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Evaluation of PET Probe [68Ga]CBP8 in the Detection of Radiation Induced Tissue Injury

Primary Purpose

Lung Cancer, Radiation Fibrosis, Radiation Induced Lung Injury

Status
Recruiting
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
[68Ga]CBP8
Sponsored by
Massachusetts General Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional diagnostic trial for Lung Cancer focused on measuring fibrosis, positron emission tomography

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria for lung cancer subjects:

  • Eligible patients will be those harboring locally advanced clinical stage I-III NSCLC who are not eligible for surgical resection, or those with stage IIIa NSCLC who are deemed candidates for multi-modality therapy, i.e. concurrent chemotherapy and radiation followed by pulmonary resection.
  • Age greater than 18 years
  • Have the ability to give written informed consent.
  • No tobacco use within the prior 6 months.

Inclusion Criteria for pancreatic cancer subjects:

  • Age ≥ 18 years.
  • Life expectancy of greater than 3 months.
  • Ability to understand and the willingness to sign a written informed consent document.
  • Histologically or cytologically confirmed diagnosis of PDAC.
  • Tumor should be confirmed with imaging based on the standard-of-care baseline abdominal CT performed within 1 month before study visit 1.
  • Core samples for initial diagnosis must be available at the Department of Pathology at Massachusetts General Hospital.
  • Participants with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational imaging and standard treatment regimen are eligible for this trial.
  • Scheduled study visit 1 within 1 month prior to starting neoadjuvant chemoradiotherapy (CRT)
  • Subjects undergo neoadjuvant chemotherapy followed by radiotherapy (CRT) as part of their standard clinical care and based on institutional standards.
  • Scheduled surgical pancreas resection within 1 month after post-CRT study visit.
  • Subjects are required to undergo pre-surgical CT of abdomen within 1 month after completion of standard neoadjuvant CRT as part of routine clinical work-up.

Exclusion Criteria for lung cancer subjects:

  • Electrical implants such as cardiac pacemaker or perfusion pump
  • Ferromagnetic implants such as aneurysm clips, surgical clips, prostheses, artificial hearts, valves with steel parts, metal fragments, shrapnel, metallic tattoos anywhere on the body, tattoos near the eye, or steel implants ferromagnetic objects such as jewelry or metal clips in clothing;
  • Pregnant or breastfeeding (a negative quantitative serum hCG pregnancy test is required for females having child-bearing potential before the subject can participate);
  • Claustrophobic reactions;
  • Research-related radiation exposure exceeds current Radiology Department guidelines (i.e. 50 mSv in the prior 12 months);
  • Unable to lie comfortably on a bed inside the MR-PET;
  • Body weight of > 300 lbs (weight limit of the MRI table);
  • Determined by the investigator(s) to be clinically unsuitable for the study (e.g. based on screening visit and/or during study procedures);
  • Known history of pulmonary disease (Except lung cancer or smoking related lung disease,)
  • Pneumonia or other acute respiratory illness within 6 weeks of study entry, pneumonia defined with elevated WBC, fever, infiltrate on CXR and need for antibiotics

Exclusion Criteria for pancreatic cancer subjects:

  • History of radiotherapy to the upper abdomen in the past.
  • History of reaction to MRI contrast (Gadoterate meglumine)
  • Clinical or imaging diagnosis of acute pancreatitis within 6 weeks prior to study visit
  • Participants with uncontrolled intercurrent illness or if determined by the investigator(s) to be clinically unsuitable for the study (e.g. based on screening and/or during study).
  • Participants with psychiatric illness/social situations that would limit compliance with study requirements.
  • Electrical implants such as cardiac pacemaker or perfusion pump;
  • Ferromagnetic implants such as aneurysm clips, surgical clips, prostheses, artificial hearts, valves with steel parts, metal fragments, shrapnel, metallic tattoos anywhere on the body, tattoos near the eye, or steel implants ferromagnetic objects such as jewelry or metal clips in clothing;
  • eGFR of less than 30 mL/min/1.73 m2 within the past 90 days;
  • Pregnant or breastfeeding (a negative quantitative serum hCG pregnancy test is required for females having child-bearing potential at each PET/MRI study visit;
  • Claustrophobic reactions;
  • Research-related radiation exposure exceeds current Radiology Department guidelines (i.e. 50 mSv in the prior 12 months);
  • Unable to lie comfortably on a bed inside the MR-PET;
  • BMI > 33 (limit of the PET-MRI table)

Sites / Locations

  • Massachusetts General HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Lung Cancer or Pancreatic Cancer Subjects Undergoing Radiation Therapy

Arm Description

Lung cancer or pancreatic cancer patients will receive [68Ga]CBP8 and undergo PET imaging 1) prior to radiation therapy and 2) 3-6 months after radiation therapy

Outcomes

Primary Outcome Measures

Ability of [68Ga]CBP8 to detect collagen deposition in areas of radiation injury.
Probe uptake will be measured in lung cancer or pancreatic cancer patients 1) prior to radiation therapy and 2) 3-6 months after radiation therapy. We expect [68Ga]CBP8 signal to be increased in post radiation measurements over pre-radiation measurements in areas of irradiated tissue. Furthermore we expect that these areas will go on to develop radiation fibrosis.

Secondary Outcome Measures

Full Information

First Posted
July 21, 2020
Last Updated
April 30, 2023
Sponsor
Massachusetts General Hospital
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT04485286
Brief Title
Evaluation of PET Probe [68Ga]CBP8 in the Detection of Radiation Induced Tissue Injury
Official Title
Evaluation of PET Probe [68Ga]CBP8 in the Detection of Radiation Induced Tissue Injury
Study Type
Interventional

2. Study Status

Record Verification Date
April 2023
Overall Recruitment Status
Recruiting
Study Start Date
July 19, 2020 (Actual)
Primary Completion Date
May 2027 (Anticipated)
Study Completion Date
July 2027 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Massachusetts General Hospital
Collaborators
National Cancer Institute (NCI)

4. Oversight

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

5. Study Description

Brief Summary
The goal of this study is to investigate the efficacy of [68Ga]CBP8 to detect collagen deposition in radiation induced tissue injury.
Detailed Description
Detailed Description: The investigators have developed [68Ga]CBP8, a gallium-68 labeled collagen binding PET imaging probe, which selectively binds collagen type I. Collagen deposition is a pivotal event in several human conditions including radiation induced lung injury and in response to radiation therapy in pancreatic cancer. The investigator's studies in murine models of lung injury including radiation induced lung injury showed that [68Ga]CBP8 binds collagen with high affinity and has excellent pharmacological and pharmacokinetic profiles with high target uptake and low retention in background tissues and organs. [68Ga]CBP8 was shown in a mouse model to be effective for detecting lung fibrosis. [68Ga]CBP8 showed high specificity for pulmonary fibrosis and high target:background ratios in diseased animals. In addition, [68Ga]CBP8 could be used to monitor response to treatment. Ex vivo analysis of lung tissue from patients with idiopathic pulmonary fibrosis (IPF) supported the animal findings. The investigators have conducted preliminary studies in humans with IPF and demonstrated a significant increase in [68Ga]CBP8 signal in subjects with IPF vs healthy controls. The investigators thus aim to evaluate [68Ga]CBP8 in human subjects with radiation induced lung injury and in patients undergoing radiation therapy for pancreatic cancer: To establish the ability of [68Ga]CBP8-PET to detect radiation-induced fibrosis in lung or pancreatic cancer patients through the course of disease development with repeated measures, and correlate signal with standard measures of radiation induced tissue injury such as HRCT or MRI.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Lung Cancer, Radiation Fibrosis, Radiation Induced Lung Injury, Pancreas Cancer
Keywords
fibrosis, positron emission tomography

7. Study Design

Primary Purpose
Diagnostic
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Model Description
Eligible subjects planning on receiving radiation for lung cancer or pancreatic cancer will be enrolled to undergo imaging with the PET Probe [68Ga]CBP8.
Masking
None (Open Label)
Allocation
N/A
Enrollment
72 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Lung Cancer or Pancreatic Cancer Subjects Undergoing Radiation Therapy
Arm Type
Experimental
Arm Description
Lung cancer or pancreatic cancer patients will receive [68Ga]CBP8 and undergo PET imaging 1) prior to radiation therapy and 2) 3-6 months after radiation therapy
Intervention Type
Drug
Intervention Name(s)
[68Ga]CBP8
Intervention Description
Up to 15 mCi of [68Ga]CBP8 will be administered to each subject. Each subject will undergo baseline imaging prior to radiation and again 3-6 months after radiation therapy.
Primary Outcome Measure Information:
Title
Ability of [68Ga]CBP8 to detect collagen deposition in areas of radiation injury.
Description
Probe uptake will be measured in lung cancer or pancreatic cancer patients 1) prior to radiation therapy and 2) 3-6 months after radiation therapy. We expect [68Ga]CBP8 signal to be increased in post radiation measurements over pre-radiation measurements in areas of irradiated tissue. Furthermore we expect that these areas will go on to develop radiation fibrosis.
Time Frame
3-6 Months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria for lung cancer subjects: Eligible patients will be those harboring locally advanced clinical stage I-III NSCLC who are not eligible for surgical resection, or those with stage IIIa NSCLC who are deemed candidates for multi-modality therapy, i.e. concurrent chemotherapy and radiation followed by pulmonary resection. Age greater than 18 years Have the ability to give written informed consent. No tobacco use within the prior 6 months. Inclusion Criteria for pancreatic cancer subjects: Age ≥ 18 years. Life expectancy of greater than 3 months. Ability to understand and the willingness to sign a written informed consent document. Histologically or cytologically confirmed diagnosis of PDAC. Tumor should be confirmed with imaging based on the standard-of-care baseline abdominal CT performed within 1 month before study visit 1. Core samples for initial diagnosis must be available at the Department of Pathology at Massachusetts General Hospital. Participants with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational imaging and standard treatment regimen are eligible for this trial. Scheduled study visit 1 within 1 month prior to starting neoadjuvant chemoradiotherapy (CRT) Subjects undergo neoadjuvant chemotherapy followed by radiotherapy (CRT) as part of their standard clinical care and based on institutional standards. Scheduled surgical pancreas resection within 1 month after post-CRT study visit. Subjects are required to undergo pre-surgical CT of abdomen within 1 month after completion of standard neoadjuvant CRT as part of routine clinical work-up. Exclusion Criteria for lung cancer subjects: Electrical implants such as cardiac pacemaker or perfusion pump Ferromagnetic implants such as aneurysm clips, surgical clips, prostheses, artificial hearts, valves with steel parts, metal fragments, shrapnel, metallic tattoos anywhere on the body, tattoos near the eye, or steel implants ferromagnetic objects such as jewelry or metal clips in clothing; Pregnant or breastfeeding (a negative quantitative serum hCG pregnancy test is required for females having child-bearing potential before the subject can participate); Claustrophobic reactions; Research-related radiation exposure exceeds current Radiology Department guidelines (i.e. 50 mSv in the prior 12 months); Unable to lie comfortably on a bed inside the MR-PET; Body weight of > 300 lbs (weight limit of the MRI table); Determined by the investigator(s) to be clinically unsuitable for the study (e.g. based on screening visit and/or during study procedures); Known history of pulmonary disease (Except lung cancer or smoking related lung disease,) Pneumonia or other acute respiratory illness within 6 weeks of study entry, pneumonia defined with elevated WBC, fever, infiltrate on CXR and need for antibiotics Exclusion Criteria for pancreatic cancer subjects: History of radiotherapy to the upper abdomen in the past. History of reaction to MRI contrast (Gadoterate meglumine) Clinical or imaging diagnosis of acute pancreatitis within 6 weeks prior to study visit Participants with uncontrolled intercurrent illness or if determined by the investigator(s) to be clinically unsuitable for the study (e.g. based on screening and/or during study). Participants with psychiatric illness/social situations that would limit compliance with study requirements. Electrical implants such as cardiac pacemaker or perfusion pump; Ferromagnetic implants such as aneurysm clips, surgical clips, prostheses, artificial hearts, valves with steel parts, metal fragments, shrapnel, metallic tattoos anywhere on the body, tattoos near the eye, or steel implants ferromagnetic objects such as jewelry or metal clips in clothing; eGFR of less than 30 mL/min/1.73 m2 within the past 90 days; Pregnant or breastfeeding (a negative quantitative serum hCG pregnancy test is required for females having child-bearing potential at each PET/MRI study visit; Claustrophobic reactions; Research-related radiation exposure exceeds current Radiology Department guidelines (i.e. 50 mSv in the prior 12 months); Unable to lie comfortably on a bed inside the MR-PET; BMI > 33 (limit of the PET-MRI table)
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Michael Lanuti, MD
Phone
6176430193
Email
mlanuti@mgh.harvard.edu
First Name & Middle Initial & Last Name or Official Title & Degree
Shadi Esfahani, MD
Email
AbdarEsfahani.Shadi@mgh.harvard.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Michael Lanuti, MD
Organizational Affiliation
Massachusetts General Hospital
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Shadi Esfahani, MD
Organizational Affiliation
Massachusetts General Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Michael Lanuti, MD
Phone
617-726-6751
Email
MLANUTI@mgh.harvard.edu
First Name & Middle Initial & Last Name & Degree
Eric Abston, MD
Phone
920-286-3773
Email
EABSTON@mgh.harvard.edu
First Name & Middle Initial & Last Name & Degree
Michael Lanuti, MD

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
31161770
Citation
Montesi SB, Izquierdo-Garcia D, Desogere P, Abston E, Liang LL, Digumarthy S, Seethamraju R, Lanuti M, Caravan P, Catana C. Type I Collagen-targeted Positron Emission Tomography Imaging in Idiopathic Pulmonary Fibrosis: First-in-Human Studies. Am J Respir Crit Care Med. 2019 Jul 15;200(2):258-261. doi: 10.1164/rccm.201903-0503LE. No abstract available.
Results Reference
background
PubMed Identifier
28611243
Citation
Desogere P, Tapias LF, Rietz TA, Rotile N, Blasi F, Day H, Elliott J, Fuchs BC, Lanuti M, Caravan P. Optimization of a Collagen-Targeted PET Probe for Molecular Imaging of Pulmonary Fibrosis. J Nucl Med. 2017 Dec;58(12):1991-1996. doi: 10.2967/jnumed.117.193532. Epub 2017 Jun 13.
Results Reference
background
PubMed Identifier
28381537
Citation
Desogere P, Tapias LF, Hariri LP, Rotile NJ, Rietz TA, Probst CK, Blasi F, Day H, Mino-Kenudson M, Weinreb P, Violette SM, Fuchs BC, Tager AM, Lanuti M, Caravan P. Type I collagen-targeted PET probe for pulmonary fibrosis detection and staging in preclinical models. Sci Transl Med. 2017 Apr 5;9(384):eaaf4696. doi: 10.1126/scitranslmed.aaf4696.
Results Reference
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Evaluation of PET Probe [68Ga]CBP8 in the Detection of Radiation Induced Tissue Injury

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