ClinicalTrials.gg
RecruitingNCT07436858Updated Oct 20, 2026

Whole Body HER2 Quantification With 89Zr-Trastuzumab PET/CT to Asses Zr-trastuzumab Accumulation in HER2-mutated and HER2-overexpressing Metastatic Non-small Cell Lung Cancer

A Phase 1 interventional study of PET imaging with ⁸⁹Zr-trastuzumab and Blood sampling for pharmacokinetics in Lung Cancer (NSCLC), HER2 Expression and HER2 Gene Mutation, sponsored by The Netherlands Cancer Institute. Recruiting at 1 site in Netherlands. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-10-20.

Primary conditionCarcinoma, Non-Small-Cell LungRegistry: Lung NeoplasmsReclassifiedWhy we changed it
Registry
Lung Neoplasms — the first condition term the registry derived for this study.
ClinicalTrials.gg
Carcinoma, Non-Small-Cell Lung
Why
  1. The study's title name Carcinoma, Non-Small-Cell Lung, a narrower term within Lung Neoplasms.
Confidence
High: the new condition is named in the study's own title. Of 46 hand-checked studies reclassified this way, 72% were exactly right and 89% in the right disease family; the registry's first term was right for 4% (measured 2026-10-21). How we classify →
Wrong?
Tell us the study's main condition →

Sponsored by The Netherlands Cancer Institute · Phase 1, Interventional, and Diagnostic

From the registry’s dates

  • Started Oct 2026; still recruiting 1 month later.
Updated Oct 20, 2026Now RecruitingSite recruiting status changed+3 moreGo to Updates ↓
Phase
Phase 1
Study type
Interventional
Enrollment
20
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

The investigators investigate whether PET imaging with ⁸⁹Zr-trastuzumab can reliably demonstrate the extent of tracer accumulation in tumors of patients with HER2-mutated or HER2-overexpressing non-small cell lung cancer (NSCLC). The aim is to determine whether differences in tracer uptake can be detected between these groups, as translational studies indicate that HER2-mutated tumors may internalize trastuzumab-based agents more efficiently than tumors that solely overexpressed HER2.

02

Conditions studied

  • Lung Cancer (NSCLC)
  • HER2 Expression
  • HER2 Gene Mutation

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03

In context

Carcinoma, Non-Small-Cell Lung Reclassified

7,620 studies on the registry are indexed under Carcinoma, Non-Small-Cell Lung; 1,838 are open to participants now.

This study's planned enrollment of 20 is below the median of 62 across 6,019 interventional studies indexed under Carcinoma, Non-Small-Cell Lung.

Browse Carcinoma, Non-Small-Cell Lung studies →

Lead sponsor

The Netherlands Cancer Institute is the lead sponsor of 231 studies on the registry; 67 are open to participants now.

Compared within Carcinoma, Non-Small-Cell Lung, this study's primary condition as ClinicalTrials.gg classifies it; the registry's first condition term is Lung Neoplasms. The counts are of registry records indexed under each term, refreshed daily. How we classify →

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Signed written
  • Age≥ 18 years, willing and able to comply with the protocol as judged by the investigator
  • performance status (ECOG PS) 0 or 1 at screening.
  • Patients with or cytologically confirmed diagnosis of advanced stage:
  • overexpression, defined as an immunohistochemistry score (IHC) of 2+ or 3+ in at least 10% of tumour cells without an activating HER2 mutation
  • HER2 activating (insertion) mutation diagnosed through RNA sequencing (RNAseq)
  • Disease progression after at least one line of platinum-based chemotherapy ± immunotherapy and starting (new) systemic treatment.
  • Be willing to provide a recent tumor tissue specimen after the last . Samples must be of sufficient quantity and of adequate tumor tissue content.
  • Able to undergo PET imaging procedures.
  • according to 1.1.
  • At least two measurable lesions with a long axis diameter ≥2 cm.
  • Adequate organ and bone marrow function within 21 days prior to tracer injection, defines as:

Laboratory Test Laboratory Value count ≥100 000/mm3 or ≥100 × 109/L (platelet transfusions are not allowed up to 14 days prior to Cycle 1 Day 1 to meet eligibility) ≥9.0 g/dL or 5.6 mmol/L (transfusion and/or growth factor support is allowed) (ANC) ≥1500/mm3 or ≥1.5 × 109/L /alanine aminotransferase ≤3 × (if liver are present, ≤5 ×ULN) Total ≤1.5 × ULN if no liver metastases (\<3 x ULN in the presence of documented Gilbert's Syndrome (unconjugated hyperbilirubinemia) or liver metastases Creatinine (CrCl) ≥30 mL/min as calculated using the Cockcroft-Gault equation.

(INR)/Prothrombin time and activated partial thromboplastin time (aPTT) ≤1.5 × (ULN), except for subjects on coumarinderivative anticoagulants or other similar anticoagulant therapy, who must have PT-INR within therapeutic range as deemed appropriate by the Investigator

  • Women aged \<50 years will be considered if they have been amenorrheic for 12 months or more following cessation of exogenous hormonal treatments and if they have luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels in the post-menopausal range for the site.
  • Women aged ≥ 50 years will be considered post-menopausal if they have been amenorrheic for 12 months or more following cessation of all exogenous hormonal treatments, had radiation-induced menopause with last menses >1 year ago, had chemotherapy-induced menopause with last menses >1 year ago.
  • Females on hormone replacement therapy (HRT) and whose menopausal status is in doubt will be required to use one of the methods outlined for women of if they wish to continue their HRT during the study. Otherwise, they must discontinue HRT to allow confirmation of post-menopausal status prior to randomization/study enrolment. For most forms of HRT, at least 2-4 weeks will elapse between the cessation of therapy and the blood draw; this interval depends on the type and dosage of HRT. Following confirmation of their post-menopausal status, they can resume use of HRT during the study without use of a contraceptive method.
  • Female patients of childbearing potential who are sexually active with a non-sterilized male partner must use at least one highly effective method of contraception, presented in Table 3. from the time of screening and must agree to continue using such precautions for 7 months after the last dose of IMP. Not all methods of contraception are highly effective. Female patients must refrain from breastfeeding while on study and for 7 months after the last dose of IMP. Complete heterosexual abstinence for the duration of the study and drug is an acceptable contraceptive method if it is line with the patient's usual lifestyle (consideration must be made to the duration of the clinical trial); however, periodic or occasional abstinence, the rhythm method, and the withdrawal method are not acceptable.
  • Female subjects must not donate, or retrieve for their own use, ova from the time of screening and throughout the study treatment period, and for at least 7 months after the final study drug administration
  • Highly Effective Methods of Contraception (\<1% failure rate) include:

    • Total heterosexual abstinence (evaluate in relation to the duration of the clinical study and the preferred and usual lifestyle choice of the participant)
    • Vasectomised sexual partner (provided that partner is the sole sexual partner of the trial participant and that the vasectomised partner has received medical assessment of the surgical success)
    • Bilateral tubal occlusion
    • Intrauterine device (provided coils are copper banded)
    • Combined (oestrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation i. Oral ii. Intravaginal iii. transdermal
    • Progestogen-only hormonal contraception associated with inhibition of ovulation (oral/injectable/implantable)
    • Intrauterine hormone-releasing system (IUS)
    • All methods of contraception must be used in combination with the use of a condom by their male sexual partners for intercourse.

Exclusion criteria

Exclusion Criteria:

  • for systemic treatment (as will be assigned by the treating physician)
  • Pregnant or lactating women
  • Prior allergic reaction to immunoglobulins or immunoglobulin allergy
  • Inability to comply with study procedures
  • Has substance abuse or any other medical conditions such as cardiac or psychological conditions, that may, in the opinion of the investigator, interfere with the subject's participation in the clinical study or evaluation of the study results
  • Prior treatment with -targeted therapies (except pan HER TKIs).
Terms in these criteria, in plain language(22)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

HER2

HER2 is a protein, made from the ERBB2 gene, that drives the growth of some cancers. A study may look for a level of the protein, extra copies of the gene, or a particular change in it.

In breast cancer, protein tests are read as HER2-positive, HER2-low or HER2-negative; other cancers use their own rules. Check which test result the study requires.

Line of therapy

A line of therapy is one course of treatment, which may combine several drugs. First-line is the first course given; second-line follows when that stops working or is not tolerated.

“Two prior lines” means two courses that count separately under the study’s rules — not simply two drugs. Ask the study team if you are unsure how yours are counted.

Measurable disease

The amount of disease can be tracked with a defined measurement, so the study can see whether it shrinks or grows. It might be a tumour measured on a scan or, in some blood cancers such as myeloma, a marker measured in blood or urine.

The criteria or the study team say which measurement counts — having no tumour visible on a scan does not by itself rule you out.

RECIST

The standard rules for measuring tumours on CT or MRI scans, to tell whether a cancer is shrinking, stable or growing during treatment.

“Measurable disease per RECIST 1.1” usually means at least one tumour 10 mm or more at its longest on a CT scan, or a lymph node 15 mm or more across its short axis.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

INR, PT and aPTT (clotting tests)

Blood tests of how long blood takes to clot. The INR is the prothrombin time (PT) put on a common scale; about 1 is usual for someone not taking a blood thinner.

Criteria often make an exception for people on a blood thinner such as warfarin, whose INR is raised on purpose.

Postmenopausal

Periods have stopped for good: usually no period for 12 months in a row without another medical reason, sometimes confirmed by a blood test (FSH).

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Washout period

A planned gap after a treatment, so that its effects can lessen before the study treatment or a study assessment. Ask the study team and the doctor who prescribed it before changing any medicine.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

05

Study design

Phase
Phase 1
Primary purpose
Diagnostic
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
20 participants (estimated)

Study arms

  • Experimental
    HER2-mutated NSCLC cohort and HER2-overexpressing NSCLC cohort

    Patients with advanced NSCLC carrying an activating HER2 mutation (N=10) Patients with advanced NSCLC whose tumors overexpress HER2, but do not have an activating HER2 mutation (N=10).

    Diagnostic Test: PET imaging with ⁸⁹Zr-trastuzumab · Diagnostic Test: Blood sampling for pharmacokinetics

Interventions

  • Diagnostic testPET imaging with ⁸⁹Zr-trastuzumab

    Participants will receive one injection of ⁸⁹Zr-trastuzumab and undergo a PET/CT scan four days later.

  • Diagnostic testBlood sampling for pharmacokinetics

    To assess the pharmacokinetics of ⁸⁹Zr-trastuzumab, the investigators collect blood samples at multiple time points following tracer administration. Samples are drawn at 10 minutes, 30 minutes, 1 hour, and 2 hours post-injection, and again on day 4 and day 7 post-injection.

This study also gives Trastuzumab. No intervention listed here names it: that was found by reading the record.

06

What researchers measure

Primary outcomes

  1. Standard uptake values (SUVs) in tumor lesions

    measurable tumor lesions and enlarged lymph nodes (\>20 mm)

    Time frame: During PET imaging with ⁸⁹Zr-trastuzumab

Secondary outcomes

  1. Tumor-to-background ratio (TBR)

    Time frame: During PET imaging with ⁸⁹Zr-trastuzumab

  2. Tumor-to-plasma ratio (TPR)

    Time frame: During PET imaging with ⁸⁹Zr-trastuzumab

  3. SUVs in tumor lesions

    Time frame: During PET imaging with ⁸⁹Zr-trastuzumab

  4. Total expression volume (TEV)

    The sum of lesion volumes with uptake above the bloodpool

    Time frame: During PET imaging with ⁸⁹Zr-trastuzumab

Other outcomes

  1. Visual PET-based heterogeneity assessment

    Time frame: During PET imaging with ⁸⁹Zr-trastuzumab

  2. Intralesion heterogeneity (only for >1.5 cm)

    Time frame: During PET imaging with ⁸⁹Zr-trastuzumab

  3. Whole-blood and plasma pharmacokinetics of ⁸⁹Zr-trastuzumab: AUCplasma

    Time frame: Day 1: 10 minutes, 30 minutes, 1 hour, and 2 hours post-injection, and again on day 4 and day 7 post-injection with ⁸⁹Zr-trastuzumab

  4. Whole-blood and plasma pharmacokinetics of ⁸⁹Zr-trastuzumab: Cplasma

    Time frame: Day 1: 10 minutes, 30 minutes, 1 hour, and 2 hours post-injection, and again on day 4 and day 7 post-injection with ⁸⁹Zr-trastuzumab

  5. Whole-blood and plasma pharmacokinetics of ⁸⁹Zr-trastuzumab: Cmax

    Time frame: Day 1: 10 minutes, 30 minutes, 1 hour, and 2 hours post-injection, and again on day 4 and day 7 post-injection with ⁸⁹Zr-trastuzumab

  6. Whole-blood and plasma pharmacokinetics of ⁸⁹Zr-trastuzumab: Clearance

    Time frame: Day 1: 10 minutes, 30 minutes, 1 hour, and 2 hours post-injection, and again on day 4 and day 7 post-injection with ⁸⁹Zr-trastuzumab

07

Study locations

1 of 1 sites recruiting
  • The Netherlands Cancer Institute - Antoni van Leeuwenhoek
    Amsterdam, North Holland 1066CX, Netherlands
    Recruiting
    • Joop de Langen, Dr · Contactj.d.langen@nki.nl · +31205129111
    • Marianne Mahn, MSc · Contactm.mahn@nki.nl · 31205129111
    • Joop de Langen, Dr · Principal investigator
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

1 registry update since Sep 25, 2026
Status
Not yet recruiting→Recruiting
changed Oct 20, 2026
Sites
The Netherlands Cancer Institute - Antoni van Leeuwenhoek is now Recruiting
Oct 20, 2026
Start date
Sep 7, 2026→Oct 2, 2026 (actual)
Oct 20, 2026
Primary completion
Jul 7, 2030→Aug 2, 2030
Oct 20, 2026
Study completion
Jul 7, 2030→Aug 2, 2030
Oct 20, 2026
Show all 1 update
  1. Oct 20, 2026
    Not yet recruiting→Recruiting
    The Netherlands Cancer Institute - Antoni van Leeuwenhoek is now Recruiting
    Start date Sep 7, 2026→Oct 2, 2026 (now actual)
    Primary completion Jul 7, 2030→Aug 2, 2030
    Study completion Jul 7, 2030→Aug 2, 2030
    + 1 other change: verification date

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT07436858
Responsible party
Sponsor
First posted
Feb 27, 2026
Start date
Oct 2, 2026
Primary completion
Aug 2, 2030 (estimated)
Completion
Aug 2, 2030 (estimated)
Last update
Oct 20, 2026

Study contacts

Joop de Langen
Contact
j.d.langen@nki.nl
+31205129111
Marianne Mahn, MSc
Contact
m.mahn@nki.nl
31205129111

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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