- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03778294
18F-DOPA-PET/MRI Scan in Imaging Elderly Patients With Newly Diagnosed Grade IV Malignant Glioma or Glioblastoma During Planning for a Short Course of Proton Beam Radiation Therapy
Phase II Study of Short Course Hypofractionated Proton Beam Therapy Incorporating 18F-DOPA-PET/MRI for Elderly Patients With Newly Diagnosed Glioblastoma
Study Overview
Status
Conditions
Detailed Description
PRIMARY OBJECTIVE:
I. Compare overall survival at 12 months for grade IV glioma patients after radiation therapy targeting volumes designed with both 18F-DOPA-PET and conventional magnetic resonance (MR) image (or PET/computed tomography [CT]) information with historical controls.
SECONDARY OBJECTIVES:
I. Compare progression free survival at 12 months after radiation therapy targeting volumes designed with both 18F-DOPA-PET and conventional MR image information with historical controls.
II. Determine acute and late effect toxicity after hypofractionated proton beam radiotherapy treatment including areas of high 18F-DOPA-PET uptake (T/N > 2.0).
CORRELATIVE RESEARCH OBJECTIVES:
I. Compare radiotherapy (RT) treatment volumes defined by MR only with RT treatment volumes defined with both PET and MR information for grade IV glioma patients.
II. Compare differences in RT volumes identified using biopsy-validated thresholds as highly aggressive disease comparing 18F-DOPA uptake and relative cerebral blood volume (relCBV) from perfusion MRI (pMRI) as well as differences in RT volumes identified using biopsy-validated thresholds as tumor extent comparing 18F-DOPA uptake and diffusion maps from diffusion tensor imaging (DTI) will be evaluated.
III. Evaluate quality of life after radiotherapy using European Organization for Research and Treatment of Cancer (EORTC) questionnaires compared with historical controls from Keim-Guibert et al.
IV. Compare differences in proton radiation planning utilizing radiobiologic modeling/evaluation techniques performed at Mayo Clinic Rochester to linear energy transfer distribution evaluation at Mayo Clinic Arizona.
OUTLINE:
Patients receive 18F-DOPA intravenously (IV) and undergo PET/MRI or PET/CT imaging scan. Patients then receive proton beam radiotherapy over 5 or 10 consecutive days excluding weekend and standard of care temozolomide on days 1-7 or 1-14. Beginning cycles 2, patients receive standard of care temozolomide on days 1-5. Cycles with temozolomide repeat every 28 days for up to 7 cycles in the in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed up every 2 months for 1 year, and then periodically for up to 5 years.
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
Arizona
-
Scottsdale, Arizona, United States, 85259
- Mayo Clinic in Arizona
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Minnesota
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Rochester, Minnesota, United States, 55905
- Mayo Clinic in Rochester
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Histologically confirmed newly diagnosed grade IV malignant glioma
- Planned radiation treatments at Mayo Clinic Arizona or Mayo Clinic Rochester
- Willing to sign release of information for any radiation and/or follow-up records
- Provide informed written consent
- Patients with estimated glomerular filtration rate (eGFR) >= 60 mg/min/1.72 m^2
- Ability to complete questionnaire(s) by themselves or with assistance
- Eastern Cooperative Oncology Group (ECOG) performance status 0, 1, 2
Exclusion Criteria:
- Patients diagnosed with grades I-III glioma
- Currently on Avastin at time of treatment
- Unable to undergo MRI scans with contrast (e.g. cardiac pacemaker, defibrillator, kidney failure)
Unable to undergo an 18F-DOPA-PET scan (e.g. Parkinson's disease, taking anti-dopaminergic, or dopamine agonist medication or less than 6 half-lives from discontinuance of dopamine agonists)
- NOTE: Other potentially interfering drugs: amoxapine, amphetamine, benztropine, buproprion, buspirone, cocaine, mazindol, methamphetamine, methylphenidate, norephedrine, phentermine, phenylpropanolamine, selegiline, paroxetine, citalopram, and sertraline. If a patient is on any of these drugs, list which ones on the on-study form
Pregnant women, nursing women, or men or women of childbearing potential who are unwilling to employ adequate contraception.
- NOTE: All women enrolled in this study will be age 65 or over, and at the determination of the principal investigator (PI), will not be of childbearing potential. If the radiology department requires a pregnancy test before administering the 18FDOPA injection, they may perform one per their standard of care
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Treatment (18F-DOPA, PET/MRI, PET/CT, temozolomide)
Patients receive 18F-DOPA IV and undergo PET/MRI or PET/CT imaging scan.
Patients then receive proton beam radiotherapy over 5 or 10 consecutive days excluding weekend and standard of care temozolomide on days 1-7 or 1-14.
Beginning cycles 2, patients receive standard of care temozolomide on days 1-5.
Cycles with temozolomide repeat every 28 days for up to 7 cycles in the in the absence of disease progression or unacceptable toxicity.
|
Ancillary studies
Other Names:
Ancillary studies
Undergo PET/CT
Other Names:
Undergo PET/MRI
Other Names:
Given IV
Other Names:
Undergo PET/CT or PET/MRI
Other Names:
Receive proton beam RT
Other Names:
Drug
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Overall Survival (OS)
Time Frame: Time from registration to death due to any cause, assessed up to 12 months
|
The proportion of successes will be estimated by the number of successes divided by the total number of evaluable patients.
Confidence intervals for the true success proportion will be calculated utilizing exact binomial methodology.
The distribution of survival time will be estimated using the method of Kaplan-Meier (1958).
|
Time from registration to death due to any cause, assessed up to 12 months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Progression Free Survival
Time Frame: Time from registration to the earliest date documenting disease progression, assessed up to 5 years
|
The distribution of progression free survival times groups will be estimated using the method of Kaplan-Meier (1958).
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Time from registration to the earliest date documenting disease progression, assessed up to 5 years
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Progression Free Survival
Time Frame: At 12 months after radiation therapy
|
The proportion of successes will be estimated by the number of successes divided by the total number of evaluable patients.
Confidence intervals for the true success proportion will be calculated utilizing exact binomial methodology.
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At 12 months after radiation therapy
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Incidence of Adverse Events (AEs)
Time Frame: Up to 5 years post treatment
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The rate of acute and late treatment-related toxicities for newly diagnosed high-grade glioma patients treated with fluorodopa F 18-positron emission tomography (18F-DOPA PET) image-guided hypofractionated proton beam therapy will be determined, with acute radiotherapy (RT) toxicities graded using Common Terminology Criteria for Adverse Events (CTCAE) version 4.0.
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Up to 5 years post treatment
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Radiotherapy (RT) Treatment Volumes
Time Frame: Up to 5 years post treatment
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Paired t-test statistical analysis will be performed to determine if any differences exist and the level of statistical significance between treatment volumes defined by magnetic resonance (MR) only and treatment volumes defined with both positron emission tomography (PET) and MR information.
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Up to 5 years post treatment
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Quality of Life (QOL)
Time Frame: Up to 5 years post treatment
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QOL surveys will be compared to data from historical controls.
Quality of life will be assessed at baseline and at each magnetic resonance imaging (MRI) evaluation (up to 6 evaluations).
QOL will be measured using the European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ)-C30.
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Up to 5 years post treatment
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Differences in Proton Radiation Planning
Time Frame: Up to 5 years post treatment
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Paired t-test statistical analysis will be performed to determine if any differences exist and the level of statistical significance between proton plan metrics based off the two modeling/evaluation techniques.
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Up to 5 years post treatment
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Sujay A Vora, Mayo Clinic
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 (Estimated)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Neoplasms by Histologic Type
- Neoplasms
- Neoplasms, Glandular and Epithelial
- Astrocytoma
- Neoplasms, Neuroepithelial
- Neuroectodermal Tumors
- Neoplasms, Germ Cell and Embryonal
- Neoplasms, Nerve Tissue
- Glioblastoma
- Glioma
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Antineoplastic Agents
- Protective Agents
- Antineoplastic Agents, Alkylating
- Alkylating Agents
- Dopamine Agents
- Cariostatic Agents
- Antiparkinson Agents
- Anti-Dyskinesia Agents
- Temozolomide
- Fluorides
- Levodopa
Other Study ID Numbers
- MC1774 (Other Identifier: Mayo Clinic in Arizona)
- NCI-2018-02800 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
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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