18F FES-PET/MRI for Tailoring Treatment of Luminal a and Lobular Breast Cancer

NCT ID: NCT05982496

Last Updated: 2024-12-10

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

221 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-03-01

Study Completion Date

2028-11-01

Brief Summary

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Study hypothesis is that combining the advantages of hybrid PET/MRI and the high sensitivity/specificity of 16-alpha-18F-fluoro-17-beta-estradiol(FES), a radiolabeled form of estrogen binding to functionally active ER, the investigators could obtain a reliable, non-invasive, operator-independent, one-stage imaging method for staging LumA and ER-positive Lobular tumours.

Detailed Description

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This is a single-centre prospective cohort study where patients with LumA and ER-positive Lob will be enrolled in 4 cohorts undergoing: primary surgery; induction endocrine therapy; neoadjuvant chemotherapy; systemic therapy for metastatic disease. For the purpose of the study an additional FES PET/MRI exam will be performed at baseline for local and systemic staging and a second exam after systemic therapy. Correlations between FES PET/MRI parameters and pathology, gene expression and FDG PET parameters, when available, will be investigated. Aim 1: Evaluating the performance of FES PET/MRI in axillary staging compared with axillary surgery. Aim 2: Evaluating potential correlations between changes in FES uptake and changes in proliferation index after 3 weeks of endocrine therapy before surgery. Aim 3: Evaluating the performance of FES PET/MRI in staging of patients undergoing systemic therapy in comparison with standard imaging. Additionally, biological determinants of tumor heterogeneity will be investigated.

Conditions

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Breast Cancer Female Lobular Breast Carcinoma PET/MRI Axillary Lymphadenopathy Luminal a Breast Cancer

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Cohort A

* candidates to surgery as first treatment regardless of cN
* ER+ Her2 negative BC with ki67\>10% Cohort B
* ER positive BC treated with induction ET Cohort C
* candidates to neoadjuvant chemotherapy Cohort D
* Metastatic LumA or ER-positive Lob BC, at first diagnosis or in progression
Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Cohort A

* Candidates to surgery as first treatment regardless of cN
* ER+ Her2 negative BC with ki67\>10%

Group Type EXPERIMENTAL

FES

Intervention Type DRUG

16-alpha-18F-fluoro-17-beta-estradiol(FES) is a radiolabeled form of estrogen binding to functionally active ER which will be used as radiotracer for the PET/MRI exam

PET/MRI A

Intervention Type PROCEDURE

An additional FES PET/MRI will be performed before surgery.

Translational analysis

Intervention Type GENETIC

Selected cases of heterogeneous tumors on imaging will be also investigated on pathology, imaging, genomic and radiomic levels.

Cohort B

• ER positive BC treated with induction ET

Group Type EXPERIMENTAL

FES

Intervention Type DRUG

16-alpha-18F-fluoro-17-beta-estradiol(FES) is a radiolabeled form of estrogen binding to functionally active ER which will be used as radiotracer for the PET/MRI exam

PET/MRI B

Intervention Type PROCEDURE

Two additional PET/MRI will be performed before and after induction ET.

Translational analysis

Intervention Type GENETIC

Selected cases of heterogeneous tumors on imaging will be also investigated on pathology, imaging, genomic and radiomic levels.

Cohort C

• Candidates to neoadjuvant chemotherapy

Group Type EXPERIMENTAL

FES

Intervention Type DRUG

16-alpha-18F-fluoro-17-beta-estradiol(FES) is a radiolabeled form of estrogen binding to functionally active ER which will be used as radiotracer for the PET/MRI exam

PET/MRI C

Intervention Type PROCEDURE

Two additional PET/MRI will be performed before and after two cycles of neoadjuvant chemotherapy.

Translational analysis

Intervention Type GENETIC

Selected cases of heterogeneous tumors on imaging will be also investigated on pathology, imaging, genomic and radiomic levels.

Cohort D

• Metastatic LumA or ER-positive Lob BC, at first diagnosis or in progression

Group Type EXPERIMENTAL

FES

Intervention Type DRUG

16-alpha-18F-fluoro-17-beta-estradiol(FES) is a radiolabeled form of estrogen binding to functionally active ER which will be used as radiotracer for the PET/MRI exam

PET/MRI D

Intervention Type PROCEDURE

Two additional PET/MRI will be performed before and after two cycles of systemic therapy.

Translational analysis

Intervention Type GENETIC

Selected cases of heterogeneous tumors on imaging will be also investigated on pathology, imaging, genomic and radiomic levels.

Interventions

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FES

16-alpha-18F-fluoro-17-beta-estradiol(FES) is a radiolabeled form of estrogen binding to functionally active ER which will be used as radiotracer for the PET/MRI exam

Intervention Type DRUG

PET/MRI A

An additional FES PET/MRI will be performed before surgery.

Intervention Type PROCEDURE

PET/MRI B

Two additional PET/MRI will be performed before and after induction ET.

Intervention Type PROCEDURE

PET/MRI C

Two additional PET/MRI will be performed before and after two cycles of neoadjuvant chemotherapy.

Intervention Type PROCEDURE

PET/MRI D

Two additional PET/MRI will be performed before and after two cycles of systemic therapy.

Intervention Type PROCEDURE

Translational analysis

Selected cases of heterogeneous tumors on imaging will be also investigated on pathology, imaging, genomic and radiomic levels.

Intervention Type GENETIC

Eligibility Criteria

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Inclusion Criteria

* Female patients, age\>= 18 yrs, diagnosed with primary or advanced breast cancer
* LumA or ER-positive Lobular subtypes Cohort A

* candidates to surgery as first treatment regardless of cN
* ER-positive Her2 negative BC with ki67\>10% Cohort B
* ER positive BC treated with induction ET Cohort C
* candidates to neoadjuvant chemotherapy Cohort D
* Metastatic LumA or ER-positive Lob BC, at first diagnosis or in progression

Exclusion Criteria

* ER-negative tumors
* Pregnancy;
* Contraindication to PET;
* Contraindication to MRI;
* Claustrophobia;
* Allergy to the MR contrast agent;
* Severe renal insufficiency
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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IRCCS San Raffaele

OTHER

Sponsor Role collaborator

Università Vita-Salute San Raffaele

OTHER

Sponsor Role lead

Responsible Party

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Rosa Di Micco, MD

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Central Contacts

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Rosa Di Micco, MD

Role: CONTACT

Phone: +39022643

Email: [email protected]

Nicole Rotmensz, MSc

Role: CONTACT

Phone: +39022643

Email: [email protected]

References

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Franquet E, Park H. Molecular imaging in oncology: Common PET/CT radiopharmaceuticals and applications. Eur J Radiol Open. 2022 Nov 24;9:100455. doi: 10.1016/j.ejro.2022.100455. eCollection 2022.

Reference Type BACKGROUND
PMID: 36439301 (View on PubMed)

Schumacher K, Inciardi M, O'Neil M, Wagner JL, Shah I, Amin AL, Balanoff CR, Larson KE. Is axillary imaging for invasive lobular carcinoma accurate in determining clinical node staging? Breast Cancer Res Treat. 2021 Feb;185(3):567-572. doi: 10.1007/s10549-020-06047-w. Epub 2021 Jan 3.

Reference Type BACKGROUND
PMID: 33389408 (View on PubMed)

Iorfida M, Maiorano E, Orvieto E, Maisonneuve P, Bottiglieri L, Rotmensz N, Montagna E, Dellapasqua S, Veronesi P, Galimberti V, Luini A, Goldhirsch A, Colleoni M, Viale G. Invasive lobular breast cancer: subtypes and outcome. Breast Cancer Res Treat. 2012 Jun;133(2):713-23. doi: 10.1007/s10549-012-2002-z. Epub 2012 Mar 8.

Reference Type BACKGROUND
PMID: 22399188 (View on PubMed)

Other Identifiers

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FESTA

Identifier Type: -

Identifier Source: org_study_id