未治療の急性骨髄性白血病患者における反応の測定における FLT PET/CT
FLT PET/CT イメージングを使用した AML の治療反応の早期評価
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.
調査の概要
状態
条件
詳細な説明
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.
研究の種類
入学 (実際)
段階
- フェーズ2
連絡先と場所
研究場所
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Minnesota
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Rochester、Minnesota、アメリカ、55905
- Mayo Clinic in Rochester
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Missouri
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St Louis、Missouri、アメリカ、63110
- Washington University School of Medicine
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New York
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New York、New York、アメリカ、10029
- Mount Sinai Hospital
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North Carolina
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Chapel Hill、North Carolina、アメリカ、27599
- UNC Lineberger Comprehensive Cancer Center
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Oklahoma
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Oklahoma City、Oklahoma、アメリカ、73104
- University of Oklahoma Health Sciences Center
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Pennsylvania
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Philadelphia、Pennsylvania、アメリカ、19111
- Fox Chase Cancer Center
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Philadelphia、Pennsylvania、アメリカ、19104
- University of Pennsylvania/Abramson Cancer Center
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Tennessee
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Nashville、Tennessee、アメリカ、37232
- Vanderbilt University/Ingram Cancer Center
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Texas
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Dallas、Texas、アメリカ、75390
- UT Southwestern/Simmons Cancer Center-Dallas
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Utah
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Salt Lake City、Utah、アメリカ、84112
- Huntsman Cancer Institute/University of Utah
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Wisconsin
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Madison、Wisconsin、アメリカ、53792
- University of Wisconsin Carbone Cancer Center - University Hospital
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
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)
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：診断
- 割り当て：なし
- 介入モデル：単一グループの割り当て
- マスキング：なし（オープンラベル）
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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実験的：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
他の名前：
Undergo blood sample collection
他の名前：
Undergo bone marrow biopsy and aspiration Undergo bone marrow biopsy and aspiration
他の名前：
Given anthracycline IV
他の名前：
Undergo FLT PET/CT
他の名前：
Undergo FLT PET/CT
他の名前：
Undergo FLT PET/CT
他の名前：
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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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)
時間枠：Up to day 35
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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
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Positive Predictive Value (PPV) of Post-treatment FLT PET/CT Imaging for Complete Remission
時間枠：Up to day 35
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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
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Sensitivity of Post-treatment FLT PET/CT for Detecting Complete Remission (a Clinical Response of CR, CRi, or LFS )
時間枠：Up to day 35
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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
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Specificity of Post-treatment FLT PET/CT for Detecting Complete Remission
時間枠：Up to day 35
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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
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FLT PET/CT Imaging Parameters With Biologic Correlates (Minimal Residual Disease Assessment)
時間枠：Up to day 35
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FLT PET/CT imaging features will be compared with biologic correlates (minimal residual disease [MRD] assessment). |
Up to day 35
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FLT PET/CT Imaging to Predict Relapse-free Survival
時間枠：Up to day 35 and up to 4 years for RFS
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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
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FLT PET/CT Imaging to Predict Overall Survival
時間枠：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
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協力者と研究者
捜査官
- 主任研究者：Robert Jeraj、ECOG-ACRIN Cancer Research Group
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (推定)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- NCI-2015-00328
- U10CA180820 (米国 NIH グラント/契約)
- NCI-2015-00328 (レジストリ識別子：CTRP (Clinical Trial Reporting Program))
- EAI141 (その他の識別子：CTEP)
- U10CA180827 (米国 NIH グラント/契約)
- EAI141
- EAI141 (その他の識別子：ECOG-ACRIN Cancer Research Group)
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