Trial Outcomes & Findings for 18F-DOPA-PET in Finding Tumors in Patients With Newly Diagnosed Gliomas Undergoing Radiation Therapy (NCT NCT01991977)

NCT ID: NCT01991977

Last Updated: 2025-10-20

Results Overview

The proportion of Grade IV MGMT un-methylated patients that experience confirmed-progression-free survival at 6 months (CPFS6). Progression is defined by any of the following: * ≥25% increase in the sum of products of perpendicular diameters of enhancing lesions compared to the smallest tumor measurement obtained either at baseline or best response, on stable or increasing doses of corticosteroids * Significant increase in T2/FLAIR non-enhancing lesion on stable or increasing doses of corticosteroids compared to baseline scan or best response following initiation of therapy, not due to co-morbid events * Any new lesion * Clear clinical deterioration not attributable to other causes apart from the tumor or changes in corticosteroid dose. * Failure to return for evaluation due to death or deteriorating condition * Clear progression of non-measurable disease

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

91 participants

Primary outcome timeframe

Time from registration to the confirmed disease progression, assessed at 6 months

Results posted on

2025-10-20

Participant Flow

Participant milestones

Participant milestones
Measure
Diagnostic (PET, pMRI, DTI, IMRT, Temozolomide)
Patients undergo 18F DOPA-PET, pMRI and DTI within 14 days before radiation therapy, 3-6 weeks after radiation therapy, and during follow-up. Patients also undergo IMRT over 30 fractions and receive temozolomide.
Overall Study
STARTED
91
Overall Study
Received PET Tracer
84
Overall Study
Received IMRT Treatment
79
Overall Study
Evaluable for the Primary Outcome
39
Overall Study
COMPLETED
79
Overall Study
NOT COMPLETED
12

Reasons for withdrawal

Reasons for withdrawal
Measure
Diagnostic (PET, pMRI, DTI, IMRT, Temozolomide)
Patients undergo 18F DOPA-PET, pMRI and DTI within 14 days before radiation therapy, 3-6 weeks after radiation therapy, and during follow-up. Patients also undergo IMRT over 30 fractions and receive temozolomide.
Overall Study
Withdrew prior to receiving treatment
7
Overall Study
Withdrew after start of treatment
5

Baseline Characteristics

18F-DOPA-PET in Finding Tumors in Patients With Newly Diagnosed Gliomas Undergoing Radiation Therapy

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Diagnostic (PET, pMRI, DTI, IMRT, Temozolomide)
n=79 Participants
Patients undergo 18F DOPA-PET, pMRI and DTI within 14 days before radiation therapy, 3-6 weeks after radiation therapy, and during follow-up. Patients also undergo IMRT over 30 fractions and receive temozolomide.
Age, Continuous
54.9 years
STANDARD_DEVIATION 11.3 • n=5 Participants
Sex: Female, Male
Female
33 Participants
n=5 Participants
Sex: Female, Male
Male
46 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
0 Participants
n=5 Participants
Race (NIH/OMB)
White
79 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
Histologic grade of primary tumor
Grade 3
4 Participants
n=5 Participants
Histologic grade of primary tumor
Grade 4
75 Participants
n=5 Participants
MGMT
Methylated
25 Participants
n=5 Participants
MGMT
Un-Methylated
39 Participants
n=5 Participants
MGMT
NA
15 Participants
n=5 Participants

PRIMARY outcome

Timeframe: Time from registration to the confirmed disease progression, assessed at 6 months

Population: All Grade IV MGMT un-methylated patients meeting eligibility criteria who have signed a consent form and who have begun treatment with 18F-DOPA PET image-guided dose escalation RT will be evaluable for the endpoint.

The proportion of Grade IV MGMT un-methylated patients that experience confirmed-progression-free survival at 6 months (CPFS6). Progression is defined by any of the following: * ≥25% increase in the sum of products of perpendicular diameters of enhancing lesions compared to the smallest tumor measurement obtained either at baseline or best response, on stable or increasing doses of corticosteroids * Significant increase in T2/FLAIR non-enhancing lesion on stable or increasing doses of corticosteroids compared to baseline scan or best response following initiation of therapy, not due to co-morbid events * Any new lesion * Clear clinical deterioration not attributable to other causes apart from the tumor or changes in corticosteroid dose. * Failure to return for evaluation due to death or deteriorating condition * Clear progression of non-measurable disease

Outcome measures

Outcome measures
Measure
Diagnostic (PET, pMRI, DTI, IMRT, Temozolomide)
n=39 Participants
Patients undergo 18F DOPA-PET, pMRI and DTI within 14 days before radiation therapy, 3-6 weeks after radiation therapy, and during follow-up. Patients also undergo IMRT over 30 fractions and receive temozolomide.
Proportion of Grade IV MGMT Un-methylated Patients That Experience Confirmed-progression-free Survival at 6 Months (CPFS6)
0.795 proportion of participants
Interval 0.631 to 0.901

SECONDARY outcome

Timeframe: Up to 5 years

Population: All eligible patients were included in analysis.

The median survival time and 95%CI will be estimated using the method of Kaplan-Meier.

Outcome measures

Outcome measures
Measure
Diagnostic (PET, pMRI, DTI, IMRT, Temozolomide)
n=63 Participants
Patients undergo 18F DOPA-PET, pMRI and DTI within 14 days before radiation therapy, 3-6 weeks after radiation therapy, and during follow-up. Patients also undergo IMRT over 30 fractions and receive temozolomide.
Overall Survival
Unmethylated patients
16.0 months
Interval 13.8 to 21.1
Overall Survival
Methylated patients
35.5 months
Interval 25.5 to 74.4

SECONDARY outcome

Timeframe: Up to 5 years

Population: All patients eligible for analysis were included

The median progression-free survival time and 95%CI will be estimated using the method of Kaplan-Meier.

Outcome measures

Outcome measures
Measure
Diagnostic (PET, pMRI, DTI, IMRT, Temozolomide)
n=63 Participants
Patients undergo 18F DOPA-PET, pMRI and DTI within 14 days before radiation therapy, 3-6 weeks after radiation therapy, and during follow-up. Patients also undergo IMRT over 30 fractions and receive temozolomide.
Progression Free Survival
Unmethylated patients
8.7 months
Interval 7.6 to 11.0
Progression Free Survival
Methylated patients
10.7 months
Interval 8.9 to 16.0

SECONDARY outcome

Timeframe: Up to 5 years

Population: Patients that completed an assessment at baseline and at the first MRI assessment were included in analysis

The MDASI-BT consists of 28 questions. Twenty-two questions are related to severity of symptoms over the last 24 hours and are answered on a scale of 0-10 where 0=not present and10=as bad as you can imagine. The remaining 6 questions are related to how symptoms have interfered with daily life over the past 24 hours and are answered on a scale of 0-10 where 0=did not interfere and 10=interfered completely. Higher scores indicate greater severity of symptoms and greater interference with daily life. Analysis will include median change percent from baseline.

Outcome measures

Outcome measures
Measure
Diagnostic (PET, pMRI, DTI, IMRT, Temozolomide)
n=61 Participants
Patients undergo 18F DOPA-PET, pMRI and DTI within 14 days before radiation therapy, 3-6 weeks after radiation therapy, and during follow-up. Patients also undergo IMRT over 30 fractions and receive temozolomide.
Quality of Life Evaluated With the M. D. Anderson Symptom Inventory - Brain Tumor (MDASI-BT) Questionnaire
-0.167 percent change
Interval -6.3 to 8.17

SECONDARY outcome

Timeframe: Up to 5 years

Adverse events graded using Common Terminology Criteria for Adverse Events version 4.0

Outcome measures

Outcome measures
Measure
Diagnostic (PET, pMRI, DTI, IMRT, Temozolomide)
n=75 Participants
Patients undergo 18F DOPA-PET, pMRI and DTI within 14 days before radiation therapy, 3-6 weeks after radiation therapy, and during follow-up. Patients also undergo IMRT over 30 fractions and receive temozolomide.
Number of Patients Experiencing Grade 3+ Treatment-related Toxicities
17 Participants

SECONDARY outcome

Timeframe: Up to 5 years

Late treatment-related toxicities will be assessed using the Radiation Therapy Oncology Group (RTOG) European Organization for Research and the Treatment of Cancer (EORTC) toxicity criteria.

Outcome measures

Outcome measures
Measure
Diagnostic (PET, pMRI, DTI, IMRT, Temozolomide)
n=63 Participants
Patients undergo 18F DOPA-PET, pMRI and DTI within 14 days before radiation therapy, 3-6 weeks after radiation therapy, and during follow-up. Patients also undergo IMRT over 30 fractions and receive temozolomide.
Number of Patients Experiencing Grade 4+ Late Treatment-related Toxicities
0 Participants

OTHER_PRE_SPECIFIED outcome

Timeframe: Up to 5 years

The concordance correlation coefficient will be used to measure agreement between volumes generated with each method, as well as to evaluate inter-observer variability, where variability associated with magnetic resonance imaging will serve as the standard for comparison.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Up to 5 years

The concordance correlation coefficient will be used to measure agreement between volumes generated with each method, as well as to evaluate inter-observer variability, where variability associated with magnetic resonance imaging will serve as the standard for comparison.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Up to 5 years

Paired t-test statistical analysis will be performed to determine if any differences exist and the level of statistical significance between treatment volumes defined by magnetic resonance imaging only and treatment volumes defined with both positron emission tomography and magnetic resonance imaging information. The analysis of volumes from 72 grade IV patients will have 90% power to detect differences in volumes with an effect size of 0.39 using a paired t-test with a 0.05 two-sided significance level. Alternate metrics for comparison will also be assessed, including spatial overlap, distanc

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Up to 5 years

Chi-square tests of proportions will be used to test for differences in the proportions of patients with central, in-field, marginal, or distant failures between the patients on this study and historical controls.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Up to 5 years

Compared by identifying the recurrence volume with each modality and correlating with identification of aggressive disease in the pre-radiation therapy planning images.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Up to 5 years

Paired t-test statistical analysis will be performed to determine if any differences exist and the level of statistical significance between treatment volumes defined by magnetic resonance imaging only and treatment volumes defined with both positron emission tomography and magnetic resonance imaging information.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Up to 5 years

Paired t-test statistical analysis will be performed to determine if any differences exist and the level of statistical significance between treatment volumes defined by magnetic resonance imaging only and treatment volumes defined with both positron emission tomography and magnetic resonance imaging information. The analysis of volumes from 72 grade IV patients will have 90% power to detect differences in volumes with an effect size of 0.39 using a paired t-test with a 0.05 two-sided significance level. Alternate metrics for comparison will also be assessed, including spatial overlap, distan

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Up to 5 years

The progression identification timing will be compared by calculating the percentage of time each modality was earlier than conventional magnetic resonance imaging. With a sample size of 72, if the observed percentage earlier than conventional magnetic resonance imaging is 30% for either modality, a two-sided 95% confidence interval for a single proportion using the large sample normal approximation will be +/- 10.6%. Progression identification timing will also be compared using Kaplan-Meier methods and paired t-tests to determine if differences exist between the modalities.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Up to 5 years

Progression identification timing will be compared using Kaplan-Meier methods and paired t-tests to determine if differences exist between the modalities. An exploratory analysis of diffusion tensor imaging for detecting invasive non-enhancing tumor recurrence will also be performed.

Outcome measures

Outcome data not reported

Adverse Events

Diagnostic (PET, pMRI, DTI, IMRT, Temozolomide)

Serious events: 3 serious events
Other events: 82 other events
Deaths: 56 deaths

Serious adverse events

Serious adverse events
Measure
Diagnostic (PET, pMRI, DTI, IMRT, Temozolomide)
n=84 participants at risk
Patients undergo 18F DOPA-PET, pMRI and DTI within 14 days before radiation therapy, 3-6 weeks after radiation therapy, and during follow-up. Patients also undergo IMRT over 30 fractions and receive temozolomide.
General disorders
Fatigue
2.4%
2/84 • Number of events 2 • Up to 5 years
Infections and infestations
Sepsis
1.2%
1/84 • Number of events 1 • Up to 5 years

Other adverse events

Other adverse events
Measure
Diagnostic (PET, pMRI, DTI, IMRT, Temozolomide)
n=84 participants at risk
Patients undergo 18F DOPA-PET, pMRI and DTI within 14 days before radiation therapy, 3-6 weeks after radiation therapy, and during follow-up. Patients also undergo IMRT over 30 fractions and receive temozolomide.
Blood and lymphatic system disorders
Anemia
2.4%
2/84 • Number of events 2 • Up to 5 years
Blood and lymphatic system disorders
Blood and lymph sys disorders - Oth Spec
2.4%
2/84 • Number of events 2 • Up to 5 years
Blood and lymphatic system disorders
Febrile neutropenia
2.4%
2/84 • Number of events 2 • Up to 5 years
Cardiac disorders
Atrial flutter
1.2%
1/84 • Number of events 1 • Up to 5 years
Cardiac disorders
Cardiac disorders - Other, specify
1.2%
1/84 • Number of events 2 • Up to 5 years
Ear and labyrinth disorders
Ear and labyrinth disorders - Oth spec
1.2%
1/84 • Number of events 1 • Up to 5 years
Ear and labyrinth disorders
Hearing impaired
1.2%
1/84 • Number of events 2 • Up to 5 years
Endocrine disorders
Endocrine disorders - Other, specify
2.4%
2/84 • Number of events 2 • Up to 5 years
Eye disorders
Blurred vision
3.6%
3/84 • Number of events 4 • Up to 5 years
Eye disorders
Eye disorders - Other, specify
2.4%
2/84 • Number of events 2 • Up to 5 years
Eye disorders
Optic nerve disorder
1.2%
1/84 • Number of events 2 • Up to 5 years
Gastrointestinal disorders
Anal fistula
1.2%
1/84 • Number of events 1 • Up to 5 years
Gastrointestinal disorders
Constipation
2.4%
2/84 • Number of events 2 • Up to 5 years
Gastrointestinal disorders
Diarrhea
1.2%
1/84 • Number of events 1 • Up to 5 years
Gastrointestinal disorders
Fecal incontinence
1.2%
1/84 • Number of events 1 • Up to 5 years
Gastrointestinal disorders
Mucositis oral
1.2%
1/84 • Number of events 1 • Up to 5 years
Gastrointestinal disorders
Nausea
6.0%
5/84 • Number of events 5 • Up to 5 years
Gastrointestinal disorders
Vomiting
1.2%
1/84 • Number of events 1 • Up to 5 years
General disorders
Edema limbs
2.4%
2/84 • Number of events 5 • Up to 5 years
General disorders
Fatigue
96.4%
81/84 • Number of events 329 • Up to 5 years
General disorders
Fever
1.2%
1/84 • Number of events 1 • Up to 5 years
General disorders
Gait disturbance
1.2%
1/84 • Number of events 1 • Up to 5 years
General disorders
Localized edema
1.2%
1/84 • Number of events 1 • Up to 5 years
General disorders
Malaise
1.2%
1/84 • Number of events 1 • Up to 5 years
General disorders
Pain
3.6%
3/84 • Number of events 3 • Up to 5 years
Infections and infestations
Infections and infestations - Oth spec
1.2%
1/84 • Number of events 1 • Up to 5 years
Infections and infestations
Peripheral nerve infection
2.4%
2/84 • Number of events 4 • Up to 5 years
Infections and infestations
Upper respiratory infection
1.2%
1/84 • Number of events 1 • Up to 5 years
Injury, poisoning and procedural complications
Dermatitis radiation
4.8%
4/84 • Number of events 4 • Up to 5 years
Investigations
Platelet count decreased
3.6%
3/84 • Number of events 3 • Up to 5 years
Investigations
Weight loss
1.2%
1/84 • Number of events 1 • Up to 5 years
Metabolism and nutrition disorders
Anorexia
2.4%
2/84 • Number of events 3 • Up to 5 years
Metabolism and nutrition disorders
Dehydration
1.2%
1/84 • Number of events 1 • Up to 5 years
Musculoskeletal and connective tissue disorders
Arthralgia
1.2%
1/84 • Number of events 1 • Up to 5 years
Musculoskeletal and connective tissue disorders
Back pain
1.2%
1/84 • Number of events 1 • Up to 5 years
Musculoskeletal and connective tissue disorders
Generalized muscle weakness
2.4%
2/84 • Number of events 2 • Up to 5 years
Musculoskeletal and connective tissue disorders
Muscle weakness lower limb
7.1%
6/84 • Number of events 7 • Up to 5 years
Musculoskeletal and connective tissue disorders
Muscle weakness upper limb
4.8%
4/84 • Number of events 4 • Up to 5 years
Musculoskeletal and connective tissue disorders
Musculoskeletal, conn tissue - Oth spec
1.2%
1/84 • Number of events 1 • Up to 5 years
Nervous system disorders
Ataxia
3.6%
3/84 • Number of events 5 • Up to 5 years
Nervous system disorders
Central nervous system necrosis
33.3%
28/84 • Number of events 81 • Up to 5 years
Nervous system disorders
Cognitive disturbance
10.7%
9/84 • Number of events 14 • Up to 5 years
Nervous system disorders
Concentration impairment
2.4%
2/84 • Number of events 2 • Up to 5 years
Nervous system disorders
Dizziness
1.2%
1/84 • Number of events 1 • Up to 5 years
Nervous system disorders
Dysarthria
4.8%
4/84 • Number of events 6 • Up to 5 years
Nervous system disorders
Dysphasia
6.0%
5/84 • Number of events 5 • Up to 5 years
Nervous system disorders
Facial muscle weakness
1.2%
1/84 • Number of events 1 • Up to 5 years
Nervous system disorders
Headache
14.3%
12/84 • Number of events 14 • Up to 5 years
Nervous system disorders
Intracranial hemorrhage
1.2%
1/84 • Number of events 1 • Up to 5 years
Nervous system disorders
Memory impairment
6.0%
5/84 • Number of events 7 • Up to 5 years
Nervous system disorders
Muscle weakness left-sided
7.1%
6/84 • Number of events 9 • Up to 5 years
Nervous system disorders
Muscle weakness right-sided
4.8%
4/84 • Number of events 5 • Up to 5 years
Nervous system disorders
Nervous system disorders - Oth spec
11.9%
10/84 • Number of events 19 • Up to 5 years
Nervous system disorders
Neuralgia
1.2%
1/84 • Number of events 1 • Up to 5 years
Nervous system disorders
Presyncope
1.2%
1/84 • Number of events 1 • Up to 5 years
Nervous system disorders
Seizure
10.7%
9/84 • Number of events 11 • Up to 5 years
Nervous system disorders
Somnolence
1.2%
1/84 • Number of events 1 • Up to 5 years
Nervous system disorders
Stroke
1.2%
1/84 • Number of events 1 • Up to 5 years
Psychiatric disorders
Confusion
1.2%
1/84 • Number of events 1 • Up to 5 years
Psychiatric disorders
Depression
2.4%
2/84 • Number of events 2 • Up to 5 years
Psychiatric disorders
Insomnia
1.2%
1/84 • Number of events 2 • Up to 5 years
Psychiatric disorders
Psychiatric disorders - Other, specify
2.4%
2/84 • Number of events 2 • Up to 5 years
Psychiatric disorders
Suicidal ideation
1.2%
1/84 • Number of events 1 • Up to 5 years
Renal and urinary disorders
Urinary incontinence
2.4%
2/84 • Number of events 2 • Up to 5 years
Skin and subcutaneous tissue disorders
Alopecia
21.4%
18/84 • Number of events 21 • Up to 5 years
Skin and subcutaneous tissue disorders
Erythema multiforme
1.2%
1/84 • Number of events 1 • Up to 5 years
Skin and subcutaneous tissue disorders
Rash maculo-papular
3.6%
3/84 • Number of events 3 • Up to 5 years
Vascular disorders
Hypertension
2.4%
2/84 • Number of events 2 • Up to 5 years
Vascular disorders
Hypotension
1.2%
1/84 • Number of events 1 • Up to 5 years
Vascular disorders
Thromboembolic event
2.4%
2/84 • Number of events 2 • Up to 5 years

Additional Information

Nadia N. Laack, MD

Mayo Clinic

Phone: 507/284-2511

Results disclosure agreements

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