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FLT PET/CT nella misurazione della risposta in pazienti con leucemia mieloide acuta precedentemente non trattata

22 settembre 2026 aggiornato da: National Cancer Institute (NCI)

Valutazione precoce della risposta al trattamento nell'AML mediante imaging FLT PET/TC

This phase II trial studies fluorothymidine F 18 (FLT) positron emission tomography (PET)/computed tomography (CT) in measuring response in patients with previously untreated acute myeloid leukemia. FLT is a radioactive substance that may "light up" where cancer is in the body. FLT is injected into the blood and builds up in cells that are dividing, including cancer cells. Diagnostic procedures, such as PET/CT, may help measure a patient's response to earlier treatment.

Panoramica dello studio

Stato

Attivo, non reclutante

Condizioni

Intervento / Trattamento

Descrizione dettagliata

PRIMARY OBJECTIVES:

I. To evaluate the negative predictive value (NPV) of post-treatment FLT PET/CT imaging for complete remission (CR) in patients receiving induction chemotherapy for acute myeloid leukemia (AML).

SECONDARY OBJECTIVES:

I. To evaluate the positive predictive value (PPV) of post-treatment FLT PET/CT imaging for complete remission.

II. To estimate the sensitivity and specificity of post-treatment FLT PET/CT imaging for detecting complete remission.

III. To correlate FLT PET/CT imaging with biologic correlates (minimal residual disease [MRD] assessment) IV. To correlate FLT PET/CT imaging with relapse-free survival and overall survival.

EXPLORATORY OBJECTIVES:

III. To evaluate pre-treatment FLT PET/CT imaging as a predictor of complete remission.

IV. To evaluate the change between pre-treatment and post-treatment FLT PET/CT imaging as a predictor of complete remission.

OUTLINE:

Patients receive anthracycline intravenously (IV) on days 1-3 and cytarabine IV on days 1-7 for up to 2 courses. Patients then undergo FLT PET/CT within 3 days before or after the nadir bone marrow biopsy (between days 10-17 after initiation of first induction cycle and prior to reinduction). Patients may undergo an optional FLT PET/CT prior to induction chemotherapy if it does not interfere with commencement of treatment. Patients also undergo bone marrow biopsy and aspiration and blood sample collection during screening and on the trial.

After completion of study, patients are followed up at day 28-35, and then up to 1 year beyond the end of study accrual period.

Tipo di studio

Interventistico

Iscrizione (Effettivo)

87

Fase

  • Fase 2

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Luoghi di studio

    • Minnesota
      • Rochester, Minnesota, Stati Uniti, 55905
        • Mayo Clinic in Rochester
    • Missouri
      • St Louis, Missouri, Stati Uniti, 63110
        • Washington University School of Medicine
    • New York
      • New York, New York, Stati Uniti, 10029
        • Mount Sinai Hospital
    • North Carolina
      • Chapel Hill, North Carolina, Stati Uniti, 27599
        • UNC Lineberger Comprehensive Cancer Center
    • Oklahoma
      • Oklahoma City, Oklahoma, Stati Uniti, 73104
        • University of Oklahoma Health Sciences Center
    • Pennsylvania
      • Philadelphia, Pennsylvania, Stati Uniti, 19111
        • Fox Chase Cancer Center
      • Philadelphia, Pennsylvania, Stati Uniti, 19104
        • University of Pennsylvania/Abramson Cancer Center
    • Tennessee
      • Nashville, Tennessee, Stati Uniti, 37232
        • Vanderbilt University/Ingram Cancer Center
    • Texas
      • Dallas, Texas, Stati Uniti, 75390
        • UT Southwestern/Simmons Cancer Center-Dallas
    • Utah
      • Salt Lake City, Utah, Stati Uniti, 84112
        • Huntsman Cancer Institute/University of Utah
    • Wisconsin
      • Madison, Wisconsin, Stati Uniti, 53792
        • University of Wisconsin Carbone Cancer Center - University Hospital

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

18 anni e precedenti (Adulto, Adulto più anziano)

Accetta volontari sani

No

Sessi ammissibili allo studio

Tutto

Descrizione

Inclusion Criteria:

  • Age ≥ 18 years
  • Patients must have previously untreated AML and be candidates for intensive induction chemotherapy; patients are allowed to have had prior hydroxyurea
  • Patients must not have acute promyelocytic leukemia (APL) and must not have evidence of t(15;17)(q22;q21)
  • Patients must have an Eastern Cooperative Oncology Group (ECOG) performance status of 0-3 (restricted to ECOG performance status [PS] 0-2 if age > 70 years)
  • Patients must have left ventricular ejection fraction (LVEF) > 45% or within institutional normal limits
  • Patients must be able to lie still for a 1.5 hour PET scan
  • Patient must NOT have a history of allergic reaction attributable to compounds of similar chemical or biologic composition to 18F-fluorothymidine
  • Patient must NOT weigh more than the maximum weight limit for the PET/CT table for the scanner(s) to be used at each center
  • The patient is participating in the trial at an institution which has agreed to perform the imaging research studies, completed the ECOG-American College of Radiology Imaging Network (ACRIN) defined scanner qualification procedures and received ECOG-ACRIN approval as outlined
  • Women must not be pregnant or breast-feeding; all females of childbearing potential must have a blood test or urine study within 2 weeks prior to registration to rule out pregnancy; a female of childbearing potential is any woman, regardless of sexual orientation or whether they have undergone tubal ligation, who meets the following criteria: 1) has not undergone a hysterectomy or bilateral oophorectomy; or 2) has not been naturally postmenopausal for at least 24 consecutive months (i.e., has had menses at any time in the preceding 24 consecutive months)

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Diagnostico
  • Assegnazione: N / A
  • Modello interventistico: Assegnazione di gruppo singolo
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: Diagnostic (anthracycline, cytarabine, FLT PET/CT)

Patients receive anthracycline IV on days 1-3 and cytarabine IV on days 1-7 for up to 2 courses. Patients then undergo FLT PET/CT within 3 days before or after the nadir bone marrow biopsy (between days 10-17 after initiation of first induction cycle and prior to reinduction). Patients may undergo an optional FLT PET/CT prior to induction chemotherapy if it does not interfere with commencement of treatment. Patients also undergo bone marrow biopsy and aspiration and blood sample collection during screening and on the trial.

Correlative studies

Given IV

Altri nomi:
  • .beta.-Citosina arabinoside
  • 1-.beta.-D-Arabinofuranosil-4-ammino-2(1H)pirimidinone
  • 1-.beta.-D-Arabinofuranosilcitosina
  • 1-Beta-D-arabinofuranosil-4-ammino-2(1H)pirimidinone
  • 1-Beta-D-arabinofuranosilcitosina
  • 1.beta.-D-Arabinofuranosilcitosina
  • 2(1H)-pirimidinone, 4-ammino-1-beta-D-arabinofuranosil-
  • 2(1H)-pirimidinone, 4-ammino-1.beta.-D-arabinofuranosil-
  • Alessandro
  • Ara-C
  • Cellula ARA
  • Arabo
  • Arabinofuranosilcitosina
  • Arabinosilcitosina
  • Aracitidina
  • Aracitina
  • Beta-citosina arabinoside
  • CHX-3311
  • Citarabinum
  • Cytarbel
  • Cytosar
  • Citosina Arabinoside
  • Citosina-.beta.-arabinoside
  • Citosina-beta-arabinoside
  • Erpalfa
  • Starasid
  • Tarabina PFS
  • U19920
  • U-19920
  • Udicil
  • WR-28453

Undergo blood sample collection

Altri nomi:
  • Raccolta di campioni biologici
  • Biocampione raccolto
  • Raccolta di campioni
  • Raccolta campione

Undergo bone marrow biopsy and aspiration

Undergo bone marrow biopsy and aspiration

Altri nomi:
  • Biopsia del midollo osseo
  • Biopsia, midollo osseo

Given anthracycline IV

Altri nomi:
  • Chemio
  • Chemioterapia (NAS)
  • Chemioterapia, Cancro, Generale

Undergo FLT PET/CT

Altri nomi:
  • CT
  • GATTO
  • TAC
  • Tomografia assiale computerizzata
  • Tomografia computerizzata
  • tomografia
  • Tomografia assiale computerizzata (procedura)
  • Scansione tomografia computerizzata (CT).
  • Scansione CAT diagnostica
  • Tipo di servizio di scansione CAT diagnostica

Undergo FLT PET/CT

Altri nomi:
  • 18F-FLT
  • 3'-deossi-3'-[18F]fluorotimidina
  • 3'-Deossi-3'-(18F) Fluorotimidina
  • Fluorotimidina F 18
  • ALOVUDINE F-18

Undergo FLT PET/CT

Altri nomi:
  • Imaging medico, tomografia a emissione di positroni
  • ANIMALE DOMESTICO
  • Scansione animale
  • Scansione di tomografia a emissione di positroni
  • Tomografia ad emissione di positroni
  • P.T
  • Tomografia a emissione di positroni (procedura)

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Negative Predictive Value of Post-treatment Fluorothymidine F 18 (FLT) Positron Emission Tomography (PET)/Computed Tomography (CT) Imaging for Complete Remission (CR) in Comparison With Blast Counts From Bone Marrow Biopsy (BMBX)
Lasso di tempo: Up to day 35

Three imaging parameters (standardized uptake value [SUV]mean, SUVmax, heterogeneity of FLT uptake [SUVhetero]) will be measured from an FLT PET/CT scan and SUVmax will be the primary endpoint. Higher values of SUVmax assume to indicate a non-response the therapy and a cut point of 7 (SUVmax >7) will be used as the threshold indicating a negative scan. The binomial proportion of negative predictive value (NPV) and the corresponding exact confidence intervals will be calculated. In addition, the calculated NPV will be tested against the null hypothesis to see if it's significantly larger than 0.64 (NPV of day-14 BMBX in CR prediction).

CR:Complete remission CRi: Complete remission with incomplete platelet recovery LFS: Leukemia-free state Non-responders defined as Not (CR,CRi,or LFS)

Negative predictive value (NPV) of the post-treatment FLT PET/CT scan is Probability ((not CR,CRi,or LFS) │ SUVmax >7 )

Up to day 35

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Positive Predictive Value (PPV) of Post-treatment FLT PET/CT Imaging for Complete Remission
Lasso di tempo: Up to day 35

The binomial proportion of PPV and the corresponding exact confidence intervals will be calculated. In addition, the calculated PPV will be tested to see if it's significantly larger than 0.79 (PPV of day-14 BMBX in CR prediction).

Up to day 35
Sensitivity of Post-treatment FLT PET/CT for Detecting Complete Remission (a Clinical Response of CR, CRi, or LFS )
Lasso di tempo: Up to day 35

The binomial proportions and the corresponding exact confidence intervals will be calculated for sensitivity estimation where

FLT Test :

Negative: SUV >7; Positive: SUV<=7

Clinical Response:

Negative: not (CR, CRi, or LFS); Positive (Responders): CR, CRi, or LFS

Up to day 35
Specificity of Post-treatment FLT PET/CT for Detecting Complete Remission
Lasso di tempo: Up to day 35

The binomial proportions and the corresponding exact confidence intervals will be calculated for specificity estimation.

Test response:

Negative: SUV >7; Positive: SUV<=7

Clinical Response = Complete remissions:

Negative (Non-Responders): not (CR, CRi, or LFS); Positive (Responders): CR, CRi, or LFS

Up to day 35
FLT PET/CT Imaging Parameters With Biologic Correlates (Minimal Residual Disease Assessment)
Lasso di tempo: Up to day 35

FLT PET/CT imaging features will be compared with biologic correlates (minimal residual disease [MRD] assessment).

Up to day 35
FLT PET/CT Imaging to Predict Relapse-free Survival
Lasso di tempo: Up to day 35 and up to 4 years for RFS

compare the Recurrence-Free Survival (RFS) between positive and negative post-treatment FLT PET/CT scans, where an SUVmax less than or equal to 7 (i.e., low FLT uptake) was considered a positive result, and an SUVmax greater than 7 (i.e., high FLT uptake) was a negative result.

Participants were followed for survival outcomes until study closure when the last participant has been followed for 1 year after study enrollment.

The relapse endpoint included both reappearance of blasts in the blood; and presence of more than 5% blasts not attributable to another cause Time-to-relapse was measured from the date of the remission bone marrow biopsy to the date of first recurrence or death, whichever came first.

RFS was only evaluable for participants with a clinical response of CR, CRi, or LFS at the remission bone marrow biopsy.

Up to day 35 and up to 4 years for RFS
FLT PET/CT Imaging to Predict Overall Survival
Lasso di tempo: Up to day 35 and up to 4 years for RFS

compare the Overall Survival (OS) between positive and negative post-treatment FLT PET/CT scans, where an SUVmax<= 7 (i.e., low FLT uptake) was considered a positive result, and an SUVmax > 7 (i.e., high FLT uptake) was a negative result.

Participants were followed for survival outcomes until study closure when the last participant has been followed for 1 year after study enrollment.

Up to day 35 and up to 4 years for RFS

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Investigatori

  • Investigatore principale: Robert Jeraj, ECOG-ACRIN Cancer Research Group

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Effettivo)

20 aprile 2016

Completamento primario (Effettivo)

31 dicembre 2023

Completamento dello studio (Stimato)

13 febbraio 2027

Date di iscrizione allo studio

Primo inviato

18 marzo 2015

Primo inviato che soddisfa i criteri di controllo qualità

18 marzo 2015

Primo Inserito (Stimato)

19 marzo 2015

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

23 settembre 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

22 settembre 2026

Ultimo verificato

1 settembre 2026

Maggiori informazioni

Termini relativi a questo studio

Altri numeri di identificazione dello studio

  • NCI-2015-00328
  • U10CA180820 (Sovvenzione/contratto NIH degli Stati Uniti)
  • NCI-2015-00328 (Identificatore di registro: CTRP (Clinical Trial Reporting Program))
  • EAI141 (Altro identificatore: CTEP)
  • U10CA180827 (Sovvenzione/contratto NIH degli Stati Uniti)
  • EAI141
  • EAI141 (Altro identificatore: ECOG-ACRIN Cancer Research Group)

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .