Lightly spray a 9x13-inch glass baking dish with non-stick cooking spray. Add half of the bread pieces to make a single layer in the base of the dish.
In a mixing bowl, whisk together the milk, pumpkin puree, eggs, pumpkin pie spice and vanilla. Pour half of this mixture over the bread in the dish.
In a small mixing bowl, cream together the cream cheese, powdered sugar and 1/2 tsp cinnamon.
Spread or dollop the cream cheese over the bottom layer of bread and egg mixture.
Add the remaining bread pieces over the cream cheese layer and pour the remaining egg mixture evenly over the second layer of bread.
In another small bowl, add the flour, brown sugar, powdered sugar, 1 tsp cinnamon and chopped pecans. Combine and then add the cold butter pieces and cut in with a pastry blender or 2 knives. Sprinkle the topping over the top of the casserole. Chill in the fridge for at least an hour, or overnight.
Bake at 350 F for 40 to 45 minutes, or until topping is golden brown and eggs have cooked through.
Serve Pumpkin Pie Stuffed French Toast with fresh fruit.