NCT04965454

Brief Summary

This prospective clinical trial will evaluate PET/CT and genomic liquid biopsy based biomarkers as predictors of clinical therapeutic response to immune-checkpoint inhibitor (ICI) therapy for patients with inoperable hepatocellular carcinoma (HCC). The primary objective of this diagnostic trial is to assess the accuracy of pre-treatment fluorine-18 (18F-) fluorocholine (FCH) PET/CT for predicting a lack of objective response (LOR) after 16 weeks of ICI therapy.

Trial Health

77
On Track

Trial Health Score

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

Enrollment
80

participants targeted

Target at P50-P75 for phase_2

Timeline
26mo left

Started Mar 2022

Longer than P75 for phase_2

Geographic Reach
1 country

1 active site

Status
recruiting

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

Study Progress66%
Mar 2022Jun 2028

First Submitted

Initial submission to the registry

July 7, 2021

Completed
9 days until next milestone

First Posted

Study publicly available on registry

July 16, 2021

Completed
9 months until next milestone

Study Start

First participant enrolled

March 28, 2022

Completed
5.8 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 31, 2027

Expected
6 months until next milestone

Study Completion

Last participant's last visit for all outcomes

June 30, 2028

Last Updated

May 1, 2025

Status Verified

April 1, 2025

Enrollment Period

5.8 years

First QC Date

July 7, 2021

Last Update Submit

April 28, 2025

Conditions

Keywords

hepatocellular carcinomaimmunotherapypositron emission tomographymutation profilingliquid biopsypersonalized medicinediagnosticfluorocholineimmune checkpoint inhibitor

Outcome Measures

Primary Outcomes (1)

  • Lack of Objective Response

    Lack of Objective Response defined after 16 weeks as meeting criteria for either Stable Disease or Progressive Disease based on RECIST v1.1

    16 weeks

Secondary Outcomes (2)

  • Objective Response

    16 weeks

  • Disease Control

    16 weeks

Study Arms (1)

Tested with Biomarkers

EXPERIMENTAL

For this single arm study, all enrolled subjects will undergo diagnostic testing with FCH PET/CT and genomic liquid biopsy before treatment involving an immune checkpoint inhibitor agent. A fluorine-18 fluorodeoxyglucose (FDG) PET/CT may also be performed before treatment and after 8 weeks if the pre-treatment FCH PET/CT shows low or heterogeneous tumor uptake.

Combination Product: Fluorine-18 fluorocholine

Interventions

Fluorine-18 fluorocholineCOMBINATION_PRODUCT

18F-fluorocholine is a radiopharmaceutical imaging agent intended for use only with positron emission tomography (PET) imaging. PET with in-line computed tomography imaging of the torso will be performed following intravenous administration of a single unit dose of this investigational new drug.

Also known as: 18F-fluorocholine, Fluorocholine, 18F-FCH, FCH, [18F]fluorocholine
Tested with Biomarkers

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Age 18 years or older (no upper limit of age)
  • Hepatocellular carcinoma diagnosis made histologically or radiographically in accordance to National Comprehensive Cancer Network guidelines (3.2019 version or higher)
  • Does not qualify for surgical resection or locoregional therapy alone or has disease that has progressed after surgical resection and/or locoregional therapy
  • Has measurable disease defined as at least one tumor lesion that can be accurately measured according to Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 on CT/MRI completed within past 6 weeks of eligibility screening
  • Under the care of a licensed medical oncologist
  • Life expectancy \> 6 months
  • Deemed eligible for treatment with an immune checkpoint inhibitor agent based on the treating medical oncologist's assessment of previous treatment failure, clinical/performance/virology status, and liver/renal/hematologic function.
  • Child-Pugh score of 9 or less
  • Creatinine clearance ≥ 40 mL/min, measured or calculated using the Cockcroft-Gault formula
  • ALT and AST ≤7x upper limit of normal
  • Total bilirubin ≤4 mg/dL
  • Albumin ≥2.8 g/dL

You may not qualify if:

  • Weight \> 500 lbs (PET/CT limit)
  • Pregnant or lactating female (those of child-bearing potential must be re-screened within 7 days prior to PET/CT imaging)
  • Serious underlying medical condition that would impair patient's ability to tolerate the imaging procedure
  • Concurrent treatment with a non-targeted therapeutic agent. Concurrent enrollment in an ICI-treatment trial and combination ICI treatment are allowed.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

The Queen's Medical Center

Honolulu, Hawaii, 96813, United States

RECRUITING

MeSH Terms

Conditions

Carcinoma, HepatocellularDisease

Interventions

fluorocholine

Condition Hierarchy (Ancestors)

AdenocarcinomaCarcinomaNeoplasms, Glandular and EpithelialNeoplasms by Histologic TypeNeoplasmsLiver NeoplasmsDigestive System NeoplasmsNeoplasms by SiteDigestive System DiseasesLiver DiseasesPathologic ProcessesPathological Conditions, Signs and Symptoms

Study Officials

  • Sandi A Kwee, MD, PhD

    The Queen's Medical Center

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Abrar M Al-Adhmi, BS

CONTACT

Tim Kelleher, RN

CONTACT

Study Design

Study Type
interventional
Phase
phase 2
Allocation
NA
Masking
NONE
Purpose
OTHER
Intervention Model
SINGLE GROUP
Model Details: prospective open-label single-arm diagnostic clinical trial
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Program Director, PET Research

Study Record Dates

First Submitted

July 7, 2021

First Posted

July 16, 2021

Study Start

March 28, 2022

Primary Completion (Estimated)

December 31, 2027

Study Completion (Estimated)

June 30, 2028

Last Updated

May 1, 2025

Record last verified: 2025-04

Data Sharing

IPD Sharing
Will share

Limited de-identified genomic and phenotypic individual participant data will be made available after the end of the trial via the NIH database of genotypes and phenotypes (dbGaP) in accordance with the NIH Genomic Data Sharing Policy. The individual level data made available by dbGaP is safeguarded by a process of controlled-access with data use limitations to be determined.

Shared Documents
ICF
Time Frame
Starting 6 months after last publication at conclusion of the trial.
Access Criteria
Controlled-Access. Contact NIH dbGaP for more information.
More information

Locations