Radiotherapy Planning Using Fluciclovine PET in Patients With Newly Diagnosed Glioblastoma

NCT04840069 | Unknown Phase 2

• 1 other identifier: 090-20-16
• Study Type: interventional
• Target: 100
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of the this study is to see if the use of a PET scan with 18F-fluciclovine (PET or Fluciclovine PET) in addition to the normal radiation planning imaging procedures (MRI and CT scan) will help determine the areas where the radiation therapy is to be delivered. It is also a goal of the study to determine if subjects live longer when treatment plans for radiation therapy are designed using a Fluciclovine PET scan, as well as MRI and CT scans. We will also collect information on if and where the tumor returns. Information on the side effects from the two different treatment planning imaging methods will also be collected. 18F-Fluciclovine is an FDA-approved radioactive diagnostic agent that is injected into the patient and then taken up by cancer cells, which can then be visualized with a PET/CT scan. 18F-Fluciclovine is FDA approved for the detection of recurrent prostate cancer, but is still investigational for the purposes of this study.

Conditions

Newly Diagnosed Glioblastoma

Outcome Measures

Primary Outcomes (2)

• Patterns of Failure

  To assess whether incorporating fluciclovine PET into radiotherapy planning significantly changes the in-field and out-of-field radiographic progression rates, by comparison to traditional MRI-based radiotherapy

  36 months

• Defining Tumor Volume

  2\. To determine the effect fluciclovine PET has on definition of the tumor volume, as compared to traditional MRI-based radiotherapy.

  36 months

Secondary Outcomes (3)

• Survival using MRI radiotherapy

  36 months

• Overall survival utilizing MRI+PET radiotherapy

  36 months

• Progression free survival utilizing MRI+PET-based radiotherapy

  36 months

Study Arms (2)

MRI-guided radiotherapy

NO INTERVENTION

Patients will undergo standard of care MRI-guided radiotherapy.

MRI + Fluciclovine PET-guided radiotherapy

EXPERIMENTAL

Patients will undergo MRI + Fluciclovine PET-guided radiotherapy

Drug: Fluciclovine PET guided Radiotherapy

Interventions

Fluciclovine PET guided Radiotherapy DRUG

PET+MRI Based There is no GTV\_5400. The GTV\_6000 will be defined as the surgical cavity inclusive of any remaining tumor enhancement and the hypermetabolic volume. CTV\_5400 will include the GTV\_6000 plus a margin of 1.0 cm which may be reduced around natural barriers to tumor growth such as the skull, ventricles, falx, etc. CTV\_5400 must also include the entirety of the GTV\_6000. There is no CTV\_6000. PTV\_5400 is the CTV\_5400 plus a geometric 3 mm expansion in all dimensions; PTV\_6000 is GTV\_6000 plus a geometric 3 mm expansion in all dimensions. PTV may extend beyond bony margins and the skin surface. The PTV\_5400 must contain the PTV\_6000. In the setting of multi-focal disease, the primary target volumes will be defined as above, but for satellite lesions, the GTV\_6000 will be defined as any tumor enhancement and hypermetabolic volume. There will be no CTV\_6000. PTV\_6000 will be defined as GTV\_6000 plus a geometric 3 mm expansion in all dimensions.

MRI + Fluciclovine PET-guided radiotherapy

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Histological diagnosis of primary, newly diagnosed supratentorial, WHO grade IV glioma
• Greater than 18 years of age
• Karnofsky performance score greater than 70%
• Recovered from surgery and on a stable or tapering dose of corticosteroids
• Plan to undergo standard therapy with XRT 60Gy/30fx with TMZ followed by 6-12 cycles of maintenance TMZ within 6 weeks of surgery
• If woman of child bearing potential, negative serum pregnancy test. Patients must agree to take adequate pregnancy preventions for the length of the study.
• Life expectancy of at least 3 months
• Written study specific consent

You may not qualify if:

• Previous treatment of glioma of any grade with bevacizumab or other molecular targeted therapies less than 6 months before MRI (and PET) used for radiotherapy planning
• Recurrent of multifocal malignant glioma
• Any sites of distant disease (for example drop metastases or leptomeningeal spread)
• Prior use of Gliadel wafers or any other intratumal or intracavity treatment
• Prior radiotherapy to the cranium, head and neck or other sites resulting in overlapping fields
• Molecular targeted therapies planned during radiotherapy
• Simultaneous participation in other interventional trials which could interfere with this trial or participation in a clinical trial within the last thirty days before patient's enrollment in current study.
• Inability to undergo an MRI or PET (Claustrophobia, non-MRI compatible pacemaker, known allergy to MRI contrast agent or fluciclovine tracer)
• Any pregnant or lactating patient
• Any prior malignancy within 3 years excluding carcinoma in-situ or early staged,localized basal or squamous cell skin cancers

Sponsors & Collaborators

• St. Joseph's Hospital and Medical Center, Phoenix: lead
• Barrow Neurological Foundation: collaborator
• Arizona Biomedical Research Commission (ABRC): collaborator
• Blue Earth Diagnostics: collaborator

Study Sites (1)

St. Joseph's Hospital and Medical Center

Phoenix, Arizona, 85013, United States

RECRUITING

Central Study Contacts

Phase 0 Navigator

CONTACT

602-406-8605; research@ivybraintumorcenter.org

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 16, 2021
• First Posted: April 9, 2021
• Study Start: June 7, 2021
• Primary Completion: March 30, 2024
• Study Completion: March 30, 2024
• Last Updated: January 13, 2023

Record last verified: 2023-01

Locations

US (1)