Trial Outcomes & Findings for FLT PET in Measuring Treatment Response in Patients With Newly Diagnosed Estrogen Receptor-Positive, HER2-Negative Stage I-III Breast Cancer (NCT NCT01928186)

NCT ID: NCT01928186

Last Updated: 2018-05-15

Results Overview

Percent change between pre-treatment (baseline) and post-therapy PET measurements in breast tumors will be computed. Association between Ki-67 and Ki by FLT (KFLT) decline will be analyzed using the mid-P adjustment to Fisher's exact test to evaluate the potential clinical utility of change in FLT as a biomarker for early response, using Ki-67 as the standard for early response.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

28 participants

Primary outcome timeframe

Baseline to up to 6 weeks

Results posted on

2018-05-15

Participant Flow

Participant milestones

Participant milestones
Measure
Diagnostic (FLT PET)
Patients undergo FLT PET at baseline and 1-6 weeks after the start of treatment. Fluorothymidine F-18: Undergo FLT PET Positron Emission Tomography: Undergo FLT PET Laboratory Biomarker Analysis: Correlative studies
Overall Study
STARTED
28
Overall Study
COMPLETED
28
Overall Study
NOT COMPLETED
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

FLT PET in Measuring Treatment Response in Patients With Newly Diagnosed Estrogen Receptor-Positive, HER2-Negative Stage I-III Breast Cancer

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Diagnostic (FLT PET)
n=28 Participants
Patients with early stage, ER positive primary breast cancer undergo FLT PET scan at baseline and 1-6 weeks after the start of standard endocrine treatment. The surgery follows 1-7 days after the second FLT PET scan. Tracer used in the FLT PET (positron emission tomography) scanning procedure: \[F18\] fluorothymidine. Positron Emission Tomography: Undergo FLT PET Laboratory Biomarker Analysis: Correlative studies - Ki67 staining of the tumor tissue in the biopsy and surgical specimen.
Age, Continuous
60.4 years
n=5 Participants
Sex: Female, Male
Female
28 Participants
n=5 Participants
Sex: Female, Male
Male
0 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
1 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
27 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
3 Participants
n=5 Participants
Race (NIH/OMB)
White
25 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
Clinical stage
Stage I
10 Participants
n=5 Participants
Clinical stage
Stage IIA
14 Participants
n=5 Participants
Clinical stage
Stage IIB
4 Participants
n=5 Participants

PRIMARY outcome

Timeframe: Baseline to up to 6 weeks

Percent change between pre-treatment (baseline) and post-therapy PET measurements in breast tumors will be computed. Association between Ki-67 and Ki by FLT (KFLT) decline will be analyzed using the mid-P adjustment to Fisher's exact test to evaluate the potential clinical utility of change in FLT as a biomarker for early response, using Ki-67 as the standard for early response.

Outcome measures

Outcome measures
Measure
Diagnostic (FLT PET)
n=28 Participants
Patients with early stage, ER positive primary breast cancer undergo FLT PET scan at baseline and 1-6 weeks after the start of standard endocrine treatment. The surgery follows 1-7 days after the second FLT PET scan. Tracer used in the FLT PET (positron emission tomography) scanning procedure: \[F18\] fluorothymidine. Positron Emission Tomography: Undergo FLT PET Laboratory Biomarker Analysis: Correlative studies - Ki67 staining of the tumor tissue in the biopsy and surgical specimen.
Percent Change in Net Influx Constant (Ki) by FLT PET
-32.0 % change
Interval -82.4 to 3953.7

PRIMARY outcome

Timeframe: Baseline to up to 6 weeks

Percent change between pre-treatment (baseline) and post-therapy measurements of FLT standardized uptake value (SUV) in breast tumors will be computed.

Outcome measures

Outcome measures
Measure
Diagnostic (FLT PET)
n=28 Participants
Patients with early stage, ER positive primary breast cancer undergo FLT PET scan at baseline and 1-6 weeks after the start of standard endocrine treatment. The surgery follows 1-7 days after the second FLT PET scan. Tracer used in the FLT PET (positron emission tomography) scanning procedure: \[F18\] fluorothymidine. Positron Emission Tomography: Undergo FLT PET Laboratory Biomarker Analysis: Correlative studies - Ki67 staining of the tumor tissue in the biopsy and surgical specimen.
Percent Change in SUV by FLT PET
-26.6 % change
Interval -77.3 to 7.4

PRIMARY outcome

Timeframe: 1 to 6 weeks post-therapy start

Surgically removed breast tumor tissue is stained using immuno-histochemistry techniques to visualize dividing cells expressing the Ki-67 protein, which is a cellular marker for proliferation.

Outcome measures

Outcome measures
Measure
Diagnostic (FLT PET)
n=28 Participants
Patients with early stage, ER positive primary breast cancer undergo FLT PET scan at baseline and 1-6 weeks after the start of standard endocrine treatment. The surgery follows 1-7 days after the second FLT PET scan. Tracer used in the FLT PET (positron emission tomography) scanning procedure: \[F18\] fluorothymidine. Positron Emission Tomography: Undergo FLT PET Laboratory Biomarker Analysis: Correlative studies - Ki67 staining of the tumor tissue in the biopsy and surgical specimen.
Percentage of Ki-67 Positive Tumor Cells in Surgical (Post-therapy) Sample
3 % stained cells
Interval 0.0 to 40.0

PRIMARY outcome

Timeframe: Baseline to up to 6 weeks

Tumor tissue samples from pre-treatment (baseline) biopsy and post-treatment surgery are stained using immuno-histochemistry techniques to visualize dividing cells expressing the Ki-67 protein, which is a cellular marker for proliferation. The % values of positive cells from the baseline and post-treatment samples are then compared for each individual patient. Association between Ki-67 and KFLT decline will be analyzed to evaluate the potential clinical utility of change in FLT as a biomarker for early response, using Ki-67 as the standard for early response.

Outcome measures

Outcome measures
Measure
Diagnostic (FLT PET)
n=28 Participants
Patients with early stage, ER positive primary breast cancer undergo FLT PET scan at baseline and 1-6 weeks after the start of standard endocrine treatment. The surgery follows 1-7 days after the second FLT PET scan. Tracer used in the FLT PET (positron emission tomography) scanning procedure: \[F18\] fluorothymidine. Positron Emission Tomography: Undergo FLT PET Laboratory Biomarker Analysis: Correlative studies - Ki67 staining of the tumor tissue in the biopsy and surgical specimen.
Percentage Change in Ki-67 Positive Cells Between Pre-therapy and Post-therapy Tumor Specimens
-80.0 % change
Interval -100.0 to 400.0

SECONDARY outcome

Timeframe: Baseline to up to 6 weeks

Percent change between pre-treatment (baseline) and post-therapy PET measurements in breast tumors will be computed.

Outcome measures

Outcome measures
Measure
Diagnostic (FLT PET)
n=28 Participants
Patients with early stage, ER positive primary breast cancer undergo FLT PET scan at baseline and 1-6 weeks after the start of standard endocrine treatment. The surgery follows 1-7 days after the second FLT PET scan. Tracer used in the FLT PET (positron emission tomography) scanning procedure: \[F18\] fluorothymidine. Positron Emission Tomography: Undergo FLT PET Laboratory Biomarker Analysis: Correlative studies - Ki67 staining of the tumor tissue in the biopsy and surgical specimen.
Percentage Change in K1 (Blood Flow Parameter) by FLT PET
-6.2 % change
Interval -94.6 to 262.1

SECONDARY outcome

Timeframe: Baseline

Ki (flux constant) in breast tumor tissue as determined by the pre-therapy (baseline) FLT PET scan

Outcome measures

Outcome measures
Measure
Diagnostic (FLT PET)
n=28 Participants
Patients with early stage, ER positive primary breast cancer undergo FLT PET scan at baseline and 1-6 weeks after the start of standard endocrine treatment. The surgery follows 1-7 days after the second FLT PET scan. Tracer used in the FLT PET (positron emission tomography) scanning procedure: \[F18\] fluorothymidine. Positron Emission Tomography: Undergo FLT PET Laboratory Biomarker Analysis: Correlative studies - Ki67 staining of the tumor tissue in the biopsy and surgical specimen.
Baseline Ki (Flux Constant) Values by FLT PET
0.015 mL/min/mL
Interval 0.0025 to 0.0353

SECONDARY outcome

Timeframe: Baseline

K1 (blood flow measure) in breast tumor tissue as determined by the pre-therapy (baseline) FLT PET

Outcome measures

Outcome measures
Measure
Diagnostic (FLT PET)
n=28 Participants
Patients with early stage, ER positive primary breast cancer undergo FLT PET scan at baseline and 1-6 weeks after the start of standard endocrine treatment. The surgery follows 1-7 days after the second FLT PET scan. Tracer used in the FLT PET (positron emission tomography) scanning procedure: \[F18\] fluorothymidine. Positron Emission Tomography: Undergo FLT PET Laboratory Biomarker Analysis: Correlative studies - Ki67 staining of the tumor tissue in the biopsy and surgical specimen.
Baseline FLT Transport (K1) Values by FLT PET
0.0501 mL/min/mL
Interval 0.0119 to 0.3699

SECONDARY outcome

Timeframe: Baseline

FLT SUV in breast tumor tissue as determined by the pre-therapy (baseline) FLT PET

Outcome measures

Outcome measures
Measure
Diagnostic (FLT PET)
n=28 Participants
Patients with early stage, ER positive primary breast cancer undergo FLT PET scan at baseline and 1-6 weeks after the start of standard endocrine treatment. The surgery follows 1-7 days after the second FLT PET scan. Tracer used in the FLT PET (positron emission tomography) scanning procedure: \[F18\] fluorothymidine. Positron Emission Tomography: Undergo FLT PET Laboratory Biomarker Analysis: Correlative studies - Ki67 staining of the tumor tissue in the biopsy and surgical specimen.
Baseline Standardized Uptake Values (SUV) by FLT PET
2.5 g/mL
Interval 1.06 to 7.77

SECONDARY outcome

Timeframe: 1 to 6 weeks post-therapy start

Ki (flux constant) in breast tumor tissue as determined by the post-therapy FLT PET

Outcome measures

Outcome measures
Measure
Diagnostic (FLT PET)
n=28 Participants
Patients with early stage, ER positive primary breast cancer undergo FLT PET scan at baseline and 1-6 weeks after the start of standard endocrine treatment. The surgery follows 1-7 days after the second FLT PET scan. Tracer used in the FLT PET (positron emission tomography) scanning procedure: \[F18\] fluorothymidine. Positron Emission Tomography: Undergo FLT PET Laboratory Biomarker Analysis: Correlative studies - Ki67 staining of the tumor tissue in the biopsy and surgical specimen.
Post-therapy Ki (Flux Constant) Values by FLT PET
0.0142 mL/min/mL
Interval 0.0015 to 0.0352

SECONDARY outcome

Timeframe: 1 to 6 weeks post-therapy start

K1 (blood flow measure) in breast tumor tissue as determined by the post-therapy FLT PET

Outcome measures

Outcome measures
Measure
Diagnostic (FLT PET)
n=28 Participants
Patients with early stage, ER positive primary breast cancer undergo FLT PET scan at baseline and 1-6 weeks after the start of standard endocrine treatment. The surgery follows 1-7 days after the second FLT PET scan. Tracer used in the FLT PET (positron emission tomography) scanning procedure: \[F18\] fluorothymidine. Positron Emission Tomography: Undergo FLT PET Laboratory Biomarker Analysis: Correlative studies - Ki67 staining of the tumor tissue in the biopsy and surgical specimen.
Post-treatment FLT Transport (K1) Values by FLT PET
0.0675 mL/min/mL
Interval 0.0018 to 0.4335

SECONDARY outcome

Timeframe: 1 to 6 weeks post-therapy start

FLT SUV in breast tumor tissue as determined by the post-treatment FLT PET

Outcome measures

Outcome measures
Measure
Diagnostic (FLT PET)
n=28 Participants
Patients with early stage, ER positive primary breast cancer undergo FLT PET scan at baseline and 1-6 weeks after the start of standard endocrine treatment. The surgery follows 1-7 days after the second FLT PET scan. Tracer used in the FLT PET (positron emission tomography) scanning procedure: \[F18\] fluorothymidine. Positron Emission Tomography: Undergo FLT PET Laboratory Biomarker Analysis: Correlative studies - Ki67 staining of the tumor tissue in the biopsy and surgical specimen.
Post-treatment Standardized Uptake Values (SUV) by FLT PET
1.76 g/mL
Interval 0.76 to 3.78

OTHER_PRE_SPECIFIED outcome

Timeframe: 1 to 6 weeks post-therapy start

Analyzed using BeadStudio software. Four clustering metrics for calculating dissimilarities (correlation, absolute correlation, Euclidean, and Manhattan) are available in BeadStudio and will be applied using standard analysis methods and diagnostics in BioConductor. To focus the analysis, proposed gene sets will be examined based on biological pathways and molecular signatures.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline

Analyzed using BeadStudio software. Four clustering metrics for calculating dissimilarities (correlation, absolute correlation, Euclidean, and Manhattan) are available in BeadStudio and will be applied using standard analysis methods and diagnostics in BioConductor. To focus the analysis, proposed gene sets will be examined based on biological pathways and molecular signatures.

Outcome measures

Outcome data not reported

Adverse Events

Diagnostic (FLT PET)

Serious events: 0 serious events
Other events: 1 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Diagnostic (FLT PET)
n=28 participants at risk
Patients with early stage, ER positive primary breast cancer undergo FLT PET scan at baseline and 1-6 weeks after the start of standard endocrine treatment. The surgery follows 1-7 days after the second FLT PET scan. Tracer used in the FLT PET (positron emission tomography) scanning procedure: \[F18\] fluorothymidine. Positron Emission Tomography: Undergo FLT PET Laboratory Biomarker Analysis: Correlative studies - Ki67 staining of the tumor tissue in the biopsy and surgical specimen.
Injury, poisoning and procedural complications
Infiltration at injection site
3.6%
1/28 • Number of events 1

Additional Information

Dr. Hannah Linden

University of Washington / Seattle Cancer Care Alliance

Phone: 206-288-6989

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place