search
Back to results

Study of 68GaNOTA-Anti-MMR-VHH2 in Oncological Lesions, Cardiovascular Atherosclerosis, Syndrome With Abnormal Immune Activation and Cardiac sarcoïdosis. (MITRAS)

Primary Purpose

Squamous Cell Carcinoma of Head and Neck, Cancer, Carotid Stenosis

Status
Recruiting
Phase
Phase 2
Locations
Belgium
Study Type
Interventional
Intervention
68GaNOTA-Anti-MMR-VHH2
Sponsored by
Universitair Ziekenhuis Brussel
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional diagnostic trial for Squamous Cell Carcinoma of Head and Neck

Eligibility Criteria

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

COHORT SPECIFIC INCLUSION CRITERIA:

  • COHORT 1:

    • Patients who have given informed consent
    • Patients at least 18 years old
    • Patients diagnosed with biopsy-proven squamous cell carcinomas of the head and neck, independent of tumour stage.
    • In order to be eligible, a new non-surgical therapeutic approach should be considered by the treating physician(s).
    • In order to minimize partial volume effect, the diameter of at least 1 tumour lesion should be ≥ 10 mm in short axis for invaded adenopathies and ≥ 10 mm in long axis for all other types of lesions.
    • Patients who already participated in the trial and who are diagnosed with progressive or recurrent disease can be re-included if all inclusion criteria and none of the exclusion criteria apply.
  • COHORT 2:

    • Patients who have given informed consent
    • Patients at least 18 years old
    • Patient with a biopsy proven local, locally advanced or metastatic malignancy with a solid component that is at least ≥ 10 mm in short axis for invaded adenopathies and ≥ 10 mm in long axis for all other types of lesions.
    • The patient is planned for immune checkpoint inhibition treatment, either or not combined with other systemic therapies.
    • Patients who already participated in the trial and who are diagnosed with progressive or recurrent disease can be re-included if all inclusion criteria and none of the exclusion criteria apply
  • COHORT 3:

    • Patients who have given informed consent
    • Patients at least 18 years old
    • Patient is planned for the surgical removal of an atherosclerotic plaque of the carotid artery, consisting of endarterectomy.
  • COHORT 4:

    • Patients who have given informed consent
    • Patients at least 18 years old
    • Patient with a biopsy-proven Hodgkin or non-Hodgkin lymphoma
    • At time of inclusion, the patient presents with at least 1 lymphoma lesion of which the diameter should be ≥ 10 mm in short axis for invaded adenopathies and ≥ 10 mm in long axis for all other types of lesions.
    • Diagnostic tissue sample is available for immunohistochemistry analysis, that was obtained < 3 months prior to patient inclusion.
    • 18F-FDG-PET/CT has been performed < 3 months prior to patient inclusion
    • The patient is eligible for systemic treatment, radiotherapy or a combination of both.
  • COHORT 5:

    • Patients who have given informed consent
    • Patients at least 18 years old
    • Patients with suspicion of HLH, based on either a previous bone marrow sample showing hemofagocytis or based on the presence of at least 3 risk criteria as follows :
    • Fever ≥ 38,5°C
    • Splenomegaly
    • Bicytopenia, with at least 2 of the 3 following parameters:
    • Hb < 9 g/dl and/or
    • Platelets < 100 000/ml and/or
    • Neutrophils < 1000/ml
    • Hypertriglyceridemia (fasting > 265 mg/dl)µ
    • Ferritin > 500 ng/ml
  • COHORT 6:

    • Patients who have given informed consent
    • Patients at least 18 years old
    • Patients with endomyocardial biopsy proven cardiac sarcoidosis or based on the presence of at least one criteria as follows : (HRS consensus recommendation (2014)
    • Corticosteroid and/or immunosuppressant-responsive cardiomyopathy or heart block
    • Unexplained reduced LVEF (<40%)
    • Unexplained sustained (spontaneous or induced) ventricular tachycardia
    • Mobitz type II second-degree block or third-degree heart block
    • Patchy uptake on dedicated cardiac FDG-PET (in a pattern consistent with CS)
    • Late Gadolinium Enhancement (LGE) on Cardiac MRI (in a pattern consistent with CS)

GENERAL EXCLUSION CRITERIA:

  • Eastern Cooperative Oncology Group (ECOG) performance status 3 or higher.
  • Pregnant patients.
  • Breast feeding patients.
  • Patients with any serious active infection.
  • Patients who have any other life-threatening illness or organ system dysfunction, which in the opinion of the investigator would either compromise patient safety or interfere with the evaluation of the safety of the test radiopharmaceutical.
  • Patients who cannot communicate reliably with the investigator.
  • Patients who are unlikely to cooperate with the requirements of the study.
  • Patients who are unwilling and/or unable to give informed consent.
  • Patients at increased risk of death from a pre-existing concurrent illness.
  • When a patient exhibits symptoms correlated with SARS-CoV-2, the patient should be tested using the standard of care testing protocol, prior to inclusion. When the test results indicate an active SARS-CoV-2-infection, the patient is excluded for this trial.

COHORT SPECIFIC EXCLUSION CRITERIA

  • COHORT 1

    - Patients planned for a surgical resection of the tumour.

  • COHORT 2 - Patients diagnosed with squamous cell carcinomas of the head and neck. These patients can be included into Cohort I.

Sites / Locations

  • Uz BrusselRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Cancer, lymphoma, carotid plaque, patients suspected for hemophagocytic lymphohistiocytosis

Arm Description

Cohort 1: Patients diagnosed with pathology-proven squamous cell carcinomas of the head and neck in need of a non-surgical therapy. Cohort 2: Patients diagnosed with any malignancy with a solid component in need of immune checkpoint inhibitor-type immunotherapy. Cohort 3: Patients diagnosed with carotid plaque, planned for standard-of-care carotid endarterectomy. Cohort 4: Patients with a biopsy-proven Hodgkin (HL) or non-Hodgkin lymphoma (NHL) eligible for systemic treatment, radiotherapy or a combination of both. Cohort 5: Patients suspected for hemophagocytic lymphohistiocytosis (HLH), planned for (SOC) bone marrow biopsy in case it is not done before. Cohort 6 : Patients with endomyocardial biopsy proven cardiac sarcoidosis or suspected CS according to HRS consensus recommendation (2014)

Outcomes

Primary Outcome Measures

Correlation of uptake of 68GaNOTA-Anti-MMR-VHH2 before start of treatment in HNSCC lesions with time to treatment failure after radiotherapy or systemic treatment including immune checkpoint inhibition. (cohort 1)
Uptake will be measured in cancer lesions on PET/CT 1. Treatment response will be evaluated by assessing time to treatment failure and by assessment of status of patients for treatment failure (Y/N) at 6 months and 12 months after start of treatment
Correlation of uptake of 68GaNOTA-Anti-MMR-VHH2 before start of treatment in solid cancer lesions with time to treatment failure after systemic treatment with immune checkpoint inhibition, either or not combined with other systemic therapies. (cohort 2)
Uptake will be measured in cancer lesions on PET/CT 1. Treatment response will be evaluated by assessing time to treatment failure and by assessment of status of patients for treatment failure (Y/N) at 6 months and 12 months after start of treatment
Correlation of uptake of 68GaNOTA-Anti-MMR-VHH2 in atherosclerotic carotid plaques before surgery with the immunohistological MMR-staining of the excised atherosclerotic carotid plaque. (cohort 3)
PET/CT and immunohistochemistry will be assessed using a semi-quantitative scale.
Correlation of uptake of 68GaNOTA-Anti-MMR-VHH2 before start of treatment in Hodgkin and non-Hodgkin lymphoma patients (cohort 4).
Uptake will be measured in lymphoma-related lesions on PET/CT 1
Correlation of uptake of 68GaNOTA-Anti-MMR-VHH2 in central bone on PET/CT with the presence of hemophagocytosis in bone marrow samples, and the presence of clinical risk factors (cohort 5).
PET/CT, results of additional blood sample analysis and bone marrow aspirate or trephine biopsy will be assessed using a semi-quantitative scale.
To investigate the uptake of 68GaNOTA-Anti-MMR-VHH2 in cardiac sarcoidosis on PET/CT in patients with endomyocardial biopsy proven cardiac sarcoidosis or suspected CS according to HRS consensus recommendation (2014) (cohort 6)
Uptake in lesions involved with cardiac sarcoidosis on MMR-PET/CT

Secondary Outcome Measures

Full Information

First Posted
February 12, 2021
Last Updated
September 2, 2022
Sponsor
Universitair Ziekenhuis Brussel
search

1. Study Identification

Unique Protocol Identification Number
NCT04758650
Brief Title
Study of 68GaNOTA-Anti-MMR-VHH2 in Oncological Lesions, Cardiovascular Atherosclerosis, Syndrome With Abnormal Immune Activation and Cardiac sarcoïdosis.
Acronym
MITRAS
Official Title
Phase II Study to Evaluate the Clinical Potential of 68GaNOTA-Anti-MMR-VHH2 for in Vivo Imaging of MMR-expressing Macrophages by Means of Positron Emission Tomography (PET) in Oncological Lesions,Cardiovascular Atherosclerosis,Syndrome With Abnormal Immune Activation and Cardiac sarcoïdosis
Study Type
Interventional

2. Study Status

Record Verification Date
August 2022
Overall Recruitment Status
Recruiting
Study Start Date
January 26, 2021 (Actual)
Primary Completion Date
January 26, 2025 (Anticipated)
Study Completion Date
January 26, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Universitair Ziekenhuis Brussel

4. Oversight

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

5. Study Description

Brief Summary
Phase II study to evaluate the clinical potential of 68GaNOTA-anti-MMR-VHH2 for in vivo imaging of Macrophage Mannose Receptor (MMR)-expressing Macrophages by means of Positron Emission Tomography (PET) in patients with oncological lesions in need of non-surgical therapy, patients with cardiovascular atherosclerosis, syndrome with abnormal immune activation and cardiac sarcoïdosis.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Squamous Cell Carcinoma of Head and Neck, Cancer, Carotid Stenosis, Atherosclerosis of Artery, Hodgkin Lymphoma, Adult, Non Hodgkin Lymphoma, HLH, Cardiac Sarcoidosis

7. Study Design

Primary Purpose
Diagnostic
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Model Description
The trial consists of 6 different patient cohorts that are each investigated using a new diagnostic imaging radiopharmaceutical
Masking
None (Open Label)
Allocation
N/A
Enrollment
140 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Cancer, lymphoma, carotid plaque, patients suspected for hemophagocytic lymphohistiocytosis
Arm Type
Experimental
Arm Description
Cohort 1: Patients diagnosed with pathology-proven squamous cell carcinomas of the head and neck in need of a non-surgical therapy. Cohort 2: Patients diagnosed with any malignancy with a solid component in need of immune checkpoint inhibitor-type immunotherapy. Cohort 3: Patients diagnosed with carotid plaque, planned for standard-of-care carotid endarterectomy. Cohort 4: Patients with a biopsy-proven Hodgkin (HL) or non-Hodgkin lymphoma (NHL) eligible for systemic treatment, radiotherapy or a combination of both. Cohort 5: Patients suspected for hemophagocytic lymphohistiocytosis (HLH), planned for (SOC) bone marrow biopsy in case it is not done before. Cohort 6 : Patients with endomyocardial biopsy proven cardiac sarcoidosis or suspected CS according to HRS consensus recommendation (2014)
Intervention Type
Drug
Intervention Name(s)
68GaNOTA-Anti-MMR-VHH2
Other Intervention Name(s)
MMR-PET/CT
Intervention Description
All subjects will receive at least one single intravenous injection of the IMP followed by a total body PET/CT prior to receiving standard-of-care therapy. For patients in cohorts 1 and 2 : an optional injection of the IMP during or after therapy can be administered if a patient is treated with non-surgical modalities. Patients in cohort 6 who receive standard-of-care treatment can receive an optional injection of the IMP.
Primary Outcome Measure Information:
Title
Correlation of uptake of 68GaNOTA-Anti-MMR-VHH2 before start of treatment in HNSCC lesions with time to treatment failure after radiotherapy or systemic treatment including immune checkpoint inhibition. (cohort 1)
Description
Uptake will be measured in cancer lesions on PET/CT 1. Treatment response will be evaluated by assessing time to treatment failure and by assessment of status of patients for treatment failure (Y/N) at 6 months and 12 months after start of treatment
Time Frame
up to 5 years
Title
Correlation of uptake of 68GaNOTA-Anti-MMR-VHH2 before start of treatment in solid cancer lesions with time to treatment failure after systemic treatment with immune checkpoint inhibition, either or not combined with other systemic therapies. (cohort 2)
Description
Uptake will be measured in cancer lesions on PET/CT 1. Treatment response will be evaluated by assessing time to treatment failure and by assessment of status of patients for treatment failure (Y/N) at 6 months and 12 months after start of treatment
Time Frame
up to 5 years
Title
Correlation of uptake of 68GaNOTA-Anti-MMR-VHH2 in atherosclerotic carotid plaques before surgery with the immunohistological MMR-staining of the excised atherosclerotic carotid plaque. (cohort 3)
Description
PET/CT and immunohistochemistry will be assessed using a semi-quantitative scale.
Time Frame
Resection of lesion up to 21 days after PET/CT
Title
Correlation of uptake of 68GaNOTA-Anti-MMR-VHH2 before start of treatment in Hodgkin and non-Hodgkin lymphoma patients (cohort 4).
Description
Uptake will be measured in lymphoma-related lesions on PET/CT 1
Time Frame
up to 5 years
Title
Correlation of uptake of 68GaNOTA-Anti-MMR-VHH2 in central bone on PET/CT with the presence of hemophagocytosis in bone marrow samples, and the presence of clinical risk factors (cohort 5).
Description
PET/CT, results of additional blood sample analysis and bone marrow aspirate or trephine biopsy will be assessed using a semi-quantitative scale.
Time Frame
up to 5 years
Title
To investigate the uptake of 68GaNOTA-Anti-MMR-VHH2 in cardiac sarcoidosis on PET/CT in patients with endomyocardial biopsy proven cardiac sarcoidosis or suspected CS according to HRS consensus recommendation (2014) (cohort 6)
Description
Uptake in lesions involved with cardiac sarcoidosis on MMR-PET/CT
Time Frame
up to 5 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
COHORT SPECIFIC INCLUSION CRITERIA: COHORT 1: Patients who have given informed consent Patients at least 18 years old Patients diagnosed with biopsy-proven squamous cell carcinomas of the head and neck, independent of tumour stage. In order to be eligible, a new non-surgical therapeutic approach should be considered by the treating physician(s). In order to minimize partial volume effect, the diameter of at least 1 tumour lesion should be ≥ 10 mm in short axis for invaded adenopathies and ≥ 10 mm in long axis for all other types of lesions. Patients who already participated in the trial and who are diagnosed with progressive or recurrent disease can be re-included if all inclusion criteria and none of the exclusion criteria apply. COHORT 2: Patients who have given informed consent Patients at least 18 years old Patient with a biopsy proven local, locally advanced or metastatic malignancy with a solid component that is at least ≥ 10 mm in short axis for invaded adenopathies and ≥ 10 mm in long axis for all other types of lesions. The patient is planned for immune checkpoint inhibition treatment, either or not combined with other systemic therapies. Patients who already participated in the trial and who are diagnosed with progressive or recurrent disease can be re-included if all inclusion criteria and none of the exclusion criteria apply COHORT 3: Patients who have given informed consent Patients at least 18 years old Patient is planned for the surgical removal of an atherosclerotic plaque of the carotid artery, consisting of endarterectomy. COHORT 4: Patients who have given informed consent Patients at least 18 years old Patient with a biopsy-proven Hodgkin or non-Hodgkin lymphoma At time of inclusion, the patient presents with at least 1 lymphoma lesion of which the diameter should be ≥ 10 mm in short axis for invaded adenopathies and ≥ 10 mm in long axis for all other types of lesions. Diagnostic tissue sample is available for immunohistochemistry analysis, that was obtained < 3 months prior to patient inclusion. 18F-FDG-PET/CT has been performed < 3 months prior to patient inclusion The patient is eligible for systemic treatment, radiotherapy or a combination of both. COHORT 5: Patients who have given informed consent Patients at least 18 years old Patients with suspicion of HLH, based on either a previous bone marrow sample showing hemofagocytis or based on the presence of at least 3 risk criteria as follows : Fever ≥ 38,5°C Splenomegaly Bicytopenia, with at least 2 of the 3 following parameters: Hb < 9 g/dl and/or Platelets < 100 000/ml and/or Neutrophils < 1000/ml Hypertriglyceridemia (fasting > 265 mg/dl)µ Ferritin > 500 ng/ml COHORT 6: Patients who have given informed consent Patients at least 18 years old Patients with endomyocardial biopsy proven cardiac sarcoidosis or based on the presence of at least one criteria as follows : (HRS consensus recommendation (2014) Corticosteroid and/or immunosuppressant-responsive cardiomyopathy or heart block Unexplained reduced LVEF (<40%) Unexplained sustained (spontaneous or induced) ventricular tachycardia Mobitz type II second-degree block or third-degree heart block Patchy uptake on dedicated cardiac FDG-PET (in a pattern consistent with CS) Late Gadolinium Enhancement (LGE) on Cardiac MRI (in a pattern consistent with CS) GENERAL EXCLUSION CRITERIA: Eastern Cooperative Oncology Group (ECOG) performance status 3 or higher. Pregnant patients. Breast feeding patients. Patients with any serious active infection. Patients who have any other life-threatening illness or organ system dysfunction, which in the opinion of the investigator would either compromise patient safety or interfere with the evaluation of the safety of the test radiopharmaceutical. Patients who cannot communicate reliably with the investigator. Patients who are unlikely to cooperate with the requirements of the study. Patients who are unwilling and/or unable to give informed consent. Patients at increased risk of death from a pre-existing concurrent illness. When a patient exhibits symptoms correlated with SARS-CoV-2, the patient should be tested using the standard of care testing protocol, prior to inclusion. When the test results indicate an active SARS-CoV-2-infection, the patient is excluded for this trial. COHORT SPECIFIC EXCLUSION CRITERIA COHORT 1 - Patients planned for a surgical resection of the tumour. COHORT 2 - Patients diagnosed with squamous cell carcinomas of the head and neck. These patients can be included into Cohort I.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
UZ Brussel
Phone
+3224776013
Email
nucgmail@uzbrussel.be
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Marleen Keyaerts, MD
Organizational Affiliation
Universitair Ziekenhuis Brussel
Official's Role
Principal Investigator
Facility Information:
Facility Name
Uz Brussel
City
Brussels
State/Province
Brussel
ZIP/Postal Code
1090
Country
Belgium
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
UZ BRUSSEL
Phone
+3224776013
Email
nucgmail@uzbrussel.be
First Name & Middle Initial & Last Name & Degree
MARLEEN KEYAERTS, MD

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Study of 68GaNOTA-Anti-MMR-VHH2 in Oncological Lesions, Cardiovascular Atherosclerosis, Syndrome With Abnormal Immune Activation and Cardiac sarcoïdosis.

We'll reach out to this number within 24 hrs