Single Microdose Trial- CXCR4 PET Tracer - Pharmacokinetics and Pharmacodynamics of [68Ga]Ga-R54, a Radiopharmaceutical Directed Toward CXCR4 in Patients With Advanced Solid Neoplasia.

Status

Recruiting

Phases

Early Phase 1

Study type

Interventional

Source

ClinicalTrials.gov

Registry ID

NCT07577206

Enrollment

Registered

2026-05-11

Start date

2025-01-24

Completion date

2027-01-01

Last updated

2026-05-11

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

Conditions

Advanced Solid Tumor, Multiple Myeloma

Keywords

"Microdose" trial, CXCR4, [68Ga]Ga-R54 PET radiopharmaceutical, pharmacokinetics, pharmacodynamics, advanced solid neoplasia, multiple myeloma

Brief summary

Phase 1, monocentric, open labeled, no profit "Microdose" trial. A single microdose of the new \[68Ga\]Ga-R54 PET radiopharmaceutical directed against CXCR4 will be injected into patients with advanced solid tumor or multiple myeloma to evaluate the binding.

Detailed description

The present study aims to evaluate the pharmacokinetic/pharmacodynamic profile and the engagement capacity of a new PET probe that binds the CXCR4 receptor. A Microdose-Trial (Guideline ICH M3(R2) CPMP/ICH/286/95 type 1 approach and EMEA/CHMP/SWP/28367/07 Rev. 1) is proposed in order to evaluate the pharmacokinetics and pharmacodynamics of a single microdose of the radiopharmaceutical \[68Ga\]Ga-R54 in patients suffering from solid tumors in the advanced stage of the disease or multiple myeloma. At least 5 and no more than 10 consenting patients with advanced solid tumors (breast, lung, colon, ovary, and pancreas) or multiple myeloma will be recruited with at least 1 patient per pathology whose neoplasm expresses CXCR4. Study patients will receive i.v. a single dose of \[68Ga\]Ga-R54 ≤100 μg. The localization of the target will be carried out with PET/CT method. Pharmacokinetics will be analyzed by blood samples taken at 2, 5, 10, 30 minutes, 1, 2 and 4 hours post infusion. Patients will be enrolled at least 7 days apart to monitor the onset of adverse events.

Interventions

DRUG[68Ga]Ga-R54 PET/CT

A single intravenous microdose (≤100 μg) of the CXCR4-targeting radiopharmaceutical \[68Ga\]Ga-R54 is administered, followed by whole-body PET/CT imaging. Serial blood samples are collected up to 4 hours post-injection to assess pharmacokinetics. Imaging is performed according to institutional standards to evaluate in vivo CXCR4 expression in tumor lesions.

Study design

Allocation

Intervention model

SINGLE_GROUP

Primary purpose

DIAGNOSTIC

Masking

NONE

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Healthy volunteers

Inclusion criteria

* Patients \> 18 years * Patients with histological diagnosis of solid neoplasm (breast, lung, colon, ovary, pancreas) in advanced stages or multiple myeloma evaluated by PET/CT with \[18F\]FDG carried out in the 3 months prior to enrollment. The neoplasm must express the CXCR4 receptor by immunohistochemistry * Patients with ECOG performance status 0-2, able to undergo the scheduled diagnostic procedure (PET/CT with \[68Ga\]Ga-R54). * Patients with alkaline phosphatase (AP), alanine aminotransferase (ALT), and aspartate aminotransferase \<3 x upper limit of reference range and total bilirubin \<2.0 mg/dL * Patients with creatinine \< 1.5 x upper limit of reference range or 24-hour creatinine clearance \> 50 mL/min * Negative serum pregnancy test (b-hCG) for women of childbearing age before administration of \[68Ga\]Ga-R54). * Signature of informed consent indicating that the patient (or legal representative) has been informed of all aspects pertinent to the study * Willingness and ability to comply with scheduled visits, laboratory tests and other study procedures.

Exclusion criteria

* Presence of active infections (e.g. requiring antibiotic therapy) or other serious concomitant illness, which, in the opinion of the investigator, would place the patient at undue risk or interfere with the study * Declared chronic active hepatitis (hepatitis B / C) * Declared active autoimmune diseases * Recovery from major trauma including surgery within 4 weeks of study enrollment * Presence of neurodegenerative diseases * Pregnancy and/or breastfeeding * Any conditions that in the opinion of the investigator could hinder compliance with the study protocol * Patients who have not signed consent to participate in the study

Design outcomes

Primary

Measure	Time frame
Quantitative analysis of the uptake (pharmacodynamics) of [68Ga]Ga-R54 in the neoplastic lesion by measuring the "maximum standardized uptake value" (SUVmax).	Single time point at PET/CT imaging (Day 1)
Pharmacokinetics of the PET radiopharmaceutical [68Ga]Ga-R54 through measurement of radioactivity in blood at the gamma counter (%ID/g).	Peri-procedural (at time of PET/CT imaging, Day 1)

Secondary

Measure	Time frame
Evaluation of the dosimetric parameters for the tumor and for healthy organs by determining the absorbed dose per unit of activity administered (mGy/MBq).	From time of [68Ga]Ga-R54 administration up to 4 hours post-injection
SUVmax correlation of the radiopharmaceutical [68Ga]Ga-R54 and CXCR4 expression assessed by immunohistochemistry in the tumor and microenvironment.	Single time point at PET/CT imaging (Day 1)

Countries

Italy

Contacts

CONTACTStefania Scala, M.D.

s.scala@istitutotumori.na.it08117770596

STUDY_DIRECTORStefania Scala, M.D.

Istituto Nazionale Tumori IRCCS - Fondazione G. Pascale

PRINCIPAL_INVESTIGATORSecondo Lastoria, M.D.