Cancer Clinical Trial
Official title:
IMaging Pilot Study of the αvβ6 Integrin Radiotracer [18F]-A20FMDV2 in PAtients With Solid Cancer Types
A substance called integrin alpha v beta six (αvβ6) is found to be increased in some cancer
cells and can play an important role in the development and spread of cancer. If the levels
of integrin αvβ6 in cancer cells can be measured by carrying out PET scans, we might be able
to identify and potentially treat tumours.
FBA-A20FMDV2 is a substance that binds or sticks to integrin αvβ6. It may therefore be
possible to find and measure the amount of integrin αvβ6 in tumours. To do this a small
amount of radioactivity will be attached to FBA-A20FMDV2 and carry out a scan called a
Positron Emission Tomography (PET) scan. FBA-A20FMDV2 attached to radioactivity is known as
[18F]FBA-A20FMDV2 or a radiotracer, as a very small amount of tracer dose is given to humans.
So far such scans have been carried out in healthy volunteers and in patients with a lung
condition called idiopathic pulmonary fibrosis (IPF). This was to assess the safety of the
radiotracer and how it is taken up in the body. However, such scans have not been performed
in cancer patients. This study will help specifically investigate αvβ6 in patients with
cancer and find out how [18F]FBA-A20FMDV2 is taken up in tumours. With this information, the
ideal imaging method for patients with cancer can be developed.
The epithelial specific integrin αvβ6 is not expressed by resting epithelia (1) but is up
regulated in several cancers. It has been estimated that approximately 250,000 or 15% of new
cancers (excluding non-melanoma skin cancers) that arise in the UK and USA combined will
overexpress αvβ6 (2-4). αvβ6 plays a key role in tumour invasion and carcinogenesis. Strong
expression of αvβ6 is associated with significant reduction in life expectancy in patients
with colon, cervical, breast or non-small cell lung cancer (3-5). Recently, it has been shown
in preclinical studies that antibody targeting of αvβ6 could suppress the growth of oral and
breast cancer human xenografts and suppress breast cancer metastasis (6). Thus αvβ6
represents a biologically relevant target for anti-cancer therapy.
The proposal is to conduct this study in patients with solid tumours as αvβ6 is expressed
exclusively by carcinomas, which are all solid tumours. As the utility of [18F]-FBA-A20FMDV2
in patients with cancer has not been evaluated a particular challenge with evaluation of this
radiotracer in patients with cancer include potential metabolism and excretion of this
radiotracer by the liver and kidney confounding the image quality for lower thoracic and
abdominal tumours requiring optimisation of the imaging protocol. In addition, as the
patients are likely to be unwell, it is imperative an imaging protocol that is
patient-friendly in terms of the scan duration is developed. Additionally it would be ideal
to confirm that the uptake of the radiotracer is indeed due to αvβ6 expression on the cancer
cells. Therefore in this study, it is planned to evaluate the feasibility of performing such
a study in patients with a variety of solid tumours.
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