Cervical Cancer
Conditions
Keywords
locally advanced cervical cancer, HPV, radiochemotherapy, FDG PET CT
Brief summary
The main purpose of the study is to describe changes in plasma HPV DNA levels in patients with locally advanced cervical cancer during radical radiochemotherapy (CRT) and to correlate changes with response to treatment. Monitoring of the response to treatment will also be assessed in FDG PET CT imaging.
Detailed description
Ninety-five per cent of cervical cancer cases are caused by persistent infections with carcinogenic HPVs. Locally advanced stage IB2 to IVA cervical cancers are treated with definitive chemoradiation therapy (CRT). Despite known clinical prognostic factors of poor treatment outcome such as advanced stage and positive nodal status, we still don't know predictors of relapse. HPV status will be assessed in the neoplastic tissue and DNA from the blood serum of patients with cervical cancer will be isolated and analyzed by real-time PCR. Plasma HPV DNA would identify patients with residual disease after CRT due to persistent detectable HPV. This would earlier detect high risk patients who would benefit from adjuvant therapy. While metabolic response in post - therapy FDG PET CT is predictive of survival, there is usually 3 months waiting period time needed to perform this imaging. This pilot study will provide preliminary estimates of the correlation between plasma HPV DNA level, PET finding and clinical outcome in polish cervical cancer patients.
Interventions
DIAGNOSTIC_TESTHPV serum level and FDG PET CT in patients with cervical cancer treated with radical radiochemotherapy
Locally advanced non-operable newly diagnosed FIGO stage IB-IVA cervical cancer patients planned for definitive radiochemotherapy will be accrued to study and will have: 1. FDG PET Scan before treatment and 3 months after treatment 2. Pre- treatment DNA from the neoplastic time preserved in the form of paraffin blocks to determine HPV status 3. Blood sample to measure HPV DNA at time point baseline (before treatment), in the middle of treatment and at the end of definitive radiochemotherapy, 4. \[F-18\] - FDG PET scan before treatment and 3 months post completion of radiochemotherapy.
Sponsors
The Greater Poland Cancer Centre
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Intervention model description
Locally advanced non-operable newly diagnosed FIGO stage IB-IVA cervical cancer patients planned for definitive radiochemotherapy will be accrued to study and will have: 1. FDG PET Scan before treatment and 3 months after treatment 2. Pre- treatment DNA from the neoplastic time preserved in the form of paraffin blocks to determine HPV status 3. Blood sample to measure HPV DNA at time point baseline (before treatment), in the middle of treatment and at the end of definitive radiochemotherapy, 4. \[F-18\] - FDG PET scan before treatment and 3 months post completion of radiochemotherapy.
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
Age Limits: more than 18Y Histologically confirmed squamous cell carcinoma, FIGO stage IB-IVA planned for radical radiochemotherapy Eastern Cooperative Oncology Group (ECOG) performance status 0,1,2
Exclusion criteria
Patients who have received any anticancer treatment for their cervical cancer. Eastern Cooperative Oncology Group (ECOG) performance status \> 2 Other cervical cancer tumor histologies (e.g. small cell, serous) Contraindications to 18FDG PET-CT Contraindication to radiochemotherapy Known pregnancy or lactating
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| local control | 18 months |
| Response to treatment | 6 months |
Secondary
| Measure | Time frame |
|---|---|
| Progression-free survival | 18 months |
| Plasma HPV DNA levels | Up to 3 months |
Countries
Poland
Outcome results
None listed