18F-FLT Positron Emission Tomography and Diffusion-Weighted Magnetic Resonance Imaging in Planning Surgery and Radiation Therapy and Measuring Response in Patients With Newly Diagnosed Ewing Sarcoma

NCT ID: NCT01825902

Last Updated: 2017-11-20

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

EARLY_PHASE1

Total Enrollment

1 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-03-31

Study Completion Date

2015-11-23

Brief Summary

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This pilot trial studies fluorine F 18 fluorothymidine (18F-FLT) positron emission tomography and diffusion-weighted magnetic resonance imaging in planing surgery and radiation therapy and measuring response in patients with newly diagnosed Ewing sarcoma. Comparing results of diagnostic procedures done before and after treatment may help doctors predict a patient's response and help plan the best treatment.

Detailed Description

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PRIMARY OBJECTIVES:

I. Establish correlation between 18F-FLT positron emission tomography (PET) activity, apparent diffusion coefficients (ADC) values from diffusion-weighted magnetic resonance imaging (DW-MRI), fludeoxyglucose F 18 (18F-FDG) PET activity, magnetic resonance imaging (MRI) contrast enhancement, and pathologic response for Ewing sarcoma.

II. Assess the efficacy of detecting therapy induced changes in 18F-FLT PET uptake and ADC from DW-MRI for more accurately predicting local control, event-free survival, and overall survival as compared to standard prognostic factors (e.g. change in tumor size).

III. Compare radiotherapy target volume delineation with pre- and post-chemotherapy 18F-FLT PET and DW-MRI information to delineation with pre-chemotherapy conventional MRI to determine role of advanced imaging in radiotherapy treatment planning for Ewing sarcoma.

SECONDARY OBJECTIVES:

I. Establish correlation between 18F-FLT PET activity, ADC values from DW-MRI, 18F-FDG PET activity, MRI contrast enhancement, and biomolecular assays for Ewing sarcoma.

II. Determine imaging thresholds to discriminate between viable and necrotic tumor, as established through pathologic correlations.

III. Assess efficacy of advanced imaging for more accurately guiding biopsy targeting by comparing planned targeting with standard (MRI contrast enhancement) vs. advanced imaging (18F -FLT PET and DW-MRI).

IV. Compare post-treatment response assessment with 18F-FLT PET and DW-MRI vs. 18F-FDG PET to determine whether 18F-FLT PET and ADC information is more accurate than 18F-FDG PET for distinguishing between necrosis and non-specific inflammation immediately following treatment.

V. Estimate potential reduction in acute and late side effects based on modified radiation therapy (RT) treatment volumes with pre- and post-chemotherapy 18F-FLT PET and DW-MRI information as compared to volumes delineated with pre-chemotherapy conventional MRI.

VI. Evaluate automatic image segmentation techniques for 18F-FLT PET and DW-MRI, comparing against biopsy determined imaging thresholds and expert Nuclear Medicine and MR Radiologist contours.

OUTLINE:

Patients undergo 18F-FLT PET, 18F-FDG PET, and DW-MRI the week prior to induction therapy, within one week after the completion of induction therapy, the week prior to RT (for patients that received surgery), and within 1 week of completion of RT.

After completion of study intervention, patients are followed up every 3 months for 1 year and then every 6 months for up to 4 years.

Conditions

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Adult Supratentorial Primitive Neuroectodermal Tumor (PNET) Ewing Sarcoma of Bone Extraosseous Ewing Sarcoma Localized Ewing Sarcoma/Peripheral Primitive Neuroectodermal Tumor Metastatic Ewing Sarcoma/Peripheral Primitive Neuroectodermal Tumor Untreated Childhood Supratentorial Primitive Neuroectodermal Tumor

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Diagnostic (18F-FLT PET, 18F-FDG PET, DW-MRI)

Patients undergo 18F-FLT PET, 18F-FDGPET, and DW-MRI the week prior to induction therapy, within one week after the completion of induction therapy, the week prior to RT (for patients that received surgery), and within 1 week of completion of RT.

Group Type EXPERIMENTAL

fluorine F 18 fluorothymidine

Intervention Type DRUG

Undergo 18F-FLT PET

fludeoxyglucose F 18

Intervention Type RADIATION

Undergo 18F-FDG PET

positron emission tomography

Intervention Type PROCEDURE

Undergo 18F-FLT PET and 18F-FDG PET

diffusion-weighted magnetic resonance imaging

Intervention Type PROCEDURE

Undergo DW-MRI

laboratory biomarker analysis

Intervention Type OTHER

Correlative studies

Interventions

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fluorine F 18 fluorothymidine

Undergo 18F-FLT PET

Intervention Type DRUG

fludeoxyglucose F 18

Undergo 18F-FDG PET

Intervention Type RADIATION

positron emission tomography

Undergo 18F-FLT PET and 18F-FDG PET

Intervention Type PROCEDURE

diffusion-weighted magnetic resonance imaging

Undergo DW-MRI

Intervention Type PROCEDURE

laboratory biomarker analysis

Correlative studies

Intervention Type OTHER

Other Intervention Names

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18F-FLT 3'-deoxy-3'-[18F]fluorothymidine fluorothymidine F-18 18FDG FDG FDG-PET PET PET scan tomography, emission computed diffusion-weighted MRI

Eligibility Criteria

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Inclusion Criteria

* Histological confirmation of newly diagnosed localized or newly diagnosed with metastatic Ewing sarcoma (ES) or primitive neuroectodermal tumor (PNET) of bone or soft tissue
* Planning to receive definitive RT or surgery with or without adjuvant RT
* Willing to sign release of information for any follow-up records
* Provide informed written consent if \>= 18 years; if \< 18 years, provide informed written assent and parent or legal guardian provide informed written consent
* Patients must have measurable disease
* Willingness to participate in mandatory imaging studies
* Willingness to provide mandatory pathology samples for correlative research

Exclusion Criteria

* Unable to undergo MRI scans with contrast (e.g. cardiac pacemaker, defibrillator, kidney failure)
* Unable to undergo 18F-FLT PET scan
* Any of the following:

* Pregnant women
* Nursing women
* Men or women of childbearing potential who are unwilling to employ adequate contraception
Minimum Eligible Age

7 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Mayo Clinic

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Nadia N. Laack, M.D.

Role: STUDY_CHAIR

Mayo Clinic

Locations

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Mayo Clinic

Rochester, Minnesota, United States

Site Status

Countries

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United States

Other Identifiers

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NCI-2013-00707

Identifier Type: REGISTRY

Identifier Source: secondary_id

MC1279

Identifier Type: -

Identifier Source: org_study_id