F-18 FES PET/CT in Measuring Hormone Expression in Patients With Primary, Recurrent, or Metastatic Breast Cancer Undergoing Endocrine-Targeted Therapy

NCT ID: NCT02149173

Last Updated: 2021-06-30

Study Results

Results available

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Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

NA

Total Enrollment

29 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-09-15

Study Completion Date

2021-01-13

Brief Summary

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This clinical trial studies use of F-18 16 alpha-fluoroestradiol (\[F-18\] FES) positron emission tomography (PET)/computed tomography (CT) in measuring tumor hormone receptor expression in patients undergoing endocrine-targeted therapy for newly diagnosed breast cancer or breast cancer that has come back or spread to other places in the body. Comparing results of diagnostic procedures done before, during, and after hormone therapy may help measure a patient's response to treatment.

Detailed Description

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PRIMARY OBJECTIVES:

I. Measure the effect of endocrine targeted therapy on estrogen receptor (ER) expression and estradiol binding to the receptor using serial FES PET and fludeoxyglucose F-18 (FDG) PET.

SECONDARY OBJECTIVES:

I. Document the safety profile of FES PET in patients with breast cancer.

II. Examine associations between FES PET results and serial measurements of hormone or other levels in peripheral blood, as related to efficacy of endocrine-targeted therapy. Correlate FES PET uptake measures with histopathological assays and tumor microenvironment studies on biopsy specimens, if relevant to specific treatment regimen.

OUTLINE:

Patients undergo F-18 FES PET/CT scan at baseline. Patients also undergo F-18 FES PET/CT and FDG PET/CT between 1-12 weeks after starting therapy, and then 1-12 weeks after the second FES PET/CT scan. Repeat FDG PET may be omitted in patients on selective estrogen receptor degrader.

After completion of study, patients are followed up for up to 20 years.

Conditions

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Estrogen Receptor Positive Recurrent Breast Carcinoma Stage IV Breast Cancer AJCC v6 and v7

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 (F-18 FES PET/CT)

Patients undergo F-18 FES PET/CT scan at baseline. Patients also undergo F-18 FES PET/CT and FDG PET/CT between 1-12 weeks after starting therapy, and then 1-12 weeks after the second FES PET/CT scan. Repeat FDG PET may be omitted in patients on selective estrogen receptor degrader.

Group Type EXPERIMENTAL

Computed Tomography

Intervention Type PROCEDURE

Undergo F-18 FES PET/CT

Computed Tomography

Intervention Type PROCEDURE

Undergo FDG PET/CT

F-18 16 Alpha-Fluoroestradiol

Intervention Type DRUG

Undergo F-18 FES PET/CT

Fludeoxyglucose F-18

Intervention Type DRUG

Undergo FDG PET/CT

Laboratory Biomarker Analysis

Intervention Type OTHER

Correlative studies

Positron Emission Tomography

Intervention Type PROCEDURE

Undergo F-18 FES PET/CT

Positron Emission Tomography

Intervention Type PROCEDURE

Undergo FDG PET/CT

Interventions

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Computed Tomography

Undergo F-18 FES PET/CT

Intervention Type PROCEDURE

Computed Tomography

Undergo FDG PET/CT

Intervention Type PROCEDURE

F-18 16 Alpha-Fluoroestradiol

Undergo F-18 FES PET/CT

Intervention Type DRUG

Fludeoxyglucose F-18

Undergo FDG PET/CT

Intervention Type DRUG

Laboratory Biomarker Analysis

Correlative studies

Intervention Type OTHER

Positron Emission Tomography

Undergo F-18 FES PET/CT

Intervention Type PROCEDURE

Positron Emission Tomography

Undergo FDG PET/CT

Intervention Type PROCEDURE

Other Intervention Names

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CAT CAT Scan Computerized Axial Tomography computerized tomography CT CT SCAN tomography CAT CAT Scan Computerized Axial Tomography computerized tomography CT CT SCAN tomography 16 alpha-fluroestradiol-17 beta F-18 FES FES Fluorine-18 16 alpha-fluoroestradiol Fluoroestradiol F-18 18FDG FDG fludeoxyglucose F 18 Fludeoxyglucose F18 Fluorine-18 2-Fluoro-2-deoxy-D-Glucose Fluorodeoxyglucose F18 Medical Imaging, Positron Emission Tomography PET PET Scan Positron Emission Tomography Scan Positron-Emission Tomography proton magnetic resonance spectroscopic imaging Medical Imaging, Positron Emission Tomography PET PET Scan Positron Emission Tomography Scan Positron-Emission Tomography proton magnetic resonance spectroscopic imaging

Eligibility Criteria

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Inclusion Criteria

* Adult, non-pregnant patients with biopsy-proven or clinically obvious primary, recurrent or metastatic breast cancer
* Breast cancer from ER+ primary that is seen on other imaging tests; tumor ER expression must have been confirmed by immunohistocytochemistry of primary tumor or recurrent disease
* At least one site of disease 1.5 cm or greater is needed to meet the spatial resolution limits of PET imaging
* Patients must have been off tamoxifen or other estrogen receptor blocking agents for at least 6 weeks and off chemotherapy for 3 weeks for the initial baseline FES
* Patients must be selected for an endocrine targeted therapy regimen for treatment of their breast cancer by the referring oncologist; selected treatments may be part of experimental treatment protocols for which the patient would be separately consented
* Patients must be willing to undergo serial imaging procedures
* Patients must agree to allow access to clinical records regarding response to treatment and long term follow up

Exclusion Criteria

* An inability to lie still for the tests
* Individuals weighing more than 300 lb; (this is the weight limit of the scanner table)
* Pregnant or lactating; women of childbearing potential with either a positive or no pregnancy test at baseline are excluded
* Any other life-threatening illness (e.g. serious, uncontrolled concurrent infection or clinically significant cardiac disease - congestive heart failure, symptomatic coronary artery disease, cardiac arrhythmia not well controlled with medication)
* Use of tamoxifen, Faslodex, diethylstilbestrol (DES) or any other ER blocking agent \< 6 weeks or chemotherapy \< 3 weeks prior to imaging scan
* Unwillingness or inability to give informed consent
* Uncontrolled diabetes mellitus (fasting glucose \> 200 mg/dL)
* Adult patients who require monitored anesthesia for PET scanning
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

University of Washington

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Hannah Linden

Role: PRINCIPAL_INVESTIGATOR

Fred Hutch/University of Washington Cancer Consortium

Locations

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Fred Hutch/University of Washington Cancer Consortium

Seattle, Washington, United States

Site Status

Countries

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United States

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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NCI-2013-02342

Identifier Type: REGISTRY

Identifier Source: secondary_id

7184

Identifier Type: OTHER

Identifier Source: secondary_id

P01CA042045

Identifier Type: NIH

Identifier Source: secondary_id

View Link

U01CA148131

Identifier Type: NIH

Identifier Source: secondary_id

View Link

RG1711032

Identifier Type: OTHER

Identifier Source: secondary_id

7184

Identifier Type: -

Identifier Source: org_study_id

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