NCT04922801

Brief Summary

This project will examine the role of the whole body, PET and SPECT imaging before, during and after radionuclide treatment for 177Lu-Dotatate therapy, whole body and SPECT imaging for 131-I for thyroid cancer therapy, and whole-body imaging for 131I for hyperthyroidism therapy. Whole-body and SPECT images will be linked to personal dosimeter readings to determine whether

  • Current radiation protection advice for patients receiving radionuclide treatment is appropriate.
  • Radiopharmaceutical retention and/or SUV change in patients undergoing repeated radionuclide treatments.
  • Data combined from early (quantitative imaging) and late (whole-body dose rate measurements) could support individual treatment planning for patients undergoing repeated cycles of molecular therapy.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
50

participants targeted

Target at P25-P50 for all trials

Timeline
Completed

Started Dec 2021

Shorter than P25 for all trials

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

May 17, 2021

Completed
25 days until next milestone

First Posted

Study publicly available on registry

June 11, 2021

Completed
6 months until next milestone

Study Start

First participant enrolled

December 9, 2021

Completed
11 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

October 20, 2022

Completed
16 days until next milestone

Study Completion

Last participant's last visit for all outcomes

November 5, 2022

Completed
Last Updated

March 8, 2023

Status Verified

March 1, 2023

Enrollment Period

11 months

First QC Date

May 17, 2021

Last Update Submit

March 7, 2023

Conditions

Keywords

MRTNeuroendocrine tumours (NET)177Lu-DOTATATESUVQuantitative SPECT/CTThyroid cancerI-131Hyperthyrodism

Outcome Measures

Primary Outcomes (2)

  • 20 patients with Lu-Dotatate MRT response to therapy outcome as Assessed by response evaluation criteria in solid tumours RECIST (version 1.1)

    * Standardised uptake value (SUV) will be extracted from SPECT/CT image using HERMES software at cycle 1 and cycle 4 of Lu-Dotatate MRT. * SUV values will be extracted from PET/CT image Pre and post Lu-Dotatate MRT using HERMES software. * The descriptive( mean, max, min, SD) and inferential (Wilcoxon signed-rank test and Spearman correlation) analysis will be applied to calculate the changes in SUV values in SPECT and PET. SUV changes will be correlated between SPECT \& PET.

    started from the day of MRT administration at cycle 1 and cycle 4. (Total 4 MRT cycles, each cycle length 8-12 weeks). each participant time frame 1 year.

  • Whole-body gamma image time activity curve (TAC) versus patient-led external dose rate (SELFIE) TAC.

    The data from both sets will be synthesised from all defined groups in this study to establish if correlation points exist between whole-body imaging and the selfie TAC. Nonlinear biexponential curve fitting will be applied using GraphPad statistics software to generate SELFIE slow and fast halflives and TAC. Hermes software will be used to generate whole-body gamma image TAC. Spearman correlation will be applied to test correlation.

    SELFIE: 28 days measurements post administration of MRT activity. and Whole-body image:24 hrs post administration of MRT activity.

Secondary Outcomes (2)

  • Patient-led external dose measurement (SELFIE) area under the curve (AUC) change between cycle 1 & 4 MRT

    1 year for Neuroendocrine tumours participants and 1 month for thyroid cancer and hyperthyroidism participants.

  • MRT patients Acceptance of patient-led monitor (SELFIE)

    28 days post MRT activity administration.

Study Arms (3)

Neuroendocrine Toumours

Patients will undergo 177LU-Dotatate Neoruendocrine Tumours MRT in accordance with existing protocols at GSTTFT. In addition, all MRT patients will be asked to undertake the following non-invasive procedures. * Post-treatment gamma camera (Planar Whole Body \& SPECT/CT) imaging to estimate disease/ target tissue and whole-body dose for Neuroendocrine and thyroid cancer MRT. * Post-treatment gamma camera planar Whole Body imaging for hyperthyroidism MRT. * Post-treatment patient-led self-monitoring. * Complete a feedback questionnaire relating to the use of self radiation monitoring.

Diagnostic Test: Nuclear Medicine whole-bodyDiagnostic Test: SPECT/CT imaging.Diagnostic Test: PET/CT imaging.Device: Patient-led radiation monitor (SELFIE)Diagnostic Test: LAB TEST

Thyroid Cancer

Patients will undergo 131I-Thyroid cancer MRT in accordance with existing protocols at GSTTFT. In addition, all MRT patients will be asked to undertake the following non-invasive procedures. * Post-treatment gamma camera (Planar Whole Body \& SPECT/CT) imaging to estimate disease/ target tissue and whole-body dose for Neuroendocrine and thyroid cancer MRT. * Post-treatment gamma camera planar Whole Body imaging for hyperthyroidism MRT. * Post-treatment patient-led self-monitoring. * Complete a feedback questionnaire relating to the use of self radiation monitoring.

Diagnostic Test: Nuclear Medicine whole-bodyDiagnostic Test: SPECT/CT imaging.Diagnostic Test: PET/CT imaging.Device: Patient-led radiation monitor (SELFIE)Diagnostic Test: LAB TEST

Hyperthyrodism

Patients will undergo 131I-Hyperthyroidism MRT in accordance with existing protocols at GSTTFT. Patients will have one whole-body scan at 24 hr post MRT which will not involve any additional radiation. In addition, all MRT patients will be asked to undertake the following non-invasive procedures. * Post-treatment gamma camera (Planar Whole Body \& SPECT/CT) imaging to estimate disease/ target tissue and whole-body dose for Neuroendocrine and thyroid cancer MRT. * Post-treatment gamma camera planar Whole Body imaging for hyperthyroidism MRT. * Post-treatment patient-led self-monitoring. * Complete a feedback questionnaire relating to the use of self radiation monitoring.

Diagnostic Test: Nuclear Medicine whole-bodyDiagnostic Test: PET/CT imaging.Device: Patient-led radiation monitor (SELFIE)Diagnostic Test: LAB TEST

Interventions

Gamma-Camera Whole-body scan at 24-48 hour post-Molecular Radiotherapy (MRT).

HyperthyrodismNeuroendocrine ToumoursThyroid Cancer
SPECT/CT imaging.DIAGNOSTIC_TEST

SPECT/CT scan at 24-48 hr post MRT

Neuroendocrine ToumoursThyroid Cancer
PET/CT imaging.DIAGNOSTIC_TEST

3-6 months Pre and post-therapy PET/CT imaging

HyperthyrodismNeuroendocrine ToumoursThyroid Cancer

Following MRT administration, a standard whole body dosimetry measurement will be taken by medical physicist at 1 and 2 meters distance. The patient will begin to take SELFIE readings at the same time under supervision so that their records can be compared with the physicists' results. After 28 days, patients will be asked to return the diary sheet and SELFIE monitor by post to GSTTFT in a pre-paid, pre-addressed envelope. On completion of the 28 day exercise, patients will be asked to complete and return a feedback questionnaire.

HyperthyrodismNeuroendocrine ToumoursThyroid Cancer
LAB TESTDIAGNOSTIC_TEST

Biochemistry, haematology and tumour markers blood tests pre, post and during MRT.

HyperthyrodismNeuroendocrine ToumoursThyroid Cancer

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)
Sampling MethodNon-Probability Sample
Study Population

Female and male patients undergoing molecular radionuclide therapy at GSTTFT using Lutetium-177 peptides for neuroendocrine tumour and I-131 for benign and malignant thyroid disease therapy will be invited to participate. The total sample size is estimated as 60 patients divided as 20 for patients receiving 131I for hyperthyroidism, 20 patients for 131I for thyroid cancer and 20 patients for177Lu-DOTATATE for neuroendocrine tumours. This sample should allow sufficient quantitative and dosimetry data to explore the research questions. The range in the number of patients who will be studied is intended to mitigate uncertainty regarding continuing restrictions related to the COVID-19 Coronavirus pandemic.

You may qualify if:

  • Patients receiving MRT (177Lu-Peptide for Neuroendocrine Tumours and 131I for Thyroid Cancer and Benign Hyperthyroidism).
  • Women of childbearing potential must use a reliable method of contraception and have a documented negative pregnancy test immediately prior to MRT administration in accordance with routine clinical practice.
  • Able to comply with treatment plans, scheduled visits, all study whole body, SPECT/CT \& PET/CT imaging and follow-up.
  • Able to use a personalised dosimetry handheld device and record daily readings for 28 days post MRT.
  • Willing and able to give informed consent.

You may not qualify if:

  • Pregnant or breastfeeding women.
  • Any other considerations that may make the patient unable to tolerate whole body, PET or SPECT scans.
  • Inability to use a personalised dosimetry handheld device and record the daily reading for 28 days post MRT.
  • Participants who are involved in current research or have recently been involved in any research prior to recruitment.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Guy's and St Thomas Hospitals Foundation Trust

London, SE1 9RT, United Kingdom

Location

MeSH Terms

Conditions

Neuroendocrine TumorsHyperthyroidismThyroid Neoplasms

Condition Hierarchy (Ancestors)

Neuroectodermal TumorsNeoplasms, Germ Cell and EmbryonalNeoplasms by Histologic TypeNeoplasmsNeoplasms, Nerve TissueThyroid DiseasesEndocrine System DiseasesEndocrine Gland NeoplasmsNeoplasms by SiteHead and Neck Neoplasms

Study Officials

  • Valerie Lewington, Professor

    King's College London

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
observational
Observational Model
COHORT
Time Perspective
PROSPECTIVE
Target Duration
6 Months
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

May 17, 2021

First Posted

June 11, 2021

Study Start

December 9, 2021

Primary Completion

October 20, 2022

Study Completion

November 5, 2022

Last Updated

March 8, 2023

Record last verified: 2023-03

Data Sharing

IPD Sharing
Will share

all IPD that underlie results in a publication.

Shared Documents
STUDY PROTOCOL, ICF
Time Frame
From June 2023 till June 2028.
Access Criteria
IPD will be shared with the lead sponsor King's College London. Name of Sponsor representative: Professor Reza Razavi Address: King's College London Vice President \& Vice-Principal (Research) Room 5.31, James Clerk Maxwell Building 57 Waterloo Road London SE1 8WA Telephone: Tel: +44 (0)207 8483224 Email: reza.razavi@kcl.ac.uk • Once the project has ended, data that supports published research and/or has long term value will be deposited with the university's research data repository to ensure long term preservation and accessibility. King's is committed to preserving research data for a minimum of 10 years since the last use of the data. Patient's images will be stored at HERMES medical system located in Nuclear Medicine Department at GSTTFT.

Locations