- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT07420036
An Open-label, Single-arm, Single-center Study to Evaluate the Diagnostic Efficacy of a Novel PET Probe, 68Ga-SFB6-ZN01, in Patients With Malignant Tumors (SFB6-ZN01 PET)
Study Overview
Detailed Description
Study Title An Open-label, Single-arm, Single-center Study to Evaluate the Diagnostic Efficacy of a Novel PET Probe, 68Ga-SFB6-ZN01, in Patients with Malignant Tumors Background and Rationale Integrin αvβ6 is an epithelial-restricted cell surface receptor that is markedly upregulated in various carcinomas (e.g., pancreatic, lung, colorectal, head and neck, breast) during tumorigenesis and metastasis, but is minimally expressed in healthy adult tissues. This expression pattern makes αvβ6 an attractive target for molecular imaging. 68Ga-SFB6-ZN01 is a novel PET radiotracer with high affinity and selectivity for integrin αvβ6. Preclinical studies have demonstrated favorable pharmacokinetics, specific tumor uptake, and acceptable dosimetry. This first-in-human diagnostic study is designed to comprehensively evaluate the clinical performance of 68Ga-SFB6-ZN01 PET/CT.
Study Design This is an open-label, single-center, single-arm, non-randomized, interventional diagnostic study. All enrolled subjects will receive a single intravenous bolus injection of 68Ga-SFB6-ZN01 followed by whole-body PET/CT acquisition. The study is prospective and will be conducted at Zhongnan Hospital of Wuhan University.
Primary Objective and Outcome Measure The primary objective is to determine the diagnostic efficacy of 68Ga-SFB6-ZN01 PET/CT for detecting malignant lesions (primary and metastatic) in patients with proven or suspected solid malignancies. The primary outcome measure is sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) on a per-patient and per-lesion basis, using histopathology as the gold standard and/or clinical/imaging follow-up of at least 6 months. This outcome will be assessed up to 6 months post-imaging.
Secondary Objectives and Outcome Measures To assess the safety and tolerability of a single microdose of 68Ga-SFB6-ZN01. The corresponding outcome measure is the incidence, severity, and relationship of adverse events, recorded from injection to 72 hours post-injection.
To characterize the biodistribution and estimate radiation dosimetry of 68Ga-SFB6-ZN01. The outcome measures include organ-specific standardized uptake values (SUV), time-activity curves, and effective dose (mSv) calculated from serial whole-body PET/CT scans obtained in a subset of patients over 0-3 hours post-injection.
To evaluate the accuracy of 68Ga-SFB6-ZN01 PET/CT for tumor staging according to the AJCC 8th edition. Outcome measures are the concordance between PET/CT-based stage and histopathology-confirmed stage, as well as the proportion of patients with a change in stage compared to conventional imaging. This will be assessed at baseline.
To explore the correlation between PET semi-quantitative parameters and histopathological features.
Study Population
Approximately 98 eligible subjects will be enrolled. The target population includes:
Patients with histologically confirmed malignant solid tumors (any stage) requiring initial staging or restaging; Patients with high clinical suspicion of malignancy based on conventional imaging and/or elevated tumor markers; Patients with suspected recurrent disease after curative-intent treatment. Inclusion Criteria Voluntary written informed consent. Age ≥ 18 years, male or female. Clinically suspected or pathologically confirmed malignant solid tumor, or suspicion of recurrence after treatment.
Eastern Cooperative Oncology Group performance status (ECOG PS) 0-1. Life expectancy ≥ 6 months. Female subjects of childbearing potential and male subjects with partners of childbearing potential must agree to use highly effective contraception from consent until 6 months after study agent administration.
Exclusion Criteria Administration of any radionuclide within a period less than 10 physical half-lives before study agent injection.
Concurrent participation in another interventional clinical trial involving an investigational drug or device.
Known hypersensitivity to 68Ga-SFB6-ZN01 or any of its excipients. Inability to lie flat or remain still during PET/CT acquisition, or any contraindication to PET/CT.
Pregnancy or breastfeeding. Any other condition that, in the opinion of the investigator, would make the subject unsuitable for participation.
Safety Monitoring Vital signs will be measured before injection and at 30 minutes, 1 hour, and 2 hours post-injection. Adverse events will be recorded throughout the visit.
PET/CT Acquisition Whole-body PET/CT will be performed at 60±10 minutes post-injection. For a subset of approximately 6 patients participating in dosimetry assessments, additional serial PET/CT scans will be obtained at approximately 10, 60, 120, and 180 minutes post-injection.
Image Reconstruction Standard vendor-provided algorithms with attenuation correction, scatter correction, and iterative reconstruction will be used.
Image Analysis Two experienced nuclear medicine physicians, blinded to clinical and histopathological data, will independently interpret all PET/CT images. Discrepancies will be resolved by consensus or a third reader.
Semi-quantitative Parameters For each identified lesion, the following parameters will be recorded: SUVmax, SUVmean, tumor-to-background ratio (TBRmax and TBRmean) using blood pool (aorta) and liver as references, and total lesion metabolism uptake (TLMU) calculated as SUVmean × metabolic tumor volume (MTV).
Staging Tumor-node-metastasis (TNM) stage according to AJCC 8th edition will be assigned based on PET/CT findings and compared with histopathology and/or conventional imaging.
Follow-up Short-term: Subjects will be contacted by telephone or seen in clinic 24-72 hours post-injection to assess for delayed adverse events.
Long-term: Clinical and imaging follow-up data (treatment received, disease status, progression, survival) will be collected at 3, 6, 12, 24, and 36 months as part of standard clinical care. These data will serve as the reference standard for diagnostic accuracy calculations when histopathology is not available.
Reference Standard Primary reference: Histopathology obtained from surgical resection or core needle biopsy, when such tissue is available.
Secondary/composite reference: For lesions without pathological confirmation, a multidisciplinary consensus diagnosis based on at least 6 months of clinical and imaging follow-up (e.g., lesion progression on follow-up imaging, response to therapy, or sustained stability) will be used.
Statistical Considerations Sample Size Justification: The sample size of 98 subjects is based on the precision required for estimating diagnostic sensitivity and specificity. Assuming an expected sensitivity of 90% and specificity of 85% for per-patient diagnosis, a two-sided 95% confidence interval half-width of approximately ±8% is achievable. Accounting for a 10% unevaluable rate, 98 patients provide sufficient precision for the primary endpoint.
Statistical Methods: Diagnostic accuracy: Sensitivity, specificity, PPV, NPV, and accuracy will be calculated with 95% Clopper-Pearson confidence intervals. The area under the receiver operating characteristic curve (AUC) will be estimated.
Ethical Considerations The study will be conducted in full compliance with the Declaration of Helsinki, the International Conference on Harmonisation Good Clinical Practice guidelines, and applicable Chinese regulations. The protocol, informed consent form, and all study-related documents have been reviewed and approved by the Medical Ethics Committee of Zhongnan Hospital, Wuhan University (Approval Number: KELUN[2025106]; Date: November 27, 2025). Written informed consent will be obtained from each participant before any study-specific procedure is performed.
Study Type
Enrollment (Estimated)
Phase
- Early Phase 1
Contacts and Locations
Study Contact
- Name: Yong He, MD, PhD
- Phone Number: +86-27-67812698
- Email: heyong@whu.edu.cn
Study Locations
-
-
Hubei
-
Wuhan, Hubei, China, 430071
- Zhongnan Hospital of Wuhan University
-
Contact:
- Yong He, MD, PhD
- Phone Number: +86-27-67812698
- Email: heyong@whu.edu.cn
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Voluntary written informed consent.
- Age ≥ 18 years, male or female.
- Clinically suspected or pathologically confirmed malignant solid tumor, or suspicion of recurrence after treatment.
- Eastern Cooperative Oncology Group performance status (ECOG PS) 0-1.
- Life expectancy ≥ 6 months.
- Female subjects of childbearing potential and male subjects with partners of childbearing potential must agree to use highly effective contraception from consent until 6 months after study agent administration.
Exclusion Criteria:
- Administration of any radionuclide within a period less than 10 physical half-lives before study agent injection.
- Concurrent participation in another interventional clinical trial involving an investigational drug or device.
- Known hypersensitivity to 68Ga-SFB6-ZN01 or any of its excipients.
- Inability to lie flat or remain still during PET/CT acquisition, or any contraindication to PET/CT.
- Pregnancy or breastfeeding.
- Any other condition that, in the opinion of the investigator, would make the subject unsuitable for participation.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
Experimental: 68Ga-SFB6-ZN01 PET/CT
Participants receive a single intravenous injection of 68Ga-SFB6-ZN01 followed by whole-body PET/CT acquisition approximately 60 minutes post-injection.
|
Single intravenous bolus injection of 68Ga-SFB6-ZN01 (target activity: 111-185 MBq) followed by whole-body PET/CT scan at 60 ± 10 minutes post-injection.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Diagnostic Efficacy of 68Ga-SFB6-ZN01 PET/CT in Malignant Solid Tumors
Time Frame: Up to 6 months post-imaging
|
Sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of 68Ga-SFB6-ZN01 PET/CT for detecting malignant lesions (primary and metastatic), using histopathology as the reference standard and/or clinical/imaging follow-up of at least 6 months as the composite reference standard.
|
Up to 6 months post-imaging
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Safety and Tolerability: Incidence of Adverse Events
Time Frame: From injection to 72 hours post-injection
|
Incidence of adverse events graded by CTCAE v5.0 following a single microdose of 68Ga-SFB6-ZN01.
|
From injection to 72 hours post-injection
|
|
Safety and Tolerability: Relationship of Adverse Events
Time Frame: From injection to 72 hours post-injection
|
Relationship of adverse events to study agent (unrelated, possibly related, related) following a single microdose of 68Ga-SFB6-ZN01.
|
From injection to 72 hours post-injection
|
|
Safety and Tolerability: Severity of Adverse Events
Time Frame: From injection to 72 hours post-injection
|
Severity of adverse events graded by CTCAE v5.0 following a single microdose of 68Ga-SFB6-ZN01.
|
From injection to 72 hours post-injection
|
|
Biodistribution: Organ-Specific Standardized Uptake Values (SUV)
Time Frame: At approximately 10, 60, 120, and 180 minutes post-injection
|
Organ-specific standardized uptake values (SUVmax and SUVmean) of 68Ga-SFB6-ZN01 measured from serial whole-body PET/CT scans in a subset of patients.
|
At approximately 10, 60, 120, and 180 minutes post-injection
|
|
Biodistribution: Time-Activity Curves
Time Frame: From 0 to 3 hours post-injection (serial scans at 10, 60, 120, and 180 minutes)
|
Time-activity curves of 68Ga-SFB6-ZN01 in major organs and tumors derived from serial whole-body PET/CT scans in a subset of patients.
|
From 0 to 3 hours post-injection (serial scans at 10, 60, 120, and 180 minutes)
|
|
Staging Accuracy: Concordance with Histopathology
Time Frame: Baseline (at time of imaging, compared with pathology results obtained within 6 weeks)
|
Concordance between PET/CT-based TNM stage (AJCC 8th edition) and histopathology-confirmed TNM stage.
|
Baseline (at time of imaging, compared with pathology results obtained within 6 weeks)
|
|
Radiation Dosimetry: Effective Dose
Time Frame: From 0 to 3 hours post-injection (serial scans at 10, 60, 120, and 180 minutes)
|
Effective dose (mSv) of 68Ga-SFB6-ZN01 calculated from serial whole-body PET/CT scans using OLINDA/EXM software.
|
From 0 to 3 hours post-injection (serial scans at 10, 60, 120, and 180 minutes)
|
|
Staging Accuracy: Proportion with Stage Change
Time Frame: Baseline
|
Proportion of patients with a change in TNM stage (AJCC 8th edition) based on 68Ga-SFB6-ZN01 PET/CT compared to conventional imaging (CT, MRI, or 18F-FDG PET/CT if performed).
|
Baseline
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Correlation of PET Parameters with Histopathological Features
Time Frame: Up to 3 months post-imaging (when surgical or biopsy specimens are available)
|
Correlation of SUVmax, SUVmean, TBRmax, TBRmean, and total lesion metabolism uptake (TLMU) with tumor grade, Ki-67 index, and integrin αvβ6 immunohistochemical expression (H-score).
|
Up to 3 months post-imaging (when surgical or biopsy specimens are available)
|
Collaborators and Investigators
Sponsor
Publications and helpful links
General Publications
- Quigley NG, Steiger K, Hoberuck S, Czech N, Zierke MA, Kossatz S, Pretze M, Richter F, Weichert W, Pox C, Kotzerke J, Notni J. PET/CT imaging of head-and-neck and pancreatic cancer in humans by targeting the "Cancer Integrin" alphavbeta6 with Ga-68-Trivehexin. Eur J Nucl Med Mol Imaging. 2022 Mar;49(4):1136-1147. doi: 10.1007/s00259-021-05559-x. Epub 2021 Sep 24.
- Xia C, Dong X, Li H, Cao M, Sun D, He S, Yang F, Yan X, Zhang S, Li N, Chen W. Cancer statistics in China and United States, 2022: profiles, trends, and determinants. Chin Med J (Engl). 2022 Feb 9;135(5):584-590. doi: 10.1097/CM9.0000000000002108.
- Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I, Jemal A. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024 May-Jun;74(3):229-263. doi: 10.3322/caac.21834. Epub 2024 Apr 4.
- Kimura RH, Wang L, Shen B, Huo L, Tummers W, Filipp FV, Guo HH, Haywood T, Abou-Elkacem L, Baratto L, Habte F, Devulapally R, Witney TH, Cheng Y, Tikole S, Chakraborti S, Nix J, Bonagura CA, Hatami N, Mooney JJ, Desai T, Turner S, Gaster RS, Otte A, Visser BC, Poultsides GA, Norton J, Park W, Stolowitz M, Lau K, Yang E, Natarajan A, Ilovich O, Srinivas S, Srinivasan A, Paulmurugan R, Willmann J, Chin FT, Cheng Z, Iagaru A, Li F, Gambhir SS. Evaluation of integrin alphavbeta6 cystine knot PET tracers to detect cancer and idiopathic pulmonary fibrosis. Nat Commun. 2019 Oct 14;10(1):4673. doi: 10.1038/s41467-019-11863-w.
- Keat N, Kenny J, Chen K, Onega M, Garman N, Slack RJ, Parker CA, Lumbers RT, Hallett W, Saleem A, Passchier J, Lukey PT. A Microdose PET Study of the Safety, Immunogenicity, Biodistribution, and Radiation Dosimetry of 18F-FB-A20FMDV2 for Imaging the Integrin alphavbeta6. J Nucl Med Technol. 2018 Jun;46(2):136-143. doi: 10.2967/jnmt.117.203547. Epub 2018 Feb 2.
- Altmann A, Sauter M, Roesch S, Mier W, Warta R, Debus J, Dyckhoff G, Herold-Mende C, Haberkorn U. Identification of a Novel ITGalphavbeta6-Binding Peptide Using Protein Separation and Phage Display. Clin Cancer Res. 2017 Aug 1;23(15):4170-4180. doi: 10.1158/1078-0432.CCR-16-3217. Epub 2017 May 3.
- Kimura RH, Iagaru A, Guo HH. Mini review of first-in-human integrin alphavbeta6 PET tracers. Front Nucl Med. 2023 Oct 9;3:1271208. doi: 10.3389/fnume.2023.1271208. eCollection 2023.
- Niu J, Li Z. The roles of integrin alphavbeta6 in cancer. Cancer Lett. 2017 Sep 10;403:128-137. doi: 10.1016/j.canlet.2017.06.012. Epub 2017 Jun 17.
- Chastney MR, Kaivola J, Leppanen VM, Ivaska J. The role and regulation of integrins in cell migration and invasion. Nat Rev Mol Cell Biol. 2025 Feb;26(2):147-167. doi: 10.1038/s41580-024-00777-1. Epub 2024 Sep 30.
Study record dates
Study Major Dates
Study Start (Estimated)
Primary Completion (Estimated)
Study Completion (Estimated)
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
- 2025LCYJZX-ZD004
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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