search
Back to results

[18F]DASA-23 and PET Scan in Evaluating Pyruvate Kinase M2 Expression in Patients With Intracranial Tumors or Recurrent Glioblastoma and Healthy Volunteers

Primary Purpose

Healthy Subject, Intracranial Neoplasm, Glioblastoma

Status
Active
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Fluorine F 18 DASA-23
Positron Emission Tomography
Sponsored by
Guido A. Davidzon, MD, SM
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional diagnostic trial for Healthy Subject

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

Age ≥18 years old.

2. Adequate organ function (obtained within 14 days prior to PET scan [Part 1, Part 2, and Part 3 ONLY] or within 28 days prior to PET scan [Part 4 ONLY]) as evidenced by:

  1. ANC ≥ 1.5 X 10^9/L w/o myeloid growth factor support for 7 d preceding lab assessment
  2. Hgb ≥ 9 g/dL (90 g/L); < 9 g/dL (< 90 g/L) is acceptable if Hgb is corrected to ≥ 9 g/dL (90 g/L) as by growth factor or transfusion prior to PET scan
  3. Platelet count ≥ 100 X 10^9/L w/o blood transfusions for 7 d preceding lab assessment
  4. Bilirubin ≤ 1.5 X ULN except for pts w/ documented history of Gilbert's disease
  5. ALT and AST ≤ 2.5 X ULN
  6. Alkaline phosphatase (AP) ≤ 3 X ULN
  7. Women of childbearing potential (WCBP): negative serum pregnancy test

    3. Ability to stand up and climb two steps with minimal assistance.

    4. Ability to understand and the willingness to sign a written informed consent document.

    5. (Part 2, intracranial tumor patients ONLY) (a) Radiographical or pathological evidence of newly-diagnosed intracranial tumor that is status-pre surgical resection, or (b) Radiographical or pathological evidence of progressive/recurrent intracranial tumor, (c) Question of pseudoprogression vs. true progression on most recent standard-of-care brain MRI, or (d) Evidence on the most recent standard-of-care brain MRI scan of intracranial metastasis/metastases in a patient with known extracranial primary cancer.

    6. (Part 3, GBM patients ONLY) Any patient with at least a 1cm3 contrast-enhancing lesion suspicious for GBM (either newly-diagnosed or 1st /2nd/ 3rd recurrence of GBM, molecular GBM, diffuse astrocytomas with molecular features of GBM, H3K27M midline gliomas, gliosarcomas, or any other WHO Grade IV glioma) on a standard-of-care (SOC) brain MRI scan. If the patient undergoes a biopsy or resection for GBM (either newly-diagnosed or 1st /2nd/ 3rd recurrence of GBM, molecular GBM, diffuse astrocytomas with molecular features of GBM, H3K27M midline gliomas, gliosarcomas, or any other WHO Grade IV glioma) then the remaining contrast-enhancing lesion is at least 1cm3 in size on the post-operative scan.

    7. (Part 3, GBM patients ONLY) Life expectancy of ≥ 6 months.

Exclusion Criteria:

  1. Known allergy to adhesive tapes or other skin adhesives used in medical care
  2. Subjects with the following co-morbid disease or incurrent illness:

    1. With known cirrhosis diagnosed with Child-Pugh Class A or higher liver disease.
    2. Severe/uncontrolled inter-current illness within the previous 28 days prior to PET scan
    3. Patients who have implantable devices that are contra-indicated for MRI
    4. Bleeding disorder
    5. Any other significant co-morbid conditions that in the opinion of the Investigator would impair study participation or cooperation.
    6. (Healthy volunteers ONLY - Part 1 and Part 4) prior or current malignancy
    7. (Healthy volunteers ONLY - Part 1 and Part 4) known kidney disease
  3. Pregnant or nursing participants
  4. History of allergic reactions to gadolinium-based MRI contrast agent
  5. (Part 2, intracranial tumor patients ONLY) Other chemotherapy (besides what is being used to treat the intracranial tumor)
  6. (Part 3, GBM patients ONLY) Has already begun therapy, prior to the first of two [18F]DASA-23 PET/MRI scans.

Sites / Locations

  • Stanford University, School of Medicine

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Active Comparator

Experimental

Experimental

Active Comparator

Arm Label

Group I ([18F]DASA-23, PET)

Group II ([18F]DASA-23, PET)

Group III ([18F]DASA-23, PET)

Group IV ([18F]DASA-23, PET)

Arm Description

Healthy volunteers receive [18F]DASA-23 IV and undergo brain PET scan over 15 minutes and 4 vertex-to-toe PET scans over 30 minutes each.

Intracranial tumor participants receive [18F]DASA-23 IV and undergo brain PET scan over 60 minutes and 1 vertex-to-toe PET scan over 30 minutes.

Patients with at least a 1cm3 contrast-enhancing lesion suspicious for GBM (either newly-diagnosed or 1st /2nd/ 3rd recurrence of GBM) on a standard-of-care (SOC) brain MRI scan. If the patient undergoes a biopsy or resection for GBM (either newly-diagnosed or 1st /2nd/ 3rd recurrence of GBM) then the remaining contrast-enhancing lesion is at least 1cm3 in size on the post-operative scan. These patients will undergo one [18F]DASA 23 PET/MRI scan before the initiation of therapy, and a second/final [18F]DASA 23 PET/MRI scan within 2-6 weeks after initiation of therapy for their GBM.

Healthy volunteers receive [18F]DASA-23 IV and undergo brain PET/MRI brain scan for 60 mins

Outcomes

Primary Outcome Measures

Change in [18F]DASA-23 PET scan signal in patients with suspected recurrent glioblastoma
Response to treatment is based on the response assessment in neuro-oncology (RANO) criteria. Each patient will be dichotomized into responding (yes) or not responding (no) to treatment based on RANO criteria. The [18F]DASA-23 PET scan signal will be calculated according to the European Organization for Research and Treatment of Cancer (EORTC) response criteria guidelines and reported as median and range, both for the entire cohort as well as separately for the responder and non-responder subgroups. The Mann-Whitney test of [18F]DASA-23 PET scan signal between responders and non-responders will be performed.

Secondary Outcome Measures

Sensitivity of [18F]DASA-23 PET imaging in identifying intracranial tumors in patients with intracranial tumors.
Sensitivity will be reported as a percentage with 95% confidence interval.
Specificity of [18F]DASA-23 PET imaging in identifying intracranial tumors in patients with intracranial tumors.
Specificity will be reported as a percentage with 95% confidence interval
Accuracy of [18F]DASA-23 PET imaging in identifying intracranial tumors in patients with intracranial tumors.
Accuracy will be reported as a percentage with 95% confidence interval.
Progression-free survival in patients with suspected recurrent glioblastoma
The percent change in SUV from the pre-treatment [18F]DASA-23 PET scan to the post-treatment [18F]DASA23 PET scan will be calculated. Patients will be divided into two groups based on whether their percent change in SUV is above or below the median. Kaplan-Meier curves for the two groups will be plotted and a log-rank test for difference in progression-free survival will be performed. A Cox proportional-hazards regression of progression-free survival on group will be performed. Progression-free survival will be reported as median survival time, with range.
Overall survival in patients with suspected recurrent glioblastoma
The percent change in SUV from the pre-treatment [18F]DASA-23 PET scan to the post-treatment [18F]DASA23 PET scan will be calculated. Patients will be divided into two groups based on whether their percent change in SUV is above or below the median. Kaplan-Meier curves for the two groups will be plotted and a log-rank test for difference in overall survival will be performed. A Cox proportional-hazards regression of overall survival on group will be performed. Overall survival will be reported as median survival time, with range.

Full Information

First Posted
May 16, 2018
Last Updated
September 23, 2023
Sponsor
Guido A. Davidzon, MD, SM
search

1. Study Identification

Unique Protocol Identification Number
NCT03539731
Brief Title
[18F]DASA-23 and PET Scan in Evaluating Pyruvate Kinase M2 Expression in Patients With Intracranial Tumors or Recurrent Glioblastoma and Healthy Volunteers
Official Title
A Phase I Study of [18F]DASA-23 as a PET Tracer for Evaluating Pyruvate Kinase M2 (PKM2) Expression in Healthy Volunteers and in Patients With Intracranial Tumors
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
April 23, 2018 (Actual)
Primary Completion Date
December 30, 2022 (Actual)
Study Completion Date
December 30, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Guido A. Davidzon, MD, SM

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
This phase I trial studies how well [18F]DASA-23 and positron emission tomography (PET) scan work in evaluating pyruvate kinase M2 (PKM2) expression in patients with intracranial tumors or recurrent glioblastoma and healthy volunteers. PKM2 regulates brain tumor metabolism, a key factor in glioblastoma growth. [18F]DASA-23 is a radioactive substance with the ability to monitor PKM2 activity. A PET scan is a procedure in which a small amount of a radioactive substance, such as [18F]DASA-23, is injected into a vein, and a scanner is used to make detailed, computerized pictures of areas inside the body where the substance is used. Tumor cells usually pick up more of these radioactive substances, allowing them to be found. Giving [18F]DASA-23 with a PET scan may help doctors evaluate PKM2 expression in healthy volunteers and in participants with intracranial tumors or recurrent glioblastoma.
Detailed Description
PRIMARY OBJECTIVES: I. Determine whether the fluorine F 18 DASA-23 ([18F]DASA 23) PET scan signal change from pre-therapy to one week after initiation of therapy can predict the tumor's responsiveness to therapy and 6 month progression free survival (PFS6), in suspected recurrent glioblastoma. SECONDARY OBJECTIVES: I. Determine the sensitivity, specificity, and accuracy of [18F]DASA-23 PET imaging in identifying intracranial tumors in patients with intracranial tumors. II. Determine whether the [18F]DASA-23 PET scan signal change from pre therapy to one week after initiation of therapy can predict progression free survival (PFS) and overall survival (OS), in suspected recurrent glioblastoma. OUTLINE: Participants are assigned to 1 of 4 groups. GROUP I: Healthy volunteers receive [18F]DASA-23 intravenously (IV) and undergo brain PET scan over 15 minutes and 4 vertex-to-toe PET scans over 30 minutes each. GROUP II: Intracranial tumor participants receive [18F]DASA-23 IV and undergo brain PET scan over 60 minutes and 1 vertex-to-toe PET scan over 30 minutes. GROUP III: Subjects with glioblastoma will receive [18F]DASA-23 IV and undergo brain PET scan over 60 minutes and 1 vertex-to-toe PET scan over 30 minutes. 15-minute vertex-to-thigh PET for Part 3 patients, Participants undergo second PET scan 7 days after the initiation of therapy. GROUP IV: Healthy volunteers will undergo the same procedures as the healthy volunteers in Group I with the following exceptions: Group IV healthy volunteers will undergo a 60-minute PET/MRI brain scan instead of a 15-minute PET/MRI brain scan. Group IV healthy volunteers will not undergo any vertex-to-toe PET scans. After completion of study treatment, intracranial tumor and recurrent glioblastoma participants are followed up every 3 months for 12 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Healthy Subject, Intracranial Neoplasm, Glioblastoma

7. Study Design

Primary Purpose
Diagnostic
Study Phase
Phase 1
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
27 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Group I ([18F]DASA-23, PET)
Arm Type
Active Comparator
Arm Description
Healthy volunteers receive [18F]DASA-23 IV and undergo brain PET scan over 15 minutes and 4 vertex-to-toe PET scans over 30 minutes each.
Arm Title
Group II ([18F]DASA-23, PET)
Arm Type
Experimental
Arm Description
Intracranial tumor participants receive [18F]DASA-23 IV and undergo brain PET scan over 60 minutes and 1 vertex-to-toe PET scan over 30 minutes.
Arm Title
Group III ([18F]DASA-23, PET)
Arm Type
Experimental
Arm Description
Patients with at least a 1cm3 contrast-enhancing lesion suspicious for GBM (either newly-diagnosed or 1st /2nd/ 3rd recurrence of GBM) on a standard-of-care (SOC) brain MRI scan. If the patient undergoes a biopsy or resection for GBM (either newly-diagnosed or 1st /2nd/ 3rd recurrence of GBM) then the remaining contrast-enhancing lesion is at least 1cm3 in size on the post-operative scan. These patients will undergo one [18F]DASA 23 PET/MRI scan before the initiation of therapy, and a second/final [18F]DASA 23 PET/MRI scan within 2-6 weeks after initiation of therapy for their GBM.
Arm Title
Group IV ([18F]DASA-23, PET)
Arm Type
Active Comparator
Arm Description
Healthy volunteers receive [18F]DASA-23 IV and undergo brain PET/MRI brain scan for 60 mins
Intervention Type
Drug
Intervention Name(s)
Fluorine F 18 DASA-23
Other Intervention Name(s)
[18F]DASA-23; [18F]DASA23; 18F-DASA-23; 1-((2-Fluoro-6-[18F]fluorophenyl)sulfonyl)-4-((4-methoxyphenyl)sulfonyl)piperazine; F18-labeled Pyruvate Kinase M2 Inhibitor DASA-23; F18-labeled PKM2 Inhibitor
Intervention Description
Given IV
Intervention Type
Procedure
Intervention Name(s)
Positron Emission Tomography
Other Intervention Name(s)
Medical Imaging, Positron Emission Tomography, PET, PET Scan, Positron Emission Tomography Scan, Positron-Emission Tomography, proton magnetic resonance spectroscopic imaging
Intervention Description
Undergo PET scan
Primary Outcome Measure Information:
Title
Change in [18F]DASA-23 PET scan signal in patients with suspected recurrent glioblastoma
Description
Response to treatment is based on the response assessment in neuro-oncology (RANO) criteria. Each patient will be dichotomized into responding (yes) or not responding (no) to treatment based on RANO criteria. The [18F]DASA-23 PET scan signal will be calculated according to the European Organization for Research and Treatment of Cancer (EORTC) response criteria guidelines and reported as median and range, both for the entire cohort as well as separately for the responder and non-responder subgroups. The Mann-Whitney test of [18F]DASA-23 PET scan signal between responders and non-responders will be performed.
Time Frame
From pre-treatment to one week after initiation of treatment
Secondary Outcome Measure Information:
Title
Sensitivity of [18F]DASA-23 PET imaging in identifying intracranial tumors in patients with intracranial tumors.
Description
Sensitivity will be reported as a percentage with 95% confidence interval.
Time Frame
Time of the [18F]DASA-23 PET scan
Title
Specificity of [18F]DASA-23 PET imaging in identifying intracranial tumors in patients with intracranial tumors.
Description
Specificity will be reported as a percentage with 95% confidence interval
Time Frame
Time of the [18F]DASA-23 PET scan
Title
Accuracy of [18F]DASA-23 PET imaging in identifying intracranial tumors in patients with intracranial tumors.
Description
Accuracy will be reported as a percentage with 95% confidence interval.
Time Frame
Time of the [18F]DASA-23 PET scan
Title
Progression-free survival in patients with suspected recurrent glioblastoma
Description
The percent change in SUV from the pre-treatment [18F]DASA-23 PET scan to the post-treatment [18F]DASA23 PET scan will be calculated. Patients will be divided into two groups based on whether their percent change in SUV is above or below the median. Kaplan-Meier curves for the two groups will be plotted and a log-rank test for difference in progression-free survival will be performed. A Cox proportional-hazards regression of progression-free survival on group will be performed. Progression-free survival will be reported as median survival time, with range.
Time Frame
Time from diagnosis up to 1 year
Title
Overall survival in patients with suspected recurrent glioblastoma
Description
The percent change in SUV from the pre-treatment [18F]DASA-23 PET scan to the post-treatment [18F]DASA23 PET scan will be calculated. Patients will be divided into two groups based on whether their percent change in SUV is above or below the median. Kaplan-Meier curves for the two groups will be plotted and a log-rank test for difference in overall survival will be performed. A Cox proportional-hazards regression of overall survival on group will be performed. Overall survival will be reported as median survival time, with range.
Time Frame
From time of initial diagnosis up to 2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Age ≥18 years old. 2. Adequate organ function (obtained within 14 days prior to PET scan [Part 1, Part 2, and Part 3 ONLY] or within 28 days prior to PET scan [Part 4 ONLY]) as evidenced by: ANC ≥ 1.5 X 10^9/L w/o myeloid growth factor support for 7 d preceding lab assessment Hgb ≥ 9 g/dL (90 g/L); < 9 g/dL (< 90 g/L) is acceptable if Hgb is corrected to ≥ 9 g/dL (90 g/L) as by growth factor or transfusion prior to PET scan Platelet count ≥ 100 X 10^9/L w/o blood transfusions for 7 d preceding lab assessment Bilirubin ≤ 1.5 X ULN except for pts w/ documented history of Gilbert's disease ALT and AST ≤ 2.5 X ULN Alkaline phosphatase (AP) ≤ 3 X ULN Women of childbearing potential (WCBP): negative serum pregnancy test 3. Ability to stand up and climb two steps with minimal assistance. 4. Ability to understand and the willingness to sign a written informed consent document. 5. (Part 2, intracranial tumor patients ONLY) (a) Radiographical or pathological evidence of newly-diagnosed intracranial tumor that is status-pre surgical resection, or (b) Radiographical or pathological evidence of progressive/recurrent intracranial tumor, (c) Question of pseudoprogression vs. true progression on most recent standard-of-care brain MRI, or (d) Evidence on the most recent standard-of-care brain MRI scan of intracranial metastasis/metastases in a patient with known extracranial primary cancer. 6. (Part 3, GBM patients ONLY) Any patient with at least a 1cm3 contrast-enhancing lesion suspicious for GBM (either newly-diagnosed or 1st /2nd/ 3rd recurrence of GBM, molecular GBM, diffuse astrocytomas with molecular features of GBM, H3K27M midline gliomas, gliosarcomas, or any other WHO Grade IV glioma) on a standard-of-care (SOC) brain MRI scan. If the patient undergoes a biopsy or resection for GBM (either newly-diagnosed or 1st /2nd/ 3rd recurrence of GBM, molecular GBM, diffuse astrocytomas with molecular features of GBM, H3K27M midline gliomas, gliosarcomas, or any other WHO Grade IV glioma) then the remaining contrast-enhancing lesion is at least 1cm3 in size on the post-operative scan. 7. (Part 3, GBM patients ONLY) Life expectancy of ≥ 6 months. Exclusion Criteria: Known allergy to adhesive tapes or other skin adhesives used in medical care Subjects with the following co-morbid disease or incurrent illness: With known cirrhosis diagnosed with Child-Pugh Class A or higher liver disease. Severe/uncontrolled inter-current illness within the previous 28 days prior to PET scan Patients who have implantable devices that are contra-indicated for MRI Bleeding disorder Any other significant co-morbid conditions that in the opinion of the Investigator would impair study participation or cooperation. (Healthy volunteers ONLY - Part 1 and Part 4) prior or current malignancy (Healthy volunteers ONLY - Part 1 and Part 4) known kidney disease Pregnant or nursing participants History of allergic reactions to gadolinium-based MRI contrast agent (Part 2, intracranial tumor patients ONLY) Other chemotherapy (besides what is being used to treat the intracranial tumor) (Part 3, GBM patients ONLY) Has already begun therapy, prior to the first of two [18F]DASA-23 PET/MRI scans.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Guido A Davidzon, MD
Organizational Affiliation
Stanford Cancer Institute Palo Alto
Official's Role
Principal Investigator
Facility Information:
Facility Name
Stanford University, School of Medicine
City
Palo Alto
State/Province
California
ZIP/Postal Code
94304
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
31938892
Citation
Beinat C, Patel CB, Haywood T, Shen B, Naya L, Gandhi H, Holley D, Khalighi M, Iagaru A, Davidzon G, Gambhir SS. Human biodistribution and radiation dosimetry of [18F]DASA-23, a PET probe targeting pyruvate kinase M2. Eur J Nucl Med Mol Imaging. 2020 Aug;47(9):2123-2130. doi: 10.1007/s00259-020-04687-0. Epub 2020 Jan 15.
Results Reference
derived
PubMed Identifier
30989436
Citation
Beinat C, Patel CB, Xie Y, Gambhir SS. Evaluation of Glycolytic Response to Multiple Classes of Anti-glioblastoma Drugs by Noninvasive Measurement of Pyruvate Kinase M2 Using [18F]DASA-23. Mol Imaging Biol. 2020 Feb;22(1):124-133. doi: 10.1007/s11307-019-01353-2.
Results Reference
derived

Learn more about this trial

[18F]DASA-23 and PET Scan in Evaluating Pyruvate Kinase M2 Expression in Patients With Intracranial Tumors or Recurrent Glioblastoma and Healthy Volunteers

We'll reach out to this number within 24 hrs