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Pharmacokinetic and Radiation Dosimetry Study Evaluating 99m TC-EC-DG SPECT/CT in Patients With Non-small Cell Lung Cancer (NSCLC)

Primary Purpose

Non Small Cell Lung Cancer

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Radiolabeled (99Tc) EC-DG (ethylenedicysteine-deoxyglucose)
Technetium 99m ethylenedicysteine-deoxyglucose
18 F fluorodeoxyglucose
Sponsored by
Cell>Point LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional diagnostic trial for Non Small Cell Lung Cancer focused on measuring Non small cell lung cancer, SPECT CT imaging, Pharmacokinetic, Radiation Dosimetry, PET CT comparison

Eligibility Criteria

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

Inclusion Criteria:

  • Male or female patients at least 18 years old;
  • Have non-incisional biopsy demonstrating definitive evidence for NSCLC and have not been treated for lung cancer (surgery, radiation and/or chemotherapy). A copy of the actual report must be requested by the patient through a medical release form if not already done. The copy must be available to the study doctor within 28 days of the screening visit/ Visit 1 ;
  • Be certified as per Centers for Medicare and Medicaid Services (CMS) requirements and be eligible for a PET scan;
  • Have an Eastern Co-operative Oncology Group (ECOG) performance rating ≤ 2 (see Appendix 1);
  • Males or non-pregnant, non-lactating females who are postmenopausal, naturally or surgically sterile, or who agree to use effective contraceptive methods throughout the course of the study. Postmenopausal is defined as at least 12 months natural spontaneous amenorrhea, or at least 6 weeks following surgical menopause (bilateral oophorectomy);
  • Females of childbearing potential and males with female sexual partners of childbearing potential must agree to use one of the following acceptable birth control methods:

    1. Surgically sterile (hysterectomy or bilateral oophorectomy);
    2. Surgically sterile (bilateral tubal ligation with surgery at least 6 weeks prior to study initiation). Documentation is required;
    3. Intrauterine device (IUD) in place for at least 3 months;
    4. Double-barrier method (condom and diaphragm) with spermicide for at least 14 days prior to screening and through study completion;
    5. Stable hormonal contraceptive (oral, topical, vaginal or implanted/injected) for at least 3 months prior to study and through study completion;
    6. Abstinence;
    7. Single-barrier method for at least 14 days prior to screening and though study completion for vasectomized males or females with vasectomized partners;
  • Have a fasting blood glucose of less than 200 mg/dL at screening;
  • Have reported clinical symptoms consistent with a confirmed diagnosis of NSCLC;
  • Be able to tolerate SPECT/CT and PET/CT imaging. This includes:
  • Laying in the same position without moving for approximately 45 minutes;
  • Able to tolerate a claustrophobic area;
  • Ability to hold their arms overhead for approximately 45 minutes;
  • Be able to fast prior to SPECT/CT and PET/CT imaging, with length of fasting dependent on the time of the scan:

    • A morning scan (08:00-12:00) will require fasting from midnight (or as per the site's fasting/diet restrictions);
    • An afternoon scan (12:00-onward) will require a minimum 6 hour fast (or as per the site's fasting/diet restrictions);
  • Be able to eat a high protein/low carbohydrate meal as the last meal before SPECT/CT and PET/CT imaging (or as per the site's fasting/diet restrictions);
  • Be able to make the scheduled appointments within the designated time windows [PET/CT imaging within 7 days of qualifying for the study, the second imaging session with SPECT/CT imaging 1 - 3 days after the initial imaging visit, with at least 24 hours between PET/CT and SPECT/CT imaging (if the PET/CT is performed as part of pre-study activities on a qualified PET camera for this study, the SPECT/CT must be done within 45 days of the PET/CT imaging procedure)];
  • Have safety laboratory values that in the opinion of the Investigator do not place the patient at undue risk if the patient were to participate in the study. This includes (but is not limited to):

    • Alanine aminotransferase 2.5 × upper limit of normal (ULN);
    • Aspartate aminotransferase 2.5 × ULN;
    • Creatinine 2.5 × ULN;
    • Bilirubin 2.0 × ULN;
  • Able to understand and provide signed informed consent;
  • Females of childbearing potential must have a negative urine or serum β-human chorionic gonadotropin (hCG) pregnancy test at screening.

Exclusion Criteria

  • Any clinically significant safety concerns (laboratory, electrocardiogram [EKG], physical examination, other) that, in the opinion of the Investigator, would place the patient at undue risk if the patient were to participate in the study;
  • Undergoing any current treatment for cancer (radiation therapy, surgery or chemotherapy)
  • Diabetic with insulin dependence (Patients who have a known insulin dependence for diabetes can be included in the study if the standard of care protocol in place at the clinical site provides for the management of the patient's glucose level sufficiently to allow the PET/CT imaging to be performed. The same glucose management used for the PET/CT imaging should be applied to the SPECT/CT imaging procedures. A waiver will be required to be completed by the clinical site and approved by the sponsor or designee);
  • Patient weight above the SPECT/CT and PET/CT table weight limit;
  • Failure to have a non-incisional biopsy definitive diagnosis (or cytology report from a bronchoscope) for NSCLC (a copy of the biopsy/cytology report must be available to the investigator within 28 days of Visit 1);
  • Will not agree to use an effective means of contraception for the duration of the study (males and females);
  • Known hypersensitivity to EC-DG or FDG or similar compounds including any of the inactive ingredients;
  • Known or suspected pregnancy, lactation or planned pregnancy (females and male partners);
  • Clinically significant mental illness (to be determined by the Investigator);
  • Exposure to any investigational agent within 30 days prior to screening visit or participating in an ongoing clinical study (this criteria can be overruled by the Principal Investigator with appropriate documentation of the reason for the exception);
  • Patient has a condition the Investigator believes would interfere with the ability to provide informed consent or comply with study instructions, or that might confound the interpretation of the study results or put the patient at undue risk.

Sites / Locations

  • University of Chicago
  • Mayo Clinic, Division of Nuclear Medicine
  • Montefiore Medical Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

99mTc EC-DG

18F FDG

Arm Description

99mTc-EC-DG with SPECT/CT imaging

18F FDG with PET/CT imaging

Outcomes

Primary Outcome Measures

Safety: through adverse event collection

Secondary Outcome Measures

Pharmacokinetic (blood)
Pharmacokinetic (urine)
Radiation Dosimetry (whole body planar imaging)
Comparison of the results of EC-DG:SPECT/CT (als) to biopsy results and FDG:PET/CT (als)

Full Information

First Posted
March 17, 2009
Last Updated
March 20, 2013
Sponsor
Cell>Point LLC
Collaborators
Numoda, Venn Life Sciences, Camargo Pharmaceutical Services, Biomedical Systems
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1. Study Identification

Unique Protocol Identification Number
NCT00864110
Brief Title
Pharmacokinetic and Radiation Dosimetry Study Evaluating 99m TC-EC-DG SPECT/CT in Patients With Non-small Cell Lung Cancer (NSCLC)
Official Title
A Multi-Center Phase 1b Pharmacokinetic and Radiation Dosimetry Study Evaluating 99mTc-EC-DG SPECT/CT in Patients With Non-small Cell Lung Cancer (NSCLC)
Study Type
Interventional

2. Study Status

Record Verification Date
March 2013
Overall Recruitment Status
Completed
Study Start Date
April 2010 (undefined)
Primary Completion Date
September 2010 (Actual)
Study Completion Date
December 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Cell>Point LLC
Collaborators
Numoda, Venn Life Sciences, Camargo Pharmaceutical Services, Biomedical Systems

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a multi-center Phase 1 b study designed to expand the patient safety using 99mTc-EC-DG with SPECT/CT imaging and to expand the patient radiation dosimetry and pharmacokinetic database using 99mTc-EC-DG in patients who have non-incisional biopsy definitive evidence of Non-small Cell Lung Cancer as compared to 18F-FDG PET/CT imaging.
Detailed Description
Male and female patients at least 18 years old with untreated Non-small Cell Lung Cancer who have non-incisional biopsy definitive evidence of disease (or cytology results from a bronchoscope procedure confirming NSCLC) and who have been previously certified (per Centers for Medicare and Medicaid Services requirements)by their physicians will be consented for the study. The study consists of a screening visit, gold-standard 18F-FDG PET/CT imaging followed by the investigational agent 99mTc-EC-DG with SPECT/CT(if the PET/CT was performed as part of the pre-study activities on a qualified PET camera for this study, the SPECT/CT must be done within 45 days of the PET/CT imaging procedures). The study procedures can be performed within 5-7 days of signing the informed consent. During the 99mTc-EC-DG SPECT/CT visit of the study, pharmacokinetic (PK) blood draws and urine collection will be taken and radiation dosimetry (Planar Imaging) will be performed at specified time points post 99mTc-EC-DG injection. Patients will be seen 24 hours after the 99mTc-EC-DG injection for safety and final PK blood and urine collection. A 21-day follow-up period (after the SPECT/CT image) will allow the investigator to acquire additional imaging, surgical, pathology and treatment documentation (an actual patient visit is not required at the 21 day follow-up time point).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Non Small Cell Lung Cancer
Keywords
Non small cell lung cancer, SPECT CT imaging, Pharmacokinetic, Radiation Dosimetry, PET CT comparison

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
99mTc EC-DG
Arm Type
Experimental
Arm Description
99mTc-EC-DG with SPECT/CT imaging
Arm Title
18F FDG
Arm Type
Active Comparator
Arm Description
18F FDG with PET/CT imaging
Intervention Type
Radiation
Intervention Name(s)
Radiolabeled (99Tc) EC-DG (ethylenedicysteine-deoxyglucose)
Intervention Description
one injection of Technetium ethylenedicysteine-deoxyglucose to yield a target activity of 20 mCi (range 20-30 mCi) to be given by slow IV push (over 3-5 minutes) 1mg of EC-DG will be injected
Intervention Type
Radiation
Intervention Name(s)
Technetium 99m ethylenedicysteine-deoxyglucose
Intervention Description
99mTc EC-DG injection, single dose, slow IV push over 3-5 minutes, yielding a target activity of 20 mCi (range 20-30 mCi)
Intervention Type
Radiation
Intervention Name(s)
18 F fluorodeoxyglucose
Intervention Description
single injection of 18F FDG (range 10-20 mCi)
Primary Outcome Measure Information:
Title
Safety: through adverse event collection
Time Frame
from 99mTc-EC-DG injection through 21 days
Secondary Outcome Measure Information:
Title
Pharmacokinetic (blood)
Time Frame
0 hour, post-injection:15 minutes, 1, 2, 4, 6, 24 hours
Title
Pharmacokinetic (urine)
Time Frame
pre-injection, 0-2, 2-4, 4-6, 6-24 hours post injection
Title
Radiation Dosimetry (whole body planar imaging)
Time Frame
15 minutes, 2, 4, 6 hours post injection
Title
Comparison of the results of EC-DG:SPECT/CT (als) to biopsy results and FDG:PET/CT (als)
Time Frame
At end of study

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female patients at least 18 years old; Have non-incisional biopsy demonstrating definitive evidence for NSCLC and have not been treated for lung cancer (surgery, radiation and/or chemotherapy). A copy of the actual report must be requested by the patient through a medical release form if not already done. The copy must be available to the study doctor within 28 days of the screening visit/ Visit 1 ; Be certified as per Centers for Medicare and Medicaid Services (CMS) requirements and be eligible for a PET scan; Have an Eastern Co-operative Oncology Group (ECOG) performance rating ≤ 2 (see Appendix 1); Males or non-pregnant, non-lactating females who are postmenopausal, naturally or surgically sterile, or who agree to use effective contraceptive methods throughout the course of the study. Postmenopausal is defined as at least 12 months natural spontaneous amenorrhea, or at least 6 weeks following surgical menopause (bilateral oophorectomy); Females of childbearing potential and males with female sexual partners of childbearing potential must agree to use one of the following acceptable birth control methods: Surgically sterile (hysterectomy or bilateral oophorectomy); Surgically sterile (bilateral tubal ligation with surgery at least 6 weeks prior to study initiation). Documentation is required; Intrauterine device (IUD) in place for at least 3 months; Double-barrier method (condom and diaphragm) with spermicide for at least 14 days prior to screening and through study completion; Stable hormonal contraceptive (oral, topical, vaginal or implanted/injected) for at least 3 months prior to study and through study completion; Abstinence; Single-barrier method for at least 14 days prior to screening and though study completion for vasectomized males or females with vasectomized partners; Have a fasting blood glucose of less than 200 mg/dL at screening; Have reported clinical symptoms consistent with a confirmed diagnosis of NSCLC; Be able to tolerate SPECT/CT and PET/CT imaging. This includes: Laying in the same position without moving for approximately 45 minutes; Able to tolerate a claustrophobic area; Ability to hold their arms overhead for approximately 45 minutes; Be able to fast prior to SPECT/CT and PET/CT imaging, with length of fasting dependent on the time of the scan: A morning scan (08:00-12:00) will require fasting from midnight (or as per the site's fasting/diet restrictions); An afternoon scan (12:00-onward) will require a minimum 6 hour fast (or as per the site's fasting/diet restrictions); Be able to eat a high protein/low carbohydrate meal as the last meal before SPECT/CT and PET/CT imaging (or as per the site's fasting/diet restrictions); Be able to make the scheduled appointments within the designated time windows [PET/CT imaging within 7 days of qualifying for the study, the second imaging session with SPECT/CT imaging 1 - 3 days after the initial imaging visit, with at least 24 hours between PET/CT and SPECT/CT imaging (if the PET/CT is performed as part of pre-study activities on a qualified PET camera for this study, the SPECT/CT must be done within 45 days of the PET/CT imaging procedure)]; Have safety laboratory values that in the opinion of the Investigator do not place the patient at undue risk if the patient were to participate in the study. This includes (but is not limited to): Alanine aminotransferase 2.5 × upper limit of normal (ULN); Aspartate aminotransferase 2.5 × ULN; Creatinine 2.5 × ULN; Bilirubin 2.0 × ULN; Able to understand and provide signed informed consent; Females of childbearing potential must have a negative urine or serum β-human chorionic gonadotropin (hCG) pregnancy test at screening. Exclusion Criteria Any clinically significant safety concerns (laboratory, electrocardiogram [EKG], physical examination, other) that, in the opinion of the Investigator, would place the patient at undue risk if the patient were to participate in the study; Undergoing any current treatment for cancer (radiation therapy, surgery or chemotherapy) Diabetic with insulin dependence (Patients who have a known insulin dependence for diabetes can be included in the study if the standard of care protocol in place at the clinical site provides for the management of the patient's glucose level sufficiently to allow the PET/CT imaging to be performed. The same glucose management used for the PET/CT imaging should be applied to the SPECT/CT imaging procedures. A waiver will be required to be completed by the clinical site and approved by the sponsor or designee); Patient weight above the SPECT/CT and PET/CT table weight limit; Failure to have a non-incisional biopsy definitive diagnosis (or cytology report from a bronchoscope) for NSCLC (a copy of the biopsy/cytology report must be available to the investigator within 28 days of Visit 1); Will not agree to use an effective means of contraception for the duration of the study (males and females); Known hypersensitivity to EC-DG or FDG or similar compounds including any of the inactive ingredients; Known or suspected pregnancy, lactation or planned pregnancy (females and male partners); Clinically significant mental illness (to be determined by the Investigator); Exposure to any investigational agent within 30 days prior to screening visit or participating in an ongoing clinical study (this criteria can be overruled by the Principal Investigator with appropriate documentation of the reason for the exception); Patient has a condition the Investigator believes would interfere with the ability to provide informed consent or comply with study instructions, or that might confound the interpretation of the study results or put the patient at undue risk.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Donald Blaufox, MD
Organizational Affiliation
Albert Einstein University, Montefiore Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Chicago
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60637
Country
United States
Facility Name
Mayo Clinic, Division of Nuclear Medicine
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905
Country
United States
Facility Name
Montefiore Medical Center
City
Bronx
State/Province
New York
ZIP/Postal Code
10461
Country
United States

12. IPD Sharing Statement

Links:
URL
http://mayoclinic.com
Description
Location of the study
URL
http://cellpointweb.com
Description
Sponsor link

Learn more about this trial

Pharmacokinetic and Radiation Dosimetry Study Evaluating 99m TC-EC-DG SPECT/CT in Patients With Non-small Cell Lung Cancer (NSCLC)

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