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18F-FPPRGD2 PET/CT or PET/MRI in Predicting Early Response in Patients With Cancer Receiving Anti-Angiogenesis Therapy

Phase 1-2 18F-FPPRGD2 PET/CT or PET/MRI Imaging of αvβ3 Integrins Expression as a Biomarker of Angiogenesis

Status
Completed
Phases
Phase 1Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01806675
Enrollment
25
Registered
2013-03-07
Start date
2013-03-04
Completion date
2019-04-30
Last updated
2019-10-03

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Adult Giant Cell Glioblastoma, Adult Glioblastoma, Adult Gliosarcoma, Male Breast Cancer, Metastatic Squamous Neck Cancer With Occult Primary Squamous Cell Carcinoma, Recurrent Adenoid Cystic Carcinoma of the Oral Cavity, Recurrent Adult Brain Tumor, Recurrent Basal Cell Carcinoma of the Lip, Recurrent Colon Cancer, Recurrent Esthesioneuroblastoma of the Paranasal Sinus and Nasal Cavity, Recurrent Hypopharyngeal Cancer, Recurrent Inverted Papilloma of the Paranasal Sinus and Nasal Cavity, Recurrent Laryngeal Cancer, Recurrent Lip and Oral Cavity Cancer, Recurrent Lymphoepithelioma of the Nasopharynx, Recurrent Lymphoepithelioma of the Oropharynx, Recurrent Metastatic Squamous Neck Cancer With Occult Primary, Recurrent Midline Lethal Granuloma of the Paranasal Sinus and Nasal Cavity, Recurrent Mucoepidermoid Carcinoma of the Oral Cavity, Recurrent Nasopharyngeal Cancer, Recurrent Non-small Cell Lung Cancer, Recurrent Oropharyngeal Cancer, Recurrent Pancreatic Cancer, Recurrent Paranasal Sinus and Nasal Cavity Cancer, Recurrent Rectal Cancer, Recurrent Renal Cell Cancer, Recurrent Salivary Gland Cancer, Stage IIIA Breast Cancer, Stage IIIA Non-small Cell Lung Cancer, Stage IIIB Breast Cancer, Stage IIIB Non-small Cell Lung Cancer, Stage IIIC Breast Cancer, Stage IV Breast Cancer, Stage IV Non-small Cell Lung Cancer, Stage IV Pancreatic Cancer, Stage IV Renal Cell Cancer, Stage IVA Colon Cancer, Stage IVA Rectal Cancer, Stage IVA Salivary Gland Cancer, Stage IVB Colon Cancer, Stage IVB Salivary Gland Cancer, Stage IVC Salivary Gland Cancer, Tongue Cancer, Unspecified Adult Solid Tumor, Protocol Specific

Brief summary

The purpose of the study is to conduct research of a new PET radiopharmaceutical in cancer patients. The uptake of the novel radiopharmaceutical 18F-FPPRGD2 will be assessed in study participants with glioblastoma multiforme (GBM), gynecological cancers, and renal cell carcinoma (RCC) who are receiving antiangiogenesis treatment.

Detailed description

PRIMARY OBJECTIVE • Evaluate 18F-FPPRGD2 and 18F-FDG as PET/CT or PET/MRI radiotracers for imaging prediction and assessment of response to anti-angiogenesis therapy in participants with glioblastoma multiforme (GBM), gynecological cancers, and renal cell carcinoma (RCC). SECONDARY OBJECTIVE • Progression-free survival (PFS) at up to 1 year after initial scans and treatment OUTLINE: Patients undergo 18F-FPPRGD2 and 18F-FDG PET/CT or PET/MRI medical imaging at baseline and at regular medical care follow-up (6 to 12 weeks). After completion of study imaging, patients are followed up at 12 months.

Interventions

18F-FDG will be used as the radiotracer for a regular medical care PET/CT or PET/MRI scan

18F-FPPRGD2 will be used as the radiotracer for a PET/CT or PET/MRI scan. Participants will be injected with less than 10 mCi of 18F-FPPRGD2.

Sponsors

National Cancer Institute (NCI)
CollaboratorNIH
Sanjiv Sam Gambhir
Lead SponsorOTHER

Study design

Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
NONE

Masking description

All human subject participants were to be evaluated with both 18F-FPPRGD2 PET/CT and 18-FDG PET/CT imaging scans.

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Provides written informed consent * Diagnosed with advanced NSCLC, breast cancer, GBM or other cancers (such as head and neck, colorectal, pancreatic, renal cancers); patients will undergo anti-angiogenesis treatment or treatment with other drugs that may alter angiogenesis * Able to remain still for duration of each imaging procedure (about one hour)

Exclusion criteria

* Pregnant or nursing * Contraindication to MRI * History of renal insufficiency (only for MRI contrast administration)

Design outcomes

Primary

MeasureTime frameDescription
Change From Baseline in Maximum Standard Uptake Values (SUVmax)At baseline and 6 weeksMaximum standard uptake values (SUVmax) were assessed on the basis of position emission tomography (PET) scans using radiotracers 18F-FPPRGD2 and 18F-FDG at baseline and at regular medical care follow-up (6 to 12 weeks after initiation of treatment). The outcome is assessed as the difference in the maximum standard uptake values (SUVmax) values from baseline to follow-up for the 2 radiotracers, and will be reported for each disease type as the median with standard deviation.

Secondary

MeasureTime frameDescription
Response Assessment by RANO CriteriaAt baseline and 6 weeksThe treatment effect for participants with glioblastoma multiforme was to be assessed on the basis of post-treatment evaluation per the Response Assessment in Neuro-Oncology (RANO) Criteria. The outcome was the number & proportion of participants that achieved either a complete response (CR) or partial response (PR), a number without dispersion. RANO criteria are: CR= No T1 gadolinium (T1-G); T2-weighted-Fluid-Attenuated Inversion Recovery (T2/FLAIR) stable/decreased, no new lesions; no corticosteroids; clinical condition improved/stable. PR= ≥50% decrease in T1-G; T2/FLAIR decreased/stable ; no new lesions; decreased/stable corticosteroids; clinical condition improved/stable. Stable disease (SD)= \<50% decrease, but more than 25% increase, in T1-G; T2/FLAIR decreased/stable; no new lesions; decreased/stable corticosteroids; clinical condition improved/stable. Progressive disease (PD)= ≥25%increase T1-G; T2/FLAIR increased; increased corticosteroids; clinical condition decreased
Change in Tumor Size9 to 12 weeksThe treatment effect for participants with gynecological cancers (GYN) and renal cell carcinoma (RCC) was assessed on the basis of change in tumor size as determined by pre- and post-treatment CT scans. The outcome is reported as the difference at treatment follow-up, reported as the median with standard deviation.
Tumor Response Rate by EORTC CriteriaAt baseline and 6 weeksTumor Response Rate by EORTC Criteria Tumor response rates were assessed from position emission tomography (PET) scans using 18F-FPPRGD2 & 18F-FDG at baseline & after 6 weeks of treatment, per European Organization for Research & Treatment of Cancer (EORTC) response criteria. The outcome is reported for each radiotracer by disease group as the number of participants achieving complete response (CR), partial response (PR), stable disease (SD), & progressive disease (PD). * CR= complete resolution of 18F-FDG uptake tumor volume * PR= reduction of 15-25% in tumor 18F-FDG SUVmax after 1 cycle of chemotherapy, and ≥25% after \>1 cycle * SD= increase in tumor 18F-FDG SUVmax of \<25% or a decrease of \<15% & no increase in 18F-FDG tumor uptake \[\>20% in the longest dimension (LD)\]; * PD= increase in 18F-FDG tumor SUVmax of \>25% in tumor region on baseline; increase in extent of 18F-FDG tumor uptake (\>20% in LD); appearance of new 18F-FDG uptake in metastatic lesions
Progression-free Survival (PFS)1 yearProgression-free survival (PFS) was defined as remaining alive at 1 year with disease progression, according to the physician's assessment of clinical status, by disease group.

Countries

United States

Participant flow

Participants by arm

ArmCount
Glioblastoma Multiforme (GBM)
Patients with glioblastoma multiforme (GBM) undergo 18F-FDG and 18F-FPPRGD2 positron emission tomography / computed tomography (PET/CT) imaging at baseline and 6 weeks (or standard of care follow-up) 18F-fludeoxyglucose (18F-FDG): 18F-FDG will be used as the radiotracer for a regular medical care PET/CT or PET/MRI scan 18F-FPPRGD2: 18F-FPPRGD2 will be used as the radiotracer for a PET/CT or PET/MRI scan. Participants will be injected with less than 10 mCi of 18F-FPPRGD2.
11
Gynecological Cancers
Patients with gynecological cancer undergo 18F-FDG and 18F-FPPRGD2 positron emission tomography / computed tomography (PET/CT) imaging at baseline and at 9 t0 12 weeks (or standard of care follow-up) 18F-fludeoxyglucose (18F-FDG): 18F-FDG will be used as the radiotracer for a regular medical care PET/CT or PET/MRI scan 18F-FPPRGD2: 18F-FPPRGD2 will be used as the radiotracer for a PET/CT or PET/MRI scan. Participants will be injected with less than 10 mCi of 18F-FPPRGD2.
6
Renal Cell Cancer (RCC)
Patients with renal cell cancer (RCC) undergo 18F-FDG and 18F-FPPRGD2 positron emission tomography / computed tomography (PET/CT) imaging at baseline and at 9 t0 12 weeks (or standard of care follow-up) 18F-fludeoxyglucose (18F-FDG): 18F-FDG will be used as the radiotracer for a regular medical care PET/CT or PET/MRI scan 18F-FPPRGD2: 18F-FPPRGD2 will be used as the radiotracer for a PET/CT or PET/MRI scan. Participants will be injected with less than 10 mCi of 18F-FPPRGD2.
8
Total25

Baseline characteristics

CharacteristicTotalGlioblastoma Multiforme (GBM)Gynecological CancersRenal Cell Cancer (RCC)
Age, Categorical
<=18 years
0 Participants0 Participants0 Participants0 Participants
Age, Categorical
>=65 years
4 Participants0 Participants0 Participants4 Participants
Age, Categorical
Between 18 and 65 years
21 Participants11 Participants6 Participants4 Participants
Age, Continuous54.9 years
STANDARD_DEVIATION 13
54.1 years
STANDARD_DEVIATION 8.3
44.3 years
STANDARD_DEVIATION 12.6
64.1 years
STANDARD_DEVIATION 13.3
Ethnicity (NIH/OMB)
Hispanic or Latino
3 Participants1 Participants1 Participants1 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
22 Participants10 Participants5 Participants7 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
6 Participants1 Participants2 Participants3 Participants
Race (NIH/OMB)
Black or African American
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
5 Participants2 Participants2 Participants1 Participants
Race (NIH/OMB)
White
14 Participants8 Participants2 Participants4 Participants
Region of Enrollment
United States
25 participants11 participants6 participants8 participants
Sex: Female, Male
Female
14 Participants5 Participants6 Participants3 Participants
Sex: Female, Male
Male
11 Participants6 Participants0 Participants5 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
deaths
Total, all-cause mortality
1 / 110 / 60 / 8
other
Total, other adverse events
0 / 110 / 60 / 8
serious
Total, serious adverse events
1 / 110 / 62 / 8

Outcome results

Primary

Change From Baseline in Maximum Standard Uptake Values (SUVmax)

Maximum standard uptake values (SUVmax) were assessed on the basis of position emission tomography (PET) scans using radiotracers 18F-FPPRGD2 and 18F-FDG at baseline and at regular medical care follow-up (6 to 12 weeks after initiation of treatment). The outcome is assessed as the difference in the maximum standard uptake values (SUVmax) values from baseline to follow-up for the 2 radiotracers, and will be reported for each disease type as the median with standard deviation.

Time frame: At baseline and 6 weeks

Population: Some participants did not contribute some or all post-treatment scans.

ArmMeasureGroupValue (MEDIAN)Dispersion
Glioblastoma Multiforme (GBM)Change From Baseline in Maximum Standard Uptake Values (SUVmax)18F-FPPRGD2 PET scans-0.98 ratioStandard Deviation 0.98
Gynecological CancersChange From Baseline in Maximum Standard Uptake Values (SUVmax)18F-FPPRGD2 PET scans0.09 ratioStandard Deviation 1.2
Gynecological CancersChange From Baseline in Maximum Standard Uptake Values (SUVmax)18F-FDG PET scans-1.90 ratioStandard Deviation 2.8
Renal Cell Cancer (RCC)Change From Baseline in Maximum Standard Uptake Values (SUVmax)18F-FPPRGD2 PET scans0.10 ratioStandard Deviation 0.29
Renal Cell Cancer (RCC)Change From Baseline in Maximum Standard Uptake Values (SUVmax)18F-FDG PET scans7.8 ratioStandard Deviation 8.2
Secondary

Change in Tumor Size

The treatment effect for participants with gynecological cancers (GYN) and renal cell carcinoma (RCC) was assessed on the basis of change in tumor size as determined by pre- and post-treatment CT scans. The outcome is reported as the difference at treatment follow-up, reported as the median with standard deviation.

Time frame: 9 to 12 weeks

Population: This assessment was restricted to gynecological cancers and renal cell carcinoma participants only. Tumor response data was not available for all participants in these groups.

ArmMeasureValue (MEDIAN)Dispersion
Gynecological CancersChange in Tumor Size0.9 centimetersStandard Deviation 1.56
Renal Cell Cancer (RCC)Change in Tumor Size1 centimetersStandard Deviation 1.56
Secondary

Progression-free Survival (PFS)

Progression-free survival (PFS) was defined as remaining alive at 1 year with disease progression, according to the physician's assessment of clinical status, by disease group.

Time frame: 1 year

Population: Data was not collected for progression-free survival (PFS).

Secondary

Response Assessment by RANO Criteria

The treatment effect for participants with glioblastoma multiforme was to be assessed on the basis of post-treatment evaluation per the Response Assessment in Neuro-Oncology (RANO) Criteria. The outcome was the number & proportion of participants that achieved either a complete response (CR) or partial response (PR), a number without dispersion. RANO criteria are: CR= No T1 gadolinium (T1-G); T2-weighted-Fluid-Attenuated Inversion Recovery (T2/FLAIR) stable/decreased, no new lesions; no corticosteroids; clinical condition improved/stable. PR= ≥50% decrease in T1-G; T2/FLAIR decreased/stable ; no new lesions; decreased/stable corticosteroids; clinical condition improved/stable. Stable disease (SD)= \<50% decrease, but more than 25% increase, in T1-G; T2/FLAIR decreased/stable; no new lesions; decreased/stable corticosteroids; clinical condition improved/stable. Progressive disease (PD)= ≥25%increase T1-G; T2/FLAIR increased; increased corticosteroids; clinical condition decreased

Time frame: At baseline and 6 weeks

Population: This assessment was restricted to glioblastoma multiforme (GBM) participants only, however, no response assessments were obtained for GBM participants.

Secondary

Tumor Response Rate by EORTC Criteria

Tumor Response Rate by EORTC Criteria Tumor response rates were assessed from position emission tomography (PET) scans using 18F-FPPRGD2 & 18F-FDG at baseline & after 6 weeks of treatment, per European Organization for Research & Treatment of Cancer (EORTC) response criteria. The outcome is reported for each radiotracer by disease group as the number of participants achieving complete response (CR), partial response (PR), stable disease (SD), & progressive disease (PD). * CR= complete resolution of 18F-FDG uptake tumor volume * PR= reduction of 15-25% in tumor 18F-FDG SUVmax after 1 cycle of chemotherapy, and ≥25% after \>1 cycle * SD= increase in tumor 18F-FDG SUVmax of \<25% or a decrease of \<15% & no increase in 18F-FDG tumor uptake \[\>20% in the longest dimension (LD)\]; * PD= increase in 18F-FDG tumor SUVmax of \>25% in tumor region on baseline; increase in extent of 18F-FDG tumor uptake (\>20% in LD); appearance of new 18F-FDG uptake in metastatic lesions

Time frame: At baseline and 6 weeks

Population: This assessment was restricted to gynecological cancers and renal cell carcinoma participants only. Tumor response data was not available for all participants in these groups.

ArmMeasureGroupValue (NUMBER)
Gynecological CancersTumor Response Rate by EORTC CriteriaComplete Response (CR)2 participants
Gynecological CancersTumor Response Rate by EORTC CriteriaPartial Repsonse (PR)1 participants
Gynecological CancersTumor Response Rate by EORTC CriteriaStable Disease (SD)0 participants
Gynecological CancersTumor Response Rate by EORTC CriteriaProgressive Disease1 participants
Renal Cell Cancer (RCC)Tumor Response Rate by EORTC CriteriaProgressive Disease2 participants
Renal Cell Cancer (RCC)Tumor Response Rate by EORTC CriteriaComplete Response (CR)0 participants
Renal Cell Cancer (RCC)Tumor Response Rate by EORTC CriteriaStable Disease (SD)2 participants
Renal Cell Cancer (RCC)Tumor Response Rate by EORTC CriteriaPartial Repsonse (PR)0 participants

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026