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Diagnostic Accuracy and Safety Study of FES PET/CT in Assessment of ER Status of Recurrent or Metastatic Breast Cancer

Primary Purpose

Recurrent Breast Cancer, Stage IV Breast Cancer

Status
Completed
Phase
Phase 3
Locations
Korea, Republic of
Study Type
Interventional
Intervention
[18F]fluoroestradiol (FES)
Sponsored by
Asan Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional diagnostic trial for Recurrent Breast Cancer focused on measuring Fluoroestradiol (FES), PET/CT scan, Estrogen Receptor, Recurrent breast cancer, Stage IV breast cancer

Eligibility Criteria

19 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • A patient will be enrolled if the patient meets the following inclusion criteria

    1. Patient is ≥19 years of age and male or female of any race/ethnicity
    2. Patients has first recurrence or stage IV disease by American Joint Committee on Cancer tumor-node-metastasis staging system for breast cancer
    3. Patients had histologically confirmed invasive primary breast carcinoma and the documented results of histology are available.
    4. Patients are scheduled to undergo core needle biopsy or surgery for histological confirmation and determination of ER status of recurrent or distant metastatic cancer within 15 days after [18F]FES PET; or patients already underwent core needle biopsy of recurrent or distant metastatic cancer within 30 days before [18F]FES PET and biopsy specimens are available for determination of ER status.
    5. Discontinuation of selective ER blocking agents including tamoxifen or fulvestrant for at least 60 days prior to [18F]FES PET
    6. Eastern Cooperative Oncology Group (ECOG) performance status of ≤2

Exclusion Criteria:

  • A patient will be excluded from this study if the patient does not full fulfill the inclusion criteria, or if any of the following conditions are observed

    1. Patient or patient's legally acceptable representative do not provide written informed consent
    2. The recurrent or metastatic lesion scheduled to undergo biopsy is located in breast, liver, ovary, uterus, or bone
    3. Female patient is pregnant or nursing. Exclusion of the possibility of pregnancy is made by one of the following: 1) woman is physiologically post menopausal (cessation of menses for more than 2 years), 2) woman is surgically sterile (has had a documented bilateral oophorectomy and/or documented hysterectomy, or 3) if the woman is of childbearing potential, a urine pregnancy test performed within 24 hours immediately prior to administration of [18F]FES has to be negative and the women is advised to apply contraceptive measures during her participation in this study
    4. Adjuvant chemotherapy within 3 weeks prior to [18F]FES PET.
    5. Radiation therapy or immuno/biologic therapy is scheduled to be given to patient before the histologic confirmation by biopsy or [18F]FES PET.
    6. Concurrent severe and/or uncontrolled and/or unstable medical disease other than cancer (e.g. congestive heart failure, acute myocardial infarction, severe pulmonary disease, chronic renal or hepatic disease which could compromise participation in the study) in the judgment of the investigator.
    7. Patient is a relative of the investigator, student of the investigator or otherwise dependent
    8. Patient has any other condition or personal circumstances that, in the judgment of the investigator, might interfere with the collection of complete data
    9. Patient has been involved in an investigative, radioactive research procedure within 7 days prior to registration

Sites / Locations

  • Asan Medical Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

[18F]fluoroestradiol (FES)

Arm Description

The injectable radioactive dose of 111-222 megabecquerel. One single IV injection over 1-2 min. [18F]FES PET/CT for imaging.

Outcomes

Primary Outcome Measures

lesion-level positive and negative percent agreement between qualitative [18F]FES PET interpretation and reference IHC testing

Secondary Outcome Measures

Full Information

First Posted
November 12, 2013
Last Updated
December 7, 2016
Sponsor
Asan Medical Center
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1. Study Identification

Unique Protocol Identification Number
NCT01986569
Brief Title
Diagnostic Accuracy and Safety Study of FES PET/CT in Assessment of ER Status of Recurrent or Metastatic Breast Cancer
Official Title
A Phase III, Open Label, Non-randomized, Single Center Study to Evaluate Diagnostic Accuracy and Safety of Fluorine-18 (18F) Fluoroestradiol PET/CT in the Assessment of ER Status of Recurrent or Metastatic Lesions in Patients With Breast Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
December 2016
Overall Recruitment Status
Completed
Study Start Date
November 2013 (undefined)
Primary Completion Date
November 2016 (Actual)
Study Completion Date
November 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Asan Medical Center

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The standard diagnostic workup for recurrent or metastatic breast cancer includes biopsy and determination of tumor estrogen status according to National Comprehensive Cancer Network and European Society for Medical Oncology. Immunohistochemistry (IHC) is currently the most commonly used method for determining ER status. A investigational imaging tracer named 16-alpha-[18F]-fluoro-17-beta-estradiol, or [18F]fluoroestradiol ([18F]FES) acts similarly in vivo to estradiol and binds to estrogen receptors (ERs). Previous studies in human have shown the efficacy of [18F]FES PET in detecting ER positive breast cancer without any observed toxicity. The investigators hypothesized that [18F]FES PET imaging can noninvasively assess ER status in recurrent or metastatic breast cancer lesion . In this study, a positive and negative percent agreement between IHC and [18F]FES will be determined.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Recurrent Breast Cancer, Stage IV Breast Cancer
Keywords
Fluoroestradiol (FES), PET/CT scan, Estrogen Receptor, Recurrent breast cancer, Stage IV breast cancer

7. Study Design

Primary Purpose
Diagnostic
Study Phase
Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
93 (Actual)

8. Arms, Groups, and Interventions

Arm Title
[18F]fluoroestradiol (FES)
Arm Type
Experimental
Arm Description
The injectable radioactive dose of 111-222 megabecquerel. One single IV injection over 1-2 min. [18F]FES PET/CT for imaging.
Intervention Type
Drug
Intervention Name(s)
[18F]fluoroestradiol (FES)
Intervention Description
[18F]FES PET/CT will be performed 90 min (± 10 min) after administration of [18F]FES. Patients will undergo core needle biopsy or surgery within 15 days after [18F]FES PET; or patients will undergo core needle biopsy within 30 days before [18F]FES PET. Experienced pathologists will determine metastatic/recurrent disease, and tumor histology including IHC. Patient will undergo surgery, radiation therapy or systemic therapy according to the results of staging workup, histology and biomarkers.
Primary Outcome Measure Information:
Title
lesion-level positive and negative percent agreement between qualitative [18F]FES PET interpretation and reference IHC testing
Time Frame
up to 3 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
19 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: A patient will be enrolled if the patient meets the following inclusion criteria Patient is ≥19 years of age and male or female of any race/ethnicity Patients has first recurrence or stage IV disease by American Joint Committee on Cancer tumor-node-metastasis staging system for breast cancer Patients had histologically confirmed invasive primary breast carcinoma and the documented results of histology are available. Patients are scheduled to undergo core needle biopsy or surgery for histological confirmation and determination of ER status of recurrent or distant metastatic cancer within 15 days after [18F]FES PET; or patients already underwent core needle biopsy of recurrent or distant metastatic cancer within 30 days before [18F]FES PET and biopsy specimens are available for determination of ER status. Discontinuation of selective ER blocking agents including tamoxifen or fulvestrant for at least 60 days prior to [18F]FES PET Eastern Cooperative Oncology Group (ECOG) performance status of ≤2 Exclusion Criteria: A patient will be excluded from this study if the patient does not full fulfill the inclusion criteria, or if any of the following conditions are observed Patient or patient's legally acceptable representative do not provide written informed consent The recurrent or metastatic lesion scheduled to undergo biopsy is located in breast, liver, ovary, uterus, or bone Female patient is pregnant or nursing. Exclusion of the possibility of pregnancy is made by one of the following: 1) woman is physiologically post menopausal (cessation of menses for more than 2 years), 2) woman is surgically sterile (has had a documented bilateral oophorectomy and/or documented hysterectomy, or 3) if the woman is of childbearing potential, a urine pregnancy test performed within 24 hours immediately prior to administration of [18F]FES has to be negative and the women is advised to apply contraceptive measures during her participation in this study Adjuvant chemotherapy within 3 weeks prior to [18F]FES PET. Radiation therapy or immuno/biologic therapy is scheduled to be given to patient before the histologic confirmation by biopsy or [18F]FES PET. Concurrent severe and/or uncontrolled and/or unstable medical disease other than cancer (e.g. congestive heart failure, acute myocardial infarction, severe pulmonary disease, chronic renal or hepatic disease which could compromise participation in the study) in the judgment of the investigator. Patient is a relative of the investigator, student of the investigator or otherwise dependent Patient has any other condition or personal circumstances that, in the judgment of the investigator, might interfere with the collection of complete data Patient has been involved in an investigative, radioactive research procedure within 7 days prior to registration
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Dae Hyuk Moon, MD. PhD
Organizational Affiliation
Asan Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Asan Medical Center
City
Seoul
ZIP/Postal Code
138-736
Country
Korea, Republic of

12. IPD Sharing Statement

Citations:
PubMed Identifier
30846327
Citation
Chae SY, Ahn SH, Kim SB, Han S, Lee SH, Oh SJ, Lee SJ, Kim HJ, Ko BS, Lee JW, Son BH, Kim J, Ahn JH, Jung KH, Kim JE, Kim SY, Choi WJ, Shin HJ, Gong G, Lee HS, Lee JB, Moon DH. Diagnostic accuracy and safety of 16alpha-[18F]fluoro-17beta-oestradiol PET-CT for the assessment of oestrogen receptor status in recurrent or metastatic lesions in patients with breast cancer: a prospective cohort study. Lancet Oncol. 2019 Apr;20(4):546-555. doi: 10.1016/S1470-2045(18)30936-7. Epub 2019 Mar 4.
Results Reference
derived
Links:
URL
http://ghr.nlm.nih.gov/condition/breast-cancer
Description
Genetics Home Reference related topics; breast cancer
URL
http://www.nlm.nih.gov/medlineplus/breastcancer.html
Description
MedlinePlus related topics; Breast cancer

Learn more about this trial

Diagnostic Accuracy and Safety Study of FES PET/CT in Assessment of ER Status of Recurrent or Metastatic Breast Cancer

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