Immune PET and Proteomics for the Assessment of Response to Spatially Fractionated or Palliative Radiotherapy With or Without Immunotherapy

NCT ID: NCT06976021

Last Updated: 2025-05-16

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

PHASE2

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-06-30

Study Completion Date

2029-12-31

Brief Summary

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The aim of the study is to evaluate the response to four schemes of treatment with novel diagnostic tools - Immuno-PET and proteomics as well as standard imaging (magnetic resonsonce imaging and computed tomography). Two fractionation schedules of radiotherapy will be used. The first will be a common standard of palliative irradiation - 20 Gy delivered in five fractions of 4 Gy (SHORT). The other is called Spatially Fractionated Radiotherapy (SFRT). SFRT is delivered in one fraction of 20 Gy but the dose is diversified inside the tumor to produce areas of high and low doses distributed alternately. This kind of irradiation may be able to stimulate immune response and improve the efficiency of immunotherapy. A drug belonging to the class of immunotherapeutic agents - Pembrolizumab will be added to the treatment scheme in two arms of the study to check that assumption. The response of the target tumor will be evaluated with PET study using Pembrolizumab labeled with zirconium-89 which will show the spatial distribution of immune receptors within the target tumor and other involved sites if there are any. The examination will be repeated after the treatment to evaluate changes in distribution of the immune receptors necessary for the drug to work. Additionally, the researchers will repeatedly test the presence and concentration of a wide panel of proteins in blood to evaluate response to the treatment more precisely.

Detailed Description

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Conditions

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Triple Negative Breast Cancer Uterine Cervical Cancer Uterine Corpus Cancer Malignant Melanoma Clear Cell Renal Cell Carcinoma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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SFRT with immunotherapy

Group Type EXPERIMENTAL

Baseline 89-Zr Pembrolizumab Immuno PET-CT

Intervention Type DIAGNOSTIC_TEST

Diagnostic imaging with novel radiotracer - drug (Pembrolizumab) labeled with zirconium-89

Proteomic assay

Intervention Type DIAGNOSTIC_TEST

Assessment of the proteomic profile before and periodically after treatment

SHORT with immunotherapy

Group Type ACTIVE_COMPARATOR

Baseline 89-Zr Pembrolizumab Immuno PET-CT

Intervention Type DIAGNOSTIC_TEST

Diagnostic imaging with novel radiotracer - drug (Pembrolizumab) labeled with zirconium-89

Proteomic assay

Intervention Type DIAGNOSTIC_TEST

Assessment of the proteomic profile before and periodically after treatment

SFRT

Group Type EXPERIMENTAL

Baseline 89-Zr Pembrolizumab Immuno PET-CT

Intervention Type DIAGNOSTIC_TEST

Diagnostic imaging with novel radiotracer - drug (Pembrolizumab) labeled with zirconium-89

Proteomic assay

Intervention Type DIAGNOSTIC_TEST

Assessment of the proteomic profile before and periodically after treatment

Follow-up 89-Zr Pembrolizumab Immuno PET-CT

Intervention Type DIAGNOSTIC_TEST

Diagnostic imaging with novel radiotracer - drug (Pembrolizumab) labeled with zirconium-89 after radiotherapy performed in patients who are not treated with immunotherapy

SHORT

Group Type ACTIVE_COMPARATOR

Baseline 89-Zr Pembrolizumab Immuno PET-CT

Intervention Type DIAGNOSTIC_TEST

Diagnostic imaging with novel radiotracer - drug (Pembrolizumab) labeled with zirconium-89

Proteomic assay

Intervention Type DIAGNOSTIC_TEST

Assessment of the proteomic profile before and periodically after treatment

Follow-up 89-Zr Pembrolizumab Immuno PET-CT

Intervention Type DIAGNOSTIC_TEST

Diagnostic imaging with novel radiotracer - drug (Pembrolizumab) labeled with zirconium-89 after radiotherapy performed in patients who are not treated with immunotherapy

Interventions

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Baseline 89-Zr Pembrolizumab Immuno PET-CT

Diagnostic imaging with novel radiotracer - drug (Pembrolizumab) labeled with zirconium-89

Intervention Type DIAGNOSTIC_TEST

Proteomic assay

Assessment of the proteomic profile before and periodically after treatment

Intervention Type DIAGNOSTIC_TEST

Follow-up 89-Zr Pembrolizumab Immuno PET-CT

Diagnostic imaging with novel radiotracer - drug (Pembrolizumab) labeled with zirconium-89 after radiotherapy performed in patients who are not treated with immunotherapy

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

1. Pathologically confirmed diagnosis of clear cell renal cell carcinoma, melanoma, cervical cancer, endometrial cancer or triple negative breast cancer.
2. Patients nnot eligible for radical treatment with radiotherapy (including stereotactic radiotherapy of the tumor in the potential planned area of irradiation in the study), chemotherapy and palliative immunotherapy in accordance with applicable national standards but who qualify for palliative radiation treatment
3. General condition according to Karnofsky scale: 60-100
4. Patients with tumor (index lesion) larger than 5 cm in size that can be irradiated with either SHORT or SFRT technique (presence of other tumors that may be independently treated locally is not an exclusion criterion)
5. The tumor may be assessed using iRECIST
6. Age over 18 years
7. Granted written, informed consent to participate in the research experiment
8. No contraindications to treatment with Pembrolizumab (according to the information provided in the product characteristics).
9. Expected survival time over 6 months.

Exclusion Criteria

1. Lack of consent to participate in the experiment
2. Contraindications to Pembrolizumab according to the product characteristics
3. Pregnancy and lactation
4. Inability of the patient to cooperate, including claustrophobia that prevents imaging tests from being performed as planned.
5. Women of childbearing potential who are unwilling or unable to use an acceptable method of contraception to avoid pregnancy throughout treatment and for 5 months after its completion.
6. Condition after organ transplantation
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Maria Sklodowska-Curie National Research Institute of Oncology

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Sławomir Blamek, MD, PhD, MBA

Role: PRINCIPAL_INVESTIGATOR

Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch

Central Contacts

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Sławomir Blamek, MD, PhD, MBA

Role: CONTACT

+48322788052

Marzena Gawkowska, MD, PhD

Role: CONTACT

+48322788625

Other Identifiers

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23/ABM/01/00078

Identifier Type: -

Identifier Source: org_study_id

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