How endocrine tumors develop resistance to alkylating chemotherapy

Longitudinal Biomarker Study in Endocrine Neoplasms to Study Acquired Resistance to Alkylator Chemotherapy

Observational Uppsala University · NCT07121998

This study will test whether patients with endocrine tumors who receive alkylating chemotherapy develop high tumor mutation rates and whether blood tests and imaging can detect those changes.

Quick facts

Study typeObservational
Enrollment94 (estimated)
Ages18 Years and up
SexAll
SponsorUppsala University Academic / other
Drugs / interventionschemotherapy, immunotherapy
Locations1 site (Uppsala)
Trial IDNCT07121998 on ClinicalTrials.gov

What this trial studies

This is a prospective multicenter study enrolling about 94 patients at Swedish endocrine cancer centers to track genetic changes after alkylating chemotherapy. Participants are divided into two groups: those about to start alkylating therapy and those with disease progression after prior alkylating treatment. The study collects tumor tissue biopsies, blood samples for circulating tumor DNA, and imaging to look for the emergence of high tumor mutational burden and mismatch repair–related mutations. Genomic sequencing will be used to quantify hypermutation and correlate tissue findings with non-invasive measures over time.

Who should consider this trial

Good fit: Adults (≥18 years) with histologically confirmed endocrine neoplasms who are either about to start alkylating chemotherapy or have disease progression after prior alkylating treatment are ideal candidates.

Not a fit: Patients who have never received alkylating chemotherapy, who cannot safely undergo biopsy or blood draws, or who are pregnant are unlikely to benefit from this study.

Why it matters

Potential benefit: If successful, the study could identify patients who develop therapy-induced hypermutation and enable non-invasive monitoring to guide treatment choices, including potential use of immunotherapy.

How similar studies have performed: Small prior studies, particularly in pancreatic neuroendocrine tumors, have reported chemotherapy-associated hypermutation in roughly 30% of cases, but broader confirmation in other endocrine neoplasms is limited.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Informed consent
* Age ≥18 years
* Histopathology confirmed endocrine neoplasm
* Treatment with alkylating chemotherapy: Arm A; about to start alkylating chemotherapy, or Arm B; at disease progression or recurrence with previous alkylating chemotherapy treatment.

Exclusion Criteria:

* If planned tissue biopsy: risk factors for biopsy-related complications accordingly to local investigator, including coagulation disorder
* Long term treatment with anticoagulant that cannot be temporarily paused without unacceptable risk
* Pregnancy

Where this trial is running

Uppsala

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Neuroendocrine TumorsEndocrine CancerAlkylating chemotherapyTreatment resistance
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.