Metastatic Head and Neck Squamous Cell Carcinoma, Metastatic Squamous Cell Carcinoma in Cervical Lymph Node
Conditions
Brief summary
This early phase I trial studies how well fluciclovine F18 positron emission tomography (PET)/computed tomography (CT) works in identifying the origin of head and neck squamous cell carcinoma in patients with cancer that has spread to the cervical lymph nodes. Fluciclovine F18 during a PET/CT scan may work better in helping doctors learn where the cancer started (called the site of origin) and directing treatment planning compared to standard fludeoxyglucose F-18 (FDG) PET-CT scans.
Detailed description
PRIMARY OBJECTIVES: I. To estimate positive predictive value with a corresponding 95% confidence interval for fluciclovine F18 (18F fluciclovine) positron emission tomography computed tomography (PET CT) to detect a primary site of disease in patients presenting with cervical metastatic nodal disease but a head and neck primary site not apparent on CT of the neck with contrast (contrast enhanced-computed tomography, CE-CT). SECONDARY OBJECTIVES: I. To estimate positive predictive value with a corresponding 95% confidence interval for fludeoxyglucose F-18 (18F FDG) PET CT in the detection of a primary site of disease in patients presenting with cervical metastatic nodal disease but a head and neck primary site not apparent on CT of the neck with contrast. EXPLORATORY OBJECTIVES: I. To compare the lesion to background (L/B) ratios for nodal metastatic disease between 18F fluciclovine PET CT and 18F FDG PET CT. II. To estimate the sensitivity of 18F fluciclovine PET CT and 18F FDG PET CT to detect nodal disease. III. To evaluate for any trends in findings on 18F fluciclovine PET CT and human papillomavirus (HPV) status. OUTLINE: Patients receive fluciclovine F18 intravenously (IV) and undergo PET/CT scan over 20-30 minutes.
Interventions
PROCEDUREComputed Tomography
Undergo PET/CT
RADIATIONFluciclovine F18
Given IV
PROCEDUREPositron Emission Tomography
Undergo PET/CT
Sponsors
National Cancer Institute (NCI)
M.D. Anderson Cancer Center
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adults with biopsy proven metastatic cervical nodal squamous cell carcinoma * CT of the neck with contrast that does not confidently identify a primary oropharyngeal site of disease * Planned standard of care 18F-FDG PET CT examination * Planned standard of care exam under anesthesia with oropharyngeal surgical biopsy
Exclusion criteria
* Pregnant women * Known allergy to FDG, fluciclovine, or iodine-based contrast agents * Severe renal dysfunction (glomerular filtrate rate \[within 30 days\] less than 30) * Inability to tolerate lying supine, relatively motionless for up to 1 hour
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of the suspected lesions that are positive by the gold standard of pathology | Up to 2 years | Positive predicative values will be estimated with a corresponding exact 95% confidence interval. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Lesion to background (L/B) ratios for nodal metastatic disease | Up to 2 years | L/B ratios for nodal metastatic disease will be compared between fluciclovine F18 (18F-flucivlovine) positron emission tomography computed tomography (PET CT) and fludeoxyglucose F-18 (18F FDG) PET CT. For lesions that are identified by both 18F FDG PET CT and 18F fluciclovine PET CT, paired t-tests will be used to compare the L/B ratios for primary sites. This analysis will be repeated for nodal metastatic disease sites that are identified by both methods. |
| Sensitivity and specificity in detecting nodal disease | Up to 2 years | For nodes that are biopsied, pathology will serve as the gold standard, and the sensitivity and specificity will be estimated separately for 18F FDG PET CT and for 18F fluciclovine PET CT. For nodes that are not, 18F FDG PET CT will serve as the gold standard, and the sensitivity and specificity of 18F-flucivlovine PET CT will be estimated. |
Countries
United States
Outcome results
None listed