IL2 Imaging in Metastatic Melanoma
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|ClinicalTrials.gov Identifier: NCT02922283|
Recruitment Status : Terminated (After an interim analysis of the data, it became clear that the imaging results did not correlate to the primary outcome measures in this subset of patients.)
First Posted : October 4, 2016
Last Update Posted : March 23, 2020
T cell infiltration of tumor lesions is a known prognostic factor in several tumor types and is used as treatment mechanism in some of these tumor types. In metastatic melanoma, treatment with immune checkpoint inhibitors induces clinical benefit in about 30-50% of the patients. These immune-based therapies are however accompanied by serious immune-related adverse events and high costs.
Tumor infiltrating T cells express the high affinity interleukin-2 (IL2) receptor on their surface. These T cells could therefore be visualized by molecular imaging with a radio-labelled ligand for this receptor. For this purpose, the investigators have developed the PET tracer [18F]FB-IL2.
The study commences with a biodistribution study (phase 1) in 5 subjects. Thereafter the main study (phase 2) starts, in which 25 subjects will receive two [18F]FB-IL2 PET scans at baseline and week 6 of treatment with either ipilimumab, nivolumab, pembrolizumab or the combination of ipilimumab and nivolumab. If [18F]FB-IL2 PET is able to detect a response to treatment, it could serve as a non-invasive early indicator of T cell response to the treatment. Besides, accumulation of the PET tracer in non-target tissue could indicate infiltration of activated T cells in normal organs and thus may predict the development of an immune-related adverse event.
|Condition or disease||Intervention/treatment||Phase|
|Melanoma||Device: IL2-PET scan Procedure: Tumor biopsy Device: CT scan Procedure: Biopsy of non-target tissue||Not Applicable|
|Study Type :||Interventional (Clinical Trial)|
|Actual Enrollment :||19 participants|
|Intervention Model:||Single Group Assignment|
|Masking:||None (Open Label)|
|Official Title:||[18F]FB-IL2 Imaging of T Cell Response as Biomarker to Guide Treatment Decisions in Metastatic Melanoma Patients|
|Actual Study Start Date :||October 20, 2016|
|Actual Primary Completion Date :||February 14, 2020|
|Actual Study Completion Date :||February 14, 2020|
Experimental: IL2-PET scan
[18F]FB-IL2 PET scan, Tumor biopsy, CT scan, Biopsy of non-target tissue
Device: IL2-PET scan
All patients in this study will undergo a IL2 PET scan at baseline and week 6 of treatment with immunotherapy.
Other Name: [18F]FB-IL2 PET scan
Procedure: Tumor biopsy
A procedure to acquire tissue of a predetermined melanoma metastasis will be performed in all patients that participate in phase 2 of this study.
Device: CT scan
A CT scan of diagnostic quality will accompany all the PET scans and will additionally been made 12 and 16 weeks after start of immunotherapy to evaluate response to treatment.
Procedure: Biopsy of non-target tissue
A biopsy of skin and colon non-target tissue involved in an immune-related side effect is optional in patients that participate in phase 2 of this study.
- Biodistribution and kinetics of [18F]FB-IL2. [ Time Frame: 2 hours ]Biodistribution and kinetics will be assessed in the first five patients that participate in this trial (phase 1). A 60-minute dynamic PET scan of the chest and 2 total-body PET scans at 60 and 120 minutes will be acquired to determine tracer kinetics and residence time of the tracer in major organs.
- The ability of the [18F]FB-IL2 PET to detect a treatment-induced immune response in tumors. [ Time Frame: 6 weeks ]For detection of a treatment-induced immune response the absolute tracer uptake in tumor lesions will be compared between the scan at baseline and the scan after 6 weeks of treatment with ipilimumab, nivolumab, pembrolizumab or the combination of ipilimumab and nivolumab.
- Correlation between tumor uptake of [18F]FB-IL2 with the number of IL2 receptor positive immune cells. [ Time Frame: 2 days ]The amount of IL2 receptor positive cells will be scored by immunohistochemical staining of tumor biopsy material and will be correlated to the tumor uptake of [18F]FB-IL2.
- Correlation between tumor uptake of [18F]FB-IL2 with response to therapy. [ Time Frame: 16 weeks ]The increase in tumor uptake of [18F]FB-IL2 ofu the tumor lesions on the PET scan at baseline and week 6 of treatment with immunotherapy, will be correlated to radiological response as measured on the CT scans at week 6, 12 and 16 according to the RECIST 1.1 criteria.
- To analyze heterogeneity in immune response to treatment between separate lesions, as determined by [18F]FB-IL2 PET. [ Time Frame: 16 weeks ]Both the heterogeneity between separate lesions in one patient and between lesions in different patients will be determined and if possible will be correlated to treatment response (lesion based).
- Treatment induced immune cell activation in non-target tissues and if possible the correlation of PET observations with side effects related to the tissue involved. [ Time Frame: 16 weeks ]Treatment induced immune cell activation in non-target tissue will be determined by visually comparing the PET results at baseline and after 6 weeks of treatment. In regions with a higher tracer uptake on the week 6 scan the absolute uptake will be determined and this will be correlated to the development of an immune-related adverse event. In case of immune-related side effects localized to the skin or colon, biopsy samples are optional and tissue infiltration of IL2 receptor positive cells can be correlated to [18F]FB-IL2 uptake on PET.
- Adverse events of [18F]FB-IL2 PET. [ Time Frame: 16 weeks ]Adverse events will be recorded. Vital signs and blood parameters will be determined before and after tracer injection and directly after the PET scan for safety reasons.
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): NCT02922283
|University Medical Center Groningen|
|Groningen, Netherlands, 9713 GZ|
|Principal Investigator:||G. A. Hospers, MD, PhD||UMCG|