- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03266562
Estrogen Receptor Expression in Breast Cancer - Assessed With Positron Emission Mammography (PEM-FES)
Assessment of the Heterogeneity of Estrogen Receptor Expression in Patients With Estrogen Receptor Positive Breast Cancer Using F-18 Fluoroestradiol and High Resolution Positron Emission Mammography
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
This pilot study will recruit up to 20 patients with newly diagnosed ER+ breast cancer who have recently undergone or are scheduled to undergo a clinically-indicated breast MRI examination and are scheduled for surgical excision of the breast cancer. All patients will undergo two PEM studies, one with F-18 FDG and the second with F-18 FES. As F-18 FES is not an FDA-approved radiopharmaceutical, this FES study will be performed under an investigator IND cross-referenced to the National Cancer Institute IND 79,005 for F-18 FES. A time interval of 6-8 hours will be required between performance of the F-18 FDG study and the F-18 FES study. All patients will have the 2 PEM studies within 30 business days of the clinically indicated MRI. See Study Schema shown below. Subjects must meet the following eligibility criteria:
- Postmenopausal women, as defined by a. Lack of menstrual periods for ≥ 12 months b. For women with prior hysterectomy and age < 60, a serum FSH level within the postmenopausal range
- Histologic proof of invasive breast carcinoma that is ER positive per ASCO/CAP guidelines (staining in ≥ 1% of cells by immunohistochemistry)
- Extent of disease confirmed, or to be confirmed, on a clinical contrast-enhanced breast MRI examination
- Minimum size criteria for index cancer of 10 mm as measured on mammogram, ultrasound, or MRI.
- Planned surgical excision of the breast cancer at Mayo Clinic, Rochester
Study participants will be consented prior to undergoing the PEM studies. The order in which the PEM and MRI studies are performed will NOT be randomized, and will be dictated by patient schedule. Co-registration of the PEM images from F-18 FDG and F-18 FES will be used to assess the heterogeneity of uptake of the F-18 FES relative to that of F-18 FDG. Heterogeneity of ER expression in the tumor will be determined by immunohistochemistry on the pathologic tissue and findings will then be correlated with the ratio of activity in the co-registered images of F-18 FES and F-18 FDG. An integrated interpretation of the MRI and PEM images will be performed to match lesions seen on the three scans and will be made available to the ordering physician and surgeon.
Study Type
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Minnesota
-
Rochester, Minnesota, United States, 55905
- Mayo Clinic
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
Eligible patients will be offered enrollment if the time interval between initial diagnosis and surgery allows for performance of the PEM studies with both F18 FDG and F-18 FES, and they meet the following criteria:
Postmenopausal women, as defined by
- Lack of menstrual periods for ≥ 12 months
- For women with prior hysterectomy and age < 60, a serum FSH level within the postmenopausal range
- Histologic proof of invasive breast carcinoma that is ER positive per ASCO/CAP guidelines (staining in ≥ 1% of cells by immunohistochemistry)
- Extent of disease confirmed, or to be confirmed, on a clinical contrast-enhanced breast MRI examination
- Minimum size criteria for index cancer of 10 mm as measured on mammogram, ultrasound, or MRI.
- Planned surgical excision of the breast cancer at Mayo Clinic, Rochester
Exclusion Criteria:
Patients are excluded if they meet any of the following criteria:
- Premenopausal
- Unable to undergo PEM scanning (weight limit of 300 lbs. on PEM system or inability to lie prone for 30 minutes)
- Total serum bilirubin > 1.5 x upper limit of normal (abnormal hepatic metabolism may interfere with FES hepatic excretion),
- Serum creatinine > 1.5 x upper limit of normal
- Patients who have received, are currently receiving, or planning to receive neoadjuvant systemic therapy prior to surgical excision
- Patients who will undergo core needle biopsy of the breast or axilla between the breast MRI and investigational PEM studies. NOTE: Axillary ultrasound with or without fine needle aspiration of an axillary mass or lymph node is allowed.
- Patients with breast implants?
Study Plan
How is the study designed?
Design Details
- Primary Purpose: DIAGNOSTIC
- Allocation: NA
- Interventional Model: SINGLE_GROUP
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
OTHER: FES vs FDG
All patients will undergo two PEM studies, one with F-18 FDG and the second with F-18 FES.
Co-registration of the PEM images from F-18 FDG and F-18 FES will be used to assess the heterogeneity of uptake of the F-18 FES relative to that of F-18 FDG.
Heterogeneity of ER expression in the tumor will be determined by immunohistochemistry on the pathologic tissue
|
Evaluate uptake of F-18 FES in breast tissue
Evaluate uptake of F-18 FDG in breast tissue
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
correlation of FES and estrogen receptors
Time Frame: 1 year
|
The primary objective of this study is to determine the correlation between F-18 FES uptake on PEM, and distribution of ER+ tissue on pathology
|
1 year
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
correlation of FES and FDG in breast tumors
Time Frame: 1 year
|
The secondary aim is to determine if the correlation (or lack of) between F-18 FES uptake and F-18 FDG uptake as imaged by PEM, is an accurate representation of the heterogeneity of ER expression in the tumor.
|
1 year
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Michael K O'Connor, Ph.D, Mayo Clinic
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ACTUAL)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 16-007764
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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