiver operating characteristic (ROC) curve analysis to stratify patients into high- vs. low-expression groups. This individual parameter will be evaluated for its ability to predict objective response or progression-free survival benefit from DLL3-targeted therapies (e.g., Tarlatamab).
Baseline (within 14 days of enrollment)
Hazard Ratio (HR) for 24-Month Overall Survival Based on Baseline SUVmax Cut-off
Временное ограничение: Baseline (within 14 days of enrollment) and Month 24
The hazard ratio (HR) with 95% confidence interval, derived from univariate Cox proportional hazards regression, comparing 24-month overall survival between neuroendocrine neoplasm patients stratified by the optimal baseline [⁶⁸Ga]Ga-DLL3 nanobody PET/CT SUVmax cut-off value (high-expression vs. low-expression groups). Overall survival is measured as time (in months) from enrollment to death from any cause.
Baseline (within 14 days of enrollment) and Month 24

Соавторы и исследователи

Здесь вы найдете людей и организации, участвующие в этом исследовании.

Спонсор

Tingting Yuan

Публикации и полезные ссылки

Лицо, ответственное за внесение сведений об исследовании, добровольно предоставляет эти публикации. Это может быть что угодно, связанное с исследованием.

Общие публикации

Даты записи исследования

Эти даты отслеживают ход отправки отчетов об исследованиях и сводных результатов на сайт ClinicalTrials.gov. Записи исследований и сообщаемые результаты проверяются Национальной медицинской библиотекой (NLM), чтобы убедиться, что они соответствуют определенным стандартам контроля качества, прежде чем публиковать их на общедоступном веб-сайте.

Изучение основных дат

Начало исследования (Оцененный)

6 июля 2026 г.

Первичное завершение (Оцененный)

31 декабря 2027 г.

Завершение исследования (Оцененный)

31 декабря 2028 г.

Даты регистрации исследования

Первый отправленный

13 июля 2026 г.

Впервые представлено, что соответствует критериям контроля качества

28 июля 2026 г.

Первый опубликованный (Действительный)

29 июля 2026 г.

Обновления учебных записей

Последнее опубликованное обновление (Действительный)

29 июля 2026 г.

Последнее отправленное обновление, отвечающее критериям контроля качества

28 июля 2026 г.

Последняя проверка

1 июля 2026 г.

Дополнительная информация

Термины, связанные с этим исследованием

Ключевые слова

Дополнительные соответствующие термины MeSH

Другие идентификационные номера исследования

  • NEC-DLL3-01

Планирование данных отдельных участников (IPD)

Планируете делиться данными об отдельных участниках (IPD)?

НЕТ

Описание плана IPD

Individual participant data will not be shared to protect participant privacy and confidentiality, as this study involves imaging data (PET/CT) that could potentially be re-identifiable. Only aggregate results will be published in peer-reviewed journals.

Информация о лекарствах и устройствах, исследовательские документы

Изучает лекарственный продукт, регулируемый FDA США.

Нет

Изучает продукт устройства, регулируемый Управлением по санитарному надзору за качеством пищевых продуктов и медикаментов США.

Нет

Эта информация была получена непосредственно с веб-сайта clinicaltrials.gov без каких-либо изменений. Если у вас есть запросы на изменение, удаление или обновление сведений об исследовании, обращайтесь по адресу register@clinicaltrials.gov. Как только изменение будет реализовано на clinicaltrials.gov, оно будет автоматически обновлено и на нашем веб-сайте. .

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