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PET-CT in Determining the Radioembolization Dose Delivered to Patients With Liver Metastasis, Primary Liver Cancer, or Biliary Cancer

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ClinicalTrials.gov Identifier: NCT02088775
Recruitment Status : Active, not recruiting
First Posted : March 17, 2014
Last Update Posted : October 8, 2020
Sponsor:
Information provided by (Responsible Party):
Fox Chase Cancer Center

Study Description
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Brief Summary:
This clinical trial studies positron emission tomography (PET)-computed tomography (CT) in determining the radiation dose delivered with radioactive spheres to patients with liver metastasis or primary liver or biliary cancer. Comparing results of diagnostic procedures dose before and after delivery of radioactive spheres to the liver may help determine radioembolization dose and plan the best treatment for liver metastasis or primary liver or biliary cancer.

Condition or disease Intervention/treatment Phase
Adult Primary Hepatocellular Carcinoma Advanced Adult Primary Liver Cancer Metastatic Extrahepatic Bile Duct Cancer Recurrent Adult Primary Liver Cancer Recurrent Extrahepatic Bile Duct Cancer Stage D Adult Primary Liver Cancer (BCLC) Unspecified Adult Solid Tumor, Protocol Specific Procedure: PET scan Procedure: CT Scan Procedure: hepatic artery embolization Not Applicable

Detailed Description:

PRIMARY OBJECTIVES:

I. To determine the relationship between radiation dose to 70% of the tumor volume as determined by post-treatment positron emission tomography (PET)-computed tomography (CT) and local control at 6 months.

SECONDARY OBJECTIVES:

I. To evaluate the ability of PET-CT to reproducibly determine dose to tumor, normal liver, and other surrounding organs.

II. To determine the stability of microsphere location by examining the changes in dose in a subset of patients with PET-CT scans performed on day 0 and day 1.

III. To determine the relationship of dose predicted by technetium-99m (Tc-99m) labeled Macro-aggregated albumin (MAA) imaged using single-photon emission computed tomography (SPECT) versus post-treatment dosimetry.

IV. To determine the effect of dose delivered on local control and normal tissue complications.

V. To measure the perfusion of the tumor for correlation with dose deposition, based on arterial phase CT measurements.

OUTLINE:

Patients undergo PET-CT scan before and after standard radioembolization on day 0. A subset of patients undergo PET-CT scan on day 1, 24 hours after the day 0 post-treatment PET-CT.

After completion of study treatment, patients are followed up at 1 week, 1 and 3 months, every 3 months for 1 year, every 6 months for 1 year and then annually for 3 years.

Study Design
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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 43 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Diagnostic
Official Title: Intrinsic Dosimetry for Radioembolization Utilizing PET-CT Imaging Data: A Prospective Registry Study
Actual Study Start Date : February 2014
Actual Primary Completion Date : August 8, 2016
Estimated Study Completion Date : December 2020

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Arms and Interventions
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Arm Intervention/treatment
Experimental: Diagnostic: PET scan - CT scan
Patients undergo PET-CT scan before and after standard radioembolization on day 0. A subset of patients undergo PET-CT scan on day 1, 24 hours after the day 0 post-treatment PET-CT.
 Procedure: PET scan
Undergo PET-CT scan
Other Name: FDG-PET, positron emission tomography, emission computed

Procedure: CT Scan
Undergo PET-CT scan
Other Name: computed tomography, computed

Procedure: hepatic artery embolization
Undergo standard radioembolization


Outcome Measures
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Primary Outcome Measures :
  1. Radiation dose to 70% of the tumor volume, evaluated using PET-CT [ Time Frame: Up to day 1 ]
    Standard summary measures such as means, medians, ranges, and standard deviations will be used to characterize the dosages received by tumor and other tissue. The relationship between radiation dose and local control will be determined using regression models with Generalized Estimating Equations (GEE) to account for within-patient correlation. Logistic regression will be used to adjust for potentially confounding factors such as tumor volume, primary histology, and SIR-Spheres versus Therasphere intervention.

  2. Local control [ Time Frame: At 6 months ]
    The relationship between radiation dose and local control will be determined using regression models with GEE to account for within-patient correlation.


Secondary Outcome Measures :
  1. Ability of PET-CT to reproducibly determine dose to tumor, normal liver, and other surrounding organs [ Time Frame: Up to day 1 ]
    Standard summary measures such as means, medians, ranges, and standard deviations will be used to characterize the dosages received by tumor and other tissue.

  2. Side effects of radiation dose to healthy tissue such as fatigue, nausea, pain, and elevated liver function tests [ Time Frame: Up to 5 years ]
    Each side effect will be characterized as present or absent. The relationship between radiation dose to the relevant type of healthy tissue and each side effect will be tested.

  3. Distribution of activity measured by PET-CT [ Time Frame: Up to day 1 ]
    Differences between PET-CT and MAA doses, and present the data graphically will be calculated and presented graphically. The method proposed by Bland & Altman (2007) will be used to assess the agreement between the two methods.

  4. Distribution predicted by T-99m labeled MAA [ Time Frame: Baseline ]
    Differences between PET-CT and MAA doses, and present the data graphically will be calculated and presented graphically. The method proposed by Bland & Altman (2007) will be used to assess the agreement between the two methods.

  5. Change in dose measured by PET-CT scan [ Time Frame: Day 0 to day 1 ]

Eligibility Criteria
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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patients must have liver-dominant or liver-only metastatic disease from any primary histology; patients with primary hepatocellular or biliary cancer are also eligible
  • Patients must be clinical candidates for radioembolization with either SIR-spheres or TheraSphere due to metastatic or primary malignancies of the liver
  • Women of child bearing potential must have a negative serum pregnancy test no more than 72 hours prior to registration
  • Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0, 1 or 2
  • Ability to understand and willingness to sign a written informed consent and Health Insurance Portability and Accountability Act (HIPAA) authorization for release of medical information
  • Complete blood count (CBC) and chemistry panel (CMP) no greater than 4 weeks prior to visit 1
  • Diagnostic imaging of the abdomen utilizing either CT with contrast, magnetic resonance imaging (MRI), or PET/CT no greater than 4 weeks prior to visit 1

Exclusion Criteria:

  • Patients not undergoing radioembolization to the liver
  • Women of childbearing potential (WOCBP) and men who refuse to comply with appropriate contraception
  • Women who are either pregnant or breast feeding
Contacts and Locations
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Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02088775


Locations
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United States, Pennsylvania
Fox Chase Cancer Center
Philadelphia, Pennsylvania, United States, 19111
Sponsors and Collaborators
Fox Chase Cancer Center
Investigators
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Principal Investigator: Joshua Meyer, MD Fox Chase Cancer Center
More Information
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Responsible Party: Fox Chase Cancer Center
ClinicalTrials.gov Identifier: NCT02088775    
Other Study ID Numbers: ERP-RT-060
IRB#13-030 ( Other Identifier: Fox Chase Cancer Center )
First Posted: March 17, 2014    Key Record Dates
Last Update Posted: October 8, 2020
Last Verified: October 2020
Additional relevant MeSH terms:
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Carcinoma, Hepatocellular
Liver Neoplasms
Bile Duct Neoplasms
Cholangiocarcinoma
Adenocarcinoma
Carcinoma
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
 Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Digestive System Diseases
Liver Diseases
Biliary Tract Neoplasms
Bile Duct Diseases
Biliary Tract Diseases