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Methionine and PBR28-PET (Peripheral Benzodiazepine Receptors) in Brain Metastases Following Radiosurgery

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT02433171
Recruitment Status : Terminated (Lack of available funding.)
First Posted : May 4, 2015
Last Update Posted : May 28, 2019
Sponsor:
Information provided by (Responsible Party):
Yale University

Brief Summary:
The goal of this protocol is to evaluate the potential of PET imaging of amino acid transport and microglial activation to improve the differentiation of tumor recurrence and radiation necrosis in patients with brain metastases after treatment with stereotactic radiosurgery (SRS) who have re-growing lesions. These state-of-the-art imaging tools will be used in combination with standard magnetic resonance imaging (MRI), MR spectroscopy (MRS) and FDG-PET (fluorodeoxyglucose).

Condition or disease Intervention/treatment
Brain Metastasis Procedure: Standard of Care FDG-PET Imaging

Detailed Description:
The investigators hypothesize that by using two different PET tracers, one sensitive to tumor metabolic activity, and one sensitive to inflammatory processes, investigators can separately identify metabolically active tumor from radiation necrosis related inflammation. This can be accomplished with quantitative assessments of tracer uptake using kinetic modeling techniques, as well as by high-resolution imaging to assess the distribution of tracer uptake in the tumor region. All participants in the study will have the receive the same diagnostic tests.

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Study Type : Observational
Actual Enrollment : 8 participants
Observational Model: Cohort
Time Perspective: Prospective
Official Title: Studies of Methionine-PET and PBR28-PET in Brain Metastases to Differentiate Tumor Recurrence and Radiation Necrosis Following Stereotactic Radiosurgery
Study Start Date : January 2015
Actual Primary Completion Date : June 27, 2017
Actual Study Completion Date : June 27, 2017

Resource links provided by the National Library of Medicine

Drug Information available for: Methionine

Group/Cohort Intervention/treatment
Melanoma Brain Metastases
Stage 4 cancer patient population with melanoma with brain metastases previously treated with SRS
Procedure: Standard of Care FDG-PET Imaging
[11C]Methionine [11]. This natural amino acid, and its various fluorinated derivatives, has been widely used in brain tumor studies due to a) high tumor-to-normal brain contrast, and b) its sensitivity to biological functions including amino acid transport and utilization. [11C]PBR28 [12]. This ligand is one of a series of second-generation tracers that bind to TSPO (translocator protein), a protein that is upregulated in activated microglia.
Other Name: DWI, MRPerfusion, MRSpectroscopy and FDG-PET

Lung Cancer Brain Metastases
Stage 4 cancer patient population with non-small cell lung cancer with brain metastases previously treated with SRS
Procedure: Standard of Care FDG-PET Imaging
[11C]Methionine [11]. This natural amino acid, and its various fluorinated derivatives, has been widely used in brain tumor studies due to a) high tumor-to-normal brain contrast, and b) its sensitivity to biological functions including amino acid transport and utilization. [11C]PBR28 [12]. This ligand is one of a series of second-generation tracers that bind to TSPO (translocator protein), a protein that is upregulated in activated microglia.
Other Name: DWI, MRPerfusion, MRSpectroscopy and FDG-PET




Primary Outcome Measures :
  1. Change in Regrowing Tumor Rate from Radiation Effect [ Time Frame: 6 months ]


Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 80 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
Patients who received SRS for melanoma or NSCLC brain metastases with regrowing lesions who are candidates for surgical intervention (biopsy or excision) at the Smilow Cancer Center or are candidates for monitoring by serial imaging will be screened for eligibility and offered enrollment
Criteria

Inclusion Criteria:

  • Patients over 18 years with brain metastases from melanoma or non-small cell lung cancer
  • Patients must have had SRS and regrowth in at least one lesion > 0.5 cm in greatest dimension and fall into one of two categories: a) patient is deemed clinically appropriate for surgical intervention (biopsy or craniotomy) OR b) patient is asymptomatic and has a life expectancy of > 6 months so that serial follow-up imaging is appropriate
  • Willingness to participate in imaging studies
  • Able to give informed consent

Exclusion Criteria:

  • Subjects with history of prior radiation exposure for research purposes within the past year, such that participation in this study would place them over the FDA limits for annual radiation exposure. This guideline is an effective dose of 5 rem received per year.
  • Subjects who are pregnant or currently breastfeeding
  • Women of child-bearing age who are sexually active, unless they agree to two forms of contraception, and have a negative urine pregnancy test at screening and on the days of the PET imaging
  • Patients unable to undergo MRI with gadolinium-based contrast for standard clinical reasons which include:
  • Cardiac pacemaker, aneurysm clip, cochlear implants, Intra Uterine Device (IUD), shrapnel, neurostimulators, defibrillator, artificial heart valve, or history of metal fragments in eyes.
  • Pregnancy
  • Body size too large for closed MRI
  • Known hepatic fibrosis.
  • Claustrophobia
  • Contraindication to MR contrast agents: eGFR (epidermal growth factor receptor) < 30 by the Cockcroft- Gault formula if > 60 years old or with chronic renal disease
  • Anaphylactic allergy to gadolinium

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02433171


Locations
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United States, Connecticut
Yale University
New Haven, Connecticut, United States, 06511
Sponsors and Collaborators
Yale University
Investigators
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Principal Investigator: Veronica Chiang, MD Yale University

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Responsible Party: Yale University
ClinicalTrials.gov Identifier: NCT02433171    
Other Study ID Numbers: 1401013294
First Posted: May 4, 2015    Key Record Dates
Last Update Posted: May 28, 2019
Last Verified: May 2019
Keywords provided by Yale University:
regrowth
radiosurgery
radiation necrosis
Additional relevant MeSH terms:
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Neoplasm Metastasis
Brain Neoplasms
Brain Diseases
Neoplastic Processes
Neoplasms
Pathologic Processes
Central Nervous System Neoplasms
Nervous System Neoplasms
Neoplasms by Site
Central Nervous System Diseases
Nervous System Diseases