Adrenal Cancer

This trial studies neuroendocrine tumors, paraganglioma, pheochromocytoma, and other SSTR-positive tumors that are not currently approved for lutetium therapy called LUTATHERA. It aims to evaluate the effectiveness and safety of a similar treatment called lutetium (177Lu) edotreotide or 177Lu-DOTATOC in patients who have these diseases but are outside the standard indications for LUTATHERA. The study focuses on expanding knowledge about this therapy's role in controlling disease and managing side effects. Participants receive treatment with 177Lu-DOTATOC given by slow intravenous infusion over 30 minutes using a pump system. The dose depends on patient risk factors: those with fewer than two risk factors receive 7.4 GBq per cycle, while those with two or more risk factors receive 5.5 GBq per cycle. Each participant will receive 4 cycles of treatment. Risk factors include kidney impairment, previous toxicities, uncontrolled diabetes or hypertension, prior therapies, and disease burden. During the study, participants will have regular assessments over several months, including scans to measure disease control at 32 months and ongoing monitoring up to 44 months for progression-free survival, overall survival, safety, and quality of life. Researchers will check blood tests, organ function, and side effects. This non-randomized phase 2 study allows patients with measurable or evaluable disease and progressive tumors confirmed by imaging to be included, with follow-up to evaluate response and safety.

This research aims to evaluate how well 18F-metafluorobenzylguanidine (18F-MFBG) PET imaging detects and measures tumor burden in patients with pheochromocytoma, a type of tumor that highly expresses the norepinephrine transporter (NET). The study addresses limitations of current imaging methods, such as low resolution and long procedure times, by assessing a newer tracer that may provide better image quality and faster results. Patients with suspected or confirmed pheochromocytoma will receive a single intravenous injection of 18F-MFBG at a dose of 5.55 MBq/kg. After 60 minutes, participants will undergo a PET/CT or PET/MR scan to visualize the tumors. This imaging method allows for scanning shortly after injection without special preparation, potentially improving diagnostic processes. During the study, researchers will evaluate the safety of 18F-MFBG, the quality of the images, and how accurately the scans correspond to pathological diagnosis and treatment effects. They will monitor false positive and false negative results over about one year. Participants will be assessed through imaging and clinical follow-up, contributing to understanding the tracer's diagnostic value in pheochromocytoma.

Researchers are studying the use of 18F-metafluorobenzylguanidine (18F-MFBG) positron emission tomography (PET) to evaluate neuroendocrine tumors, mainly pheochromocytoma, paraganglioma (PPGL), and neuroblastoma (NB). These tumors express norepinephrine transporter (NET), which is targeted by imaging substances like 123I/131I-MIBG. However, current imaging methods have limitations such as low resolution and long waiting times, which affect diagnosis. This study aims to assess the safety, image quality, diagnostic accuracy, and tumor burden detection of 18F-MFBG PET in these neural crest tumors.

Researchers are studying adrenal tumor removal surgeries using a high-definition 3D laparoscopic system to improve outcomes compared to traditional 2D laparoscopy. This observational study explores the benefits of using 3D imaging, which offers better depth perception and spatial orientation, potentially reducing errors, fatigue, and operating time during adrenalectomies. The study focuses on both benign and malignant adrenal tumors. The surgery uses a 3D laparoscopic system where all operating room personnel wear polarized glasses to see stereoscopic images. Dissection is performed with a hybrid energy device called Thunderbeat. The study observes patients who underwent unilateral 3D laparoscopic adrenalectomy between 2013 and 2033, without comparing to other surgical approaches. Participants have their surgical outcomes monitored up to 30 days after surgery, including complication rates and length of hospital stay. Researchers also evaluate factors like bleeding, operative time, use of drainage, and differences in morbidity related to obesity, previous surgeries, patient age, anesthesia risk scores, tumor size, diagnosis, and tumor side. The study collects detailed data to understand how 3D laparoscopy affects adrenalectomy results over time.

This research aims to evaluate a new drug called ADCT-701 in adults with neuroendocrine neoplasms (NENs), including rare cancers found in the gastrointestinal tract, pancreas, lungs, adrenal glands, and other areas. These cancers often have a high risk of returning and low survival rates, and current treatments have limited benefits. The study is a first-in-human Phase I trial designed to find the maximum tolerated dose of ADCT-701, a drug targeting DLK1, which is present in various neuroendocrine tumors and related cancers. Participants will receive ADCT-701 as an intravenous infusion over 30 to 45 minutes on the first day of each 21-day treatment cycle. The study uses a dose-escalation design to determine the best dose, with up to 10 dose levels tested in approximately 70 patients. Treatment can continue for up to two years. After completing treatment, participants will have follow-up visits including physical exams, heart and blood tests, and imaging scans for up to five years to monitor health and disease status. During the study, participants will undergo screening that includes physical exams, blood and urine tests, imaging scans, heart function tests, and possibly a tumor biopsy. Clinic visits are frequent at first, with 10 visits over the first two cycles, then two visits per cycle thereafter. Each visit may last up to eight hours and includes repeated tests and assessments of daily activity ability. Researchers will monitor safety, drug levels in the body, immune responses, and antitumor activity throughout the trial and follow-up periods.

Researchers are studying aggressive pituitary tumors through a national research registry called HYPOcare, which gathers patient information from a multidisciplinary consultation meeting. This meeting brings together experts from across the country to help guide patient care and collect one of the largest cohorts of patients with aggressive pituitary tumors both nationally and internationally. Currently, the data is used only for clinical management and not for research purposes. The study involves adult patients with pituitary tumors whose medical files have been reviewed by the HYPOcare consultation meeting. There is a single group of participants, and the study is observational, meaning no new treatments or interventions are given as part of the trial. The registry collects clinical data to support research on the characteristics of aggressive pituitary tumors. Participants provide their medical information for analysis, and researchers will study the aggressiveness of the tumors using transcriptome analysis over a three-year period. No experimental treatments are administered, and no direct patient visits or interventions are required as part of this observational research. The study aims to improve understanding and future management of aggressive pituitary tumors through data collection and analysis.

Researchers are investigating a gene transfer therapy using a patient's own white blood cells genetically engineered to attack specific mutations in metastatic solid cancers that have not responded to standard treatments. This Phase II study aims to determine if these modified cells, alone or combined with pembrolizumab, can shrink tumors in patients with various cancers including gastrointestinal, genitourinary, breast, ovarian, non-small cell lung cancer, endocrine tumors, neuroendocrine tumors, and multiple myeloma with solid masses. Participants receive a preparative regimen involving cyclophosphamide and fludarabine to prepare the body, followed by an infusion of their own T-cells modified to express T-cell receptors targeting their tumor's neoantigens. Some participants also receive pembrolizumab before and after cell infusion. Treatment includes high- or low-dose aldesleukin to support the infused cells. The study involves hospitalization for treatment and recovery, followed by long-term antibiotic and possible antiviral therapy. During the study, participants undergo extensive screening, including tumor biopsies, scans, blood tests, and physical exams. After treatment, researchers monitor tumor response with imaging and clinical assessments at multiple time points up to two years. Safety and tolerance are also evaluated. Participants are followed closely with regular visits to assess treatment effects, manage side effects, and track disease status.

Researchers are conducting a retrospective observational cohort study to evaluate clinical, pathological, and treatment data of people diagnosed with adrenocortical carcinoma since the year 2000. This rare cancer has a notably higher incidence in certain regions of Brazil, partly due to a common genetic mutation called TP53-R337H. The study aims to characterize this patient group and identify factors that influence outcomes, focusing on cases from major Brazilian treatment centers. Participants in this study are identified based on past clinical records rather than receiving new treatments. The study collects data from medical evaluations and follow-ups conducted at reference centers, including initial diagnosis and recurrences from 2000 onward. There are no interventions or experimental treatments given during this observational study. Participants' involvement includes reviewing their medical history and clinical data over approximately 18 months. Researchers will analyze demographic and clinical characteristics from existing records to better understand the disease in this population. The study does not involve active treatment but focuses on data collection and analysis for improved knowledge of adrenocortical carcinoma in Brazil.

Researchers are investigating the causes and development of adrenal tumors, which include adrenocortical carcinoma, Cushing syndrome, Conn syndrome, and pheochromocytoma. The study aims to better understand how these tumors form and to evaluate new treatment options for patients with malignant adrenal tumors, addressing the limited current therapies available. This observational research is sponsored by the University of Wuerzburg and has been ongoing since 2002. Participants in the study may provide tumor material and related biological samples if they have adrenal tumors. Additionally, biological samples are collected from patients without adrenal tumors to serve as comparison controls. The research does not involve experimental treatments but focuses on collecting and analyzing biospecimens to explore tumor biology and potential therapies. Throughout the study, participants contribute by providing tumor and biosample materials. Researchers analyze these samples to study tumor characteristics and evaluate possible new treatments. There are no specific outcome measures listed. The study is observational, with no assigned treatments, and aims to gather information to support future therapeutic developments. Participants' involvement duration varies, and the study is expected to continue until December 2032.

Researchers are evaluating the tissue-agnostic effectiveness of the anti-PD1 antibody nivolumab in patients with advanced or metastatic rare tumors that express PD-L1 with a combined positive score of 10 or higher. This phase II basket trial includes patients whose cancers have progressed despite standard treatments. Rare tumors, defined by low incidence rates, collectively represent a significant portion of cancers with generally poor prognosis and limited clinical trial representation. Participants receive intravenous nivolumab at a dose of 480 mg every 4 weeks, continuing until disease progression, limiting toxicity, or for up to 12 months if responses are stable or improving. After treatment ends or discontinuation, patients are followed by phone every 60 days until death. This innovative approach targets the molecular characteristic PD-L1 regardless of tumor origin, aiming to provide new therapeutic options across many rare cancer types. During the study, researchers assess tumor response using RECIST v1.1 criteria and monitor biomarkers including PD-L1 expression, circulating tumor DNA, and microvesicles to understand treatment effects. Patients undergo regular evaluations to measure objective response and progression-free survival. Safety is closely monitored throughout the treatment and follow-up periods. The study is conducted across multiple centers to overcome challenges in rare cancer research and is expected to last about four years.