FLT PET Imaging for Cervical Cancer

October 25, 2017 updated by: Sarah McGuire, University of Iowa

'F-18 Fluorothymidine ([18F]FLT) PET Imaging for Early Evaluation of Response to Chemoradiation Therapy in Patients With Cervical Cancer

Our primary hypothesis is that [18F]FLT PET can identify active bone marrow in addition to metabolically active tumor.

This trial will use FLT-PET imaging to define areas of active bone marrow in the pelvis. The radiation plan is then designed to spare that area, in hopes of keeping the bone marrow active during therapy. Bone marrow and tumor activity will be monitored using a sequence of FLT PET scans during the course of chemotherapy and radiation therapy.

Study Overview

Status

Terminated

Conditions

Intervention / Treatment

Detailed Description

Subjects will undergo a total of up to 5 FLT PET scans.

Subjects are randomized between two groups to reduce radiation exposure from the FLT PET scans. If bone marrow activity is not identified in one scan, further scans are cancelled until the 1-month follow up scan. This is not a randomization to compare therapeutic efficacy between two study arms. Data will be pooled for analysis as pre-specified in the study's statistical plan.

Group 1 has FLT PET scans pretreatment, after 5 radiation treatments, after 10 radiation treatments, after 15 radiation treatments, and then 1 month after completing radiation therapy.

Group 2 has FLT PET scans pretreatment, after 5 radiation treatments, after 10 radiation treatments, after 20 radiation treatments, and then 1 month after completing radiation therapy.

Study Type

Interventional

Enrollment (Actual)

6

Phase

  • Phase 2

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Iowa
      • Iowa City, Iowa, United States, 52242
        • Holden Comprehensive Cancer Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

Female

Description

Inclusion Criteria:

  • Ability to understand and willingness to sign a written informed consent document.
  • Histologically confirmed stage IB2, IIA, IIB, IIIB, and IVA squamous cell carcinoma of the cervix.
  • Scheduled to receive chemo-radiation for oncologic treatment.
  • Karnofsky of at least 60 at time of screening
  • Life expectancy of at least 6 months.
  • Leukocytes at least 3,000/microL
  • absolute neutrophil count at least 1,500/microL
  • platelets at least 100,000/microL
  • total bilirubin at maximum 1.0 mg/dL (UIHC limit of normal)
  • either ALT or AST less than 2.5 times the upper limit of normal
  • creatinine less than 1.5 times the upper limit of normal
  • non-pregnant, non-nursing, willing to use contraception

Exclusion Criteria:

  • oncology research protocol requiring full pelvic radiation (i.e., 4-field box technique) or experimental chemotherapy
  • uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with the study requirements.
  • subjects taking nucleoside analog medications such as those used as antiretroviral agents.
  • patients who have undergone hysterectomy or will have a hysterectomy as part of their cancer therapy.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Group 2
Receives fourth [F18]Fluorothymidine (FLT) PET scan after 20 fractions of radiation therapy.
Drug: [F18]Fluorothymidine
FLT PET scan 5 mCi (+/- 10%)
Other Names:
  • FLT
Experimental: Group 1
Receives fourth [F18]Fluorothymidine (FLT) PET scan after 15 fractions of radiation therapy.
Drug: [F18]Fluorothymidine
FLT PET scan 5 mCi (+/- 10%)
Other Names:
  • FLT

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Percent Difference From Baseline IMRT Plan (%)
Time Frame: Baseline (pre-treatment)
The difference in volume of bone marrow receiving radiation using a bone-marrow-sparing radiation plan compared to a standard radiation plan (IMRT), expressed as a percentage. Both plans are patient-specific. Bone-marrow is identified using the baseline FLT PET/CT obtained pre-imaging. Active bone marrow is considered to have an uptake value (SUV) of 2, 3, or 4. The standard IMRT plan was created using the criteria of the National Cancer Institute's Radiation Therapy Oncology Group study RTOG-0418. Radiation dose bins evaluated are 5 Gray, 10 Gray, 20 Gray, and 30 Gray. The change in dose to tumor is also provided. A negative value indicates that more bone marrow or tissue was spared using the bone-marrow sparing plan.
Baseline (pre-treatment)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Chemotherapy Compliance
Time Frame: post-treatment
The number of participants who missed at least one prescribed chemotherapy administration due to low blood counts.
post-treatment
Number of Participants With Standardized Toxicity Severity Grades for White Blood Cell Counts
Time Frame: baseline, weekly during radiation treatment for up to 5 weeks, and 30 days post treatment
White blood cell counts measurements expressed in standardized toxicity severity grades (Common Terminology Criteria for Adverse Events, v4.03) measured weekly during combined chemotherapy and radiation therapy treatment and then once at 30 day follow-up and at 1 year follow-up
baseline, weekly during radiation treatment for up to 5 weeks, and 30 days post treatment
Number of Participants With Standardized Toxicity Severity Grades for Decreased Platelet Counts.
Time Frame: baseline, weekly during radiation treatment for up to 5 weeks, and 30 days post treatment
Platelet cell counts measurements expressed in standardized toxicity severity grades (Common Terminology Criteria for Adverse Events, v4.03) measured once weekly during combined chemotherapy and radiation therapy, then once at 30 day follow-up, and once at 1 year follow-up
baseline, weekly during radiation treatment for up to 5 weeks, and 30 days post treatment
Number of Participants With Standardized Toxicity Severity Grades for Decreased Absolute Neutrophil Counts (ANCs)
Time Frame: baseline, weekly during radiation treatment for up to 5 weeks, and 30 days post treatment
Absolute neutrophil counts (ANCs) measurements expressed in standardized toxicity severity grades (Common Terminology Criteria for Adverse Events, v4.03) measured once weekly during combined chemotherapy and radiation therapy, then once at 30 day follow-up, and once at 1 year follow-up.
baseline, weekly during radiation treatment for up to 5 weeks, and 30 days post treatment
Number of Participants With Standardized Toxicity Severity Grades for Decreased Lymphocyte Counts.
Time Frame: baseline, weekly during radiation treatment for up to 5 weeks, and 30 days post treatment
Lymphocyte counts measurements expressed in standardized toxicity severity grades (Common Terminology Criteria for Adverse Events, v4.03) measured once weekly during combined chemotherapy and radiation therapy, then once at 30 day follow-up, and once at 1 year follow-up
baseline, weekly during radiation treatment for up to 5 weeks, and 30 days post treatment

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Iowa

Collaborators

Holden Comprehensive Cancer Center

Investigators

  • Study Director: Michael M Graham, Ph.D., M.D., University of Iowa
  • Principal Investigator: Sarah McGuire, Ph.D., University of Iowa

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

September 1, 2009

Primary Completion (Actual)

March 3, 2016

Study Completion (Actual)

April 11, 2016

Study Registration Dates

First Submitted

February 23, 2010

First Submitted That Met QC Criteria

February 23, 2010

First Posted (Estimate)

February 25, 2010

Study Record Updates

Last Update Posted (Actual)

December 2, 2017

Last Update Submitted That Met QC Criteria

October 25, 2017

Last Verified

October 1, 2017

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 200906786

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

Yes, data will be shared utilizing clinicaltrials.gov results

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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