Feasibility of FMISO in Brain Tumors

NCT ID: NCT03649880

Last Updated: 2025-03-25

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

RECRUITING

Clinical Phase

PHASE2

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-06-01

Study Completion Date

2030-01-31

Brief Summary

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This phase II trial studies how well ¹⁸F- fluoromisonidazole (FMISO) works with positron emission tomography (PET)/magnetic resonance imaging (MRI) in assessing participants with malignant (cancerous) brain tumors. FMISO provides information about the oxygen levels in a tumor, which may affect how the tumor behaves. PET/MRI imaging produces images of the brain and how the body functions. FMISO PET/MRI may help investigators see how much oxygen is getting in the brain tumors.

Detailed Description

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PRIMARY OBJECTIVES:

I. Determine the feasibility of obtaining ¹⁸F- fluoromisonidazole (FMISO) PET (hypoxic volume and tumor to blood background values \[T/B\]) and dynamic susceptibility contrast enhanced (DSC) \& diffusion-weighted imaging (DWI) MRI measures in patients with intracranial brain tumors.

II. Determine if MRI contrast-enhancement and hypoxic volume are imaging profiles of glioblastoma immunotherapy-mediated pseudoprogression or true progression in a clinical trial.

SECONDARY OBJECTIVE:

I. Determine the feasibility of baseline and follow-up FMISO PET and MR imaging co-registration.

TERTIARY OBJECTIVE:

I. Determine the reproducibility of the baseline FMISO PET imaging metrics as assessed by baseline "test" and "retest" experiments.

OUTLINE:

Participants receive FMISO intravenously (IV). Participants also undergo dynamic PET/computed tomography (CT) or PET/MRI over 120 minutes beginning 1 minute prior to FMISO injection, and static PET/CT or PET/MRI over 20-40 minutes approximately 90 minutes after FMISO injection. Participants then undergo a retest examination within 7 days. Participants may undergo 2 more PET/MRI or PET/CT scans no sooner than every 4 weeks. Supplemental oxygen may be administered to effect MRI signal.

After conclusion of the diagnostic tests, participants are followed for up to 5 years.

Conditions

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Malignant Brain Neoplasm

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Diagnostic (FMISO, PET/MRI or PET/CT)

Participants receive FMISO intravenously (IV). Participants also undergo dynamic PET/computed tomography (CT) or PET/MRI over 120 minutes beginning 1 minute prior to FMISO injection, and static PET/CT or PET/MRI over 20-40 minutes approximately 90 minutes after FMISO injection. Participants then undergo a retest examination within 7 days. Participants may undergo 2 more PET/MRI or PET/CT scans no sooner than every 4 weeks. Supplemental oxygen may be administered to effect MRI signal.

Group Type EXPERIMENTAL

¹⁸F-Fluoromisonidazole

Intervention Type DRUG

Given IV

Computed Tomography

Intervention Type PROCEDURE

Undergo PET/CT

Magnetic Resonance Imaging

Intervention Type PROCEDURE

Undergo PET/MRI or PET/CT

Positron Emission Tomography

Intervention Type PROCEDURE

Undergo PET/MRI

Oxygen Therapy

Intervention Type PROCEDURE

Receive supplemental oxygen

Interventions

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¹⁸F-Fluoromisonidazole

Given IV

Intervention Type DRUG

Computed Tomography

Undergo PET/CT

Intervention Type PROCEDURE

Magnetic Resonance Imaging

Undergo PET/MRI or PET/CT

Intervention Type PROCEDURE

Positron Emission Tomography

Undergo PET/MRI

Intervention Type PROCEDURE

Oxygen Therapy

Receive supplemental oxygen

Intervention Type PROCEDURE

Other Intervention Names

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¹⁸F-MISO ¹⁸F-Misonidazole FMISO CAT CAT Scan Computerized Axial Tomography Computerized Tomography Computerized Tomography (CT) scan CT CT Scan tomography Magnetic Resonance Imaging Scan Medical Imaging, Magnetic Resonance / Nuclear Magnetic Resonance MR Imaging MRI MRI Scan NMR Imaging Magnetic Resonance Imaging (MRI) Magnetic resonance imaging (procedure) NMRI Nuclear Magnetic Resonance Imaging Medical Imaging, Positron Emission Tomography PET PET Scan Positron Emission Tomography Scan Positron-Emission Tomography proton magnetic resonance spectroscopic imaging supplemental oxygen therapy

Eligibility Criteria

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Inclusion Criteria

* Adult patients (greater than 18 years of age) with a known or suspected intracranial tumor.
* Able to provide informed written consent and/or acceptable surrogate capable of providing consent on the patient's behalf.
* Legally authorized representative (LAR)-signed informed consent and assent obtained for those subjects identified as decisionally impaired
* Intracranial lesion known or suspected to be neoplastic greater than 10 mL as assessed by T2/fluid attenuated inversion recovery (FLAIR) MR imaging.
* Karnofsky performance score \> 60 or Eastern Cooperative Oncology Group (ECOG) \< 3 as assessed by referring clinician.
* Planning to undergo or previously received therapeutic intervention for the intracranial tumor.

Exclusion Criteria

* Pregnant or breast feeding.
* Contraindication to PET, MRI, FMISO, or intravenous gadolinium based contrast agents.

* Claustrophobia.
* Weight greater than modality maximum capacity.
* Presence of metallic foreign body or implanted medical devices in body not documented as MRI safe according to the Oregon Health \& Science University (OHSU) Department of Radiology guidelines (including but not limited to cardiac pacemaker, aneurysm clips, surgical clips, prostheses, artificial hearts, valves with steel parts, metal fragments, shrapnel, tattoos near the eye, or steel implants).
* Sickle cell disease.
* Reduced renal function, as determined by glomerular filtration rate (GFR) \< 45 mL/min/1.73 m\^2 based on a serum creatinine level obtained per OHSU Department of Radiology and Advanced Imaging Research Center (AIRC) clinical criteria.
* History of allergic reactions attributed to compounds of similar chemical or biologic composition to FMISO. An allergic reaction to nitroimidazoles is highly unlikely.
* Unsure of pregnancy status as assessed by Department of Radiology and AIRC guidelines.
* Subjects for whom supplemental oxygen could be harmful such as people with potential for hypoventilation (end-stage COPD, OSA on CPAP/Bi-PAP, etc).
* Subjects with a relative contraindication to supplemental oxygen administration will not be provided oxygen but may still participate in the study.
* Presence of any other co-existing condition that, in the judgment of the principal investigator, might increase the risk to the subject (i.e., plans for hospice or end of life care).
* Poor peripheral intravenous access evaluated by patient history.
* Presence of other serious systemic illnesses, including: uncontrolled infection, other uncontrolled malignancy, uncontrolled diabetes type II, or psychiatric/social situations which might impact the endpoint of the study or limit compliance with study requirements.
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

Oregon Health and Science University

OTHER

Sponsor Role collaborator

Weill Cornell University

UNKNOWN

Sponsor Role collaborator

OHSU Knight Cancer Institute

OTHER

Sponsor Role lead

Responsible Party

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Ramon Barajas

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ramon Barajas

Role: PRINCIPAL_INVESTIGATOR

OHSU Knight Cancer Institute

Locations

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OHSU Knight Cancer Institute

Portland, Oregon, United States

Site Status RECRUITING

Countries

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United States

Facility Contacts

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Ramon Barajas

Role: primary

503-494-3408

Other Identifiers

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NCI-2018-01479

Identifier Type: REGISTRY

Identifier Source: secondary_id

STUDY00016043

Identifier Type: OTHER

Identifier Source: secondary_id

K08CA237809

Identifier Type: NIH

Identifier Source: secondary_id

View Link

STUDY00016043

Identifier Type: -

Identifier Source: org_study_id

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