Quantitative Imaging Biomarkers for Sarcoma

Sarcoma Clinical Trial

Official title:

Development of Quantitative Imaging Biomarkers for Evaluating Sarcoma Patients

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02579980
• Other study ID #: AAAO9603
• Secondary ID: U54CA168512
• Status: Completed
• Phase: N/A
• Start date: October 2015
• Est. completion date: December 2017

Study information

• Verified date: March 2019
• Source: Columbia University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Unless a cancer quickly gets smaller with radiation or chemotherapy, the investigators cannot tell if the treatment is working or not. In this research program, two techniques using magnetic resonance imaging (MRI) scanning will be tested in people who have sarcomas, which are rare cancers starting in muscle, tendons, and bones. These particular MRI tests are called dynamic contrast enhanced MRI and diffusion weighted MRI. These MRI scans allow visualization of how sarcomas are different from the normal organs of the body. These MRI tests will tell us the location of sarcoma and its proximity to other structures, as well as correlation of imaging with pathological characteristics after surgery

Description:

Dynamic Contrast Enhanced MRI (DCE-MRI) and Diffusion Weighted MRI (DW-MRI) are imaging approaches that are being utilized in preclinical evaluation as well as clinical trials. DW-MRI is a technique for quantifying the increase in water diffusion caused by cellular necrosis or apoptosis in tumors within days of therapy. DCE-MRI is frequently used in preclinical and early clinical trial assessment of anti-angiogenic and vascular disrupting compounds, also within hours of therapeutic intervention. Evidence of drug efficacy and dose-dependent response has been demonstrated with certain angiogenesis inhibitors. It may also provide useful information for identifying early disease progression, independent of the treatment modality. While these approaches provide additional functional information, they have yet to be validated in sarcoma patients. This study seeks to develop a standardized protocol for performing DCE-MRI and DW-MRI and implement this in a clinical trial of patients with sarcomas who will have surgical resection as part of their standard care. This will allow the accuracy of in vivo MRI measurements to be directly compared to histology as ground truth. The study will also determine the reproducibility of these techniques using repeat baseline imaging as well as evaluate the quantitative changes in these parameters before and after therapy and correlate with histopathology. The collaboration between Columbia University and the University of Utah for this project will allow the existing quantitative MRI approaches to be expanded to a multi-center setting, and will establish a paradigm infrastructure for future expansion to larger scale multi-center therapeutic trials in sarcoma.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 32
• Est. completion date: December 2017
• Est. primary completion date: December 2017
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• New diagnosis of de novo sarcoma of all histologies (including soft tissue sarcoma, osteosarcoma, Ewing sarcoma, and chondrosarcoma) confirmed by biopsy

• Scheduled to be treated with surgical resection at the sarcoma or cancer center of participating sites

• Availability of the patient's medical information

• Provide written informed consent for the study

• Eighteen years of age or older

• Ability to remain motionless in MRI scanner for approximately 40 minutes

Exclusion Criteria:

• Patients with contra-indications for contrast enhanced MR exam, including:

• Cardiac pacemaker or pacemaker wiring in situ

• Cerebral clips or metal artificial cardiac valves

• Ossicle prosthesis

• Conditions that could produce a dangerous situation in the presence of a strong magnetic field: line metallic implants, shrapnel, inability to lie still, and conditions that can worsen inside confined spaces (severe claustrophobia, psychosis)

• Acute or chronic severe renal disease as determined by glomerular filtration rate (GFR) < 30 ml/min/1.73m2

• Pregnancy or breastfeeding

Related Conditions & MeSH terms

• Sarcoma

Intervention

Procedure:
• DCE and DWI MRI
Dynamic Contrast Enhanced MRI (DCE-MRI) and Diffusion Weighted MRI (DW-MRI): DW-MRI is a technique for quantifying the increase in water diffusion caused by cellular necrosis or apoptosis in tumors within days of therapy. DCE-MRI is frequently used in preclinical and early clinical trial assessment of anti-angiogenic and vascular disrupting compounds, also within hours of therapeutic intervention.
• Surgery
Standard of care procedure for sarcoma patients

Locations

Country	Name	City	State
United States	Columbia University Medical Center	New York	New York
United States	Huntsman Cancer Institute, University of Utah	Salt Lake City	Utah

Sponsors (2)

Lead Sponsor	Collaborator
Columbia University	National Cancer Institute (NCI)

Country where clinical trial is conducted

United States, 

References & Publications (38)

Babsky AM, Topper S, Zhang H, Gao Y, James JR, Hekmatyar SK, Bansal N. Evaluation of extra- and intracellular apparent diffusion coefficient of sodium in rat skeletal muscle: effects of prolonged ischemia. Magn Reson Med. 2008 Mar;59(3):485-91. doi: 10.1002/mrm.21568. — View Citation

Bartolozzi C, Lencioni R, Caramella D, Mazzeo S, Ciancia EM. Treatment of hepatocellular carcinoma with percutaneous ethanol injection: evaluation with contrast-enhanced MR imaging. AJR Am J Roentgenol. 1994 Apr;162(4):827-31. — View Citation

Brunberg JA, Chenevert TL, McKeever PE, Ross DA, Junck LR, Muraszko KM, Dauser R, Pipe JG, Betley AT. In vivo MR determination of water diffusion coefficients and diffusion anisotropy: correlation with structural alteration in gliomas of the cerebral hemispheres. AJNR Am J Neuroradiol. 1995 Feb;16(2):361-71. Erratum in: AJNR Am J Neuroradiol 1995 Jun-Jul;16(6):1384. — View Citation

Castillo M, Arbelaez A, Smith JK, Fisher LL. Diffusion-weighted MR imaging offers no advantage over routine noncontrast MR imaging in the detection of vertebral metastases. AJNR Am J Neuroradiol. 2000 May;21(5):948-53. — View Citation

Castrucci M, Sironi S, De Cobelli F, Salvioni M, Del Maschio A. Plain and gadolinium-DTPA-enhanced MR imaging of hepatocellular carcinoma treated with transarterial chemoembolization. Abdom Imaging. 1996 Nov-Dec;21(6):488-94. — View Citation

Chenevert TL, Meyer CR, Moffat BA, Rehemtulla A, Mukherji SK, Gebarski SS, Quint DJ, Robertson PL, Lawrence TS, Junck L, Taylor JM, Johnson TD, Dong Q, Muraszko KM, Brunberg JA, Ross BD. Diffusion MRI: a new strategy for assessment of cancer therapeutic efficacy. Mol Imaging. 2002 Oct;1(4):336-43. Review. — View Citation

Chenevert TL, Stegman LD, Taylor JM, Robertson PL, Greenberg HS, Rehemtulla A, Ross BD. Diffusion magnetic resonance imaging: an early surrogate marker of therapeutic efficacy in brain tumors. J Natl Cancer Inst. 2000 Dec 20;92(24):2029-36. — View Citation

Devries AF, Griebel J, Kremser C, Judmaier W, Gneiting T, Kreczy A, Ofner D, Pfeiffer KP, Brix G, Lukas P. Tumor microcirculation evaluated by dynamic magnetic resonance imaging predicts therapy outcome for primary rectal carcinoma. Cancer Res. 2001 Mar 15;61(6):2513-6. — View Citation

Ei Khouli RH, Jacobs MA, Mezban SD, Huang P, Kamel IR, Macura KJ, Bluemke DA. Diffusion-weighted imaging improves the diagnostic accuracy of conventional 3.0-T breast MR imaging. Radiology. 2010 Jul;256(1):64-73. doi: 10.1148/radiol.10091367. — View Citation

Evelhoch J, Garwood M, Vigneron D, Knopp M, Sullivan D, Menkens A, Clarke L, Liu G. Expanding the use of magnetic resonance in the assessment of tumor response to therapy: workshop report. Cancer Res. 2005 Aug 15;65(16):7041-4. — View Citation

Evelhoch JL, LoRusso PM, He Z, DelProposto Z, Polin L, Corbett TH, Langmuir P, Wheeler C, Stone A, Leadbetter J, Ryan AJ, Blakey DC, Waterton JC. Magnetic resonance imaging measurements of the response of murine and human tumors to the vascular-targeting agent ZD6126. Clin Cancer Res. 2004 Jun 1;10(11):3650-7. — View Citation

Feydy A, Anract P, Tomeno B, Chevrot A, Drapé JL. Assessment of vascular invasion by musculoskeletal tumors of the limbs: use of contrast-enhanced MR angiography. Radiology. 2006 Feb;238(2):611-21. Erratum in: Radiology. 2007 Mar;242(3):950. — View Citation

Herneth AM, Friedrich K, Weidekamm C, Schibany N, Krestan C, Czerny C, Kainberger F. Diffusion weighted imaging of bone marrow pathologies. Eur J Radiol. 2005 Jul;55(1):74-83. Review. — View Citation

Herneth AM, Philipp MO, Naude J, Funovics M, Beichel RR, Bammer R, Imhof H. Vertebral metastases: assessment with apparent diffusion coefficient. Radiology. 2002 Dec;225(3):889-94. — View Citation

Hoskin PJ, Saunders MI, Goodchild K, Powell ME, Taylor NJ, Baddeley H. Dynamic contrast enhanced magnetic resonance scanning as a predictor of response to accelerated radiotherapy for advanced head and neck cancer. Br J Radiol. 1999 Nov;72(863):1093-8. — View Citation

Hosseinzadeh K, Schwarz SD. Endorectal diffusion-weighted imaging in prostate cancer to differentiate malignant and benign peripheral zone tissue. J Magn Reson Imaging. 2004 Oct;20(4):654-61. — View Citation

Hylton N. Dynamic contrast-enhanced magnetic resonance imaging as an imaging biomarker. J Clin Oncol. 2006 Jul 10;24(20):3293-8. Review. — View Citation

Jacobs MA, Herskovits EH, Kim HS. Uterine fibroids: diffusion-weighted MR imaging for monitoring therapy with focused ultrasound surgery--preliminary study. Radiology. 2005 Jul;236(1):196-203. — View Citation

Jacobs MA, Ouwerkerk R, Kamel I, Bottomley PA, Bluemke DA, Kim HS. Proton, diffusion-weighted imaging, and sodium (23Na) MRI of uterine leiomyomata after MR-guided high-intensity focused ultrasound: a preliminary study. J Magn Reson Imaging. 2009 Mar;29(3):649-56. doi: 10.1002/jmri.21677. — View Citation

Jacobs MA, Ouwerkerk R, Wolff AC, Stearns V, Bottomley PA, Barker PB, Argani P, Khouri N, Davidson NE, Bhujwalla ZM, Bluemke DA. Multiparametric and multinuclear magnetic resonance imaging of human breast cancer: current applications. Technol Cancer Res Treat. 2004 Dec;3(6):543-50. — View Citation

Jin G, An N, Jacobs MA, Li K. The role of parallel diffusion-weighted imaging and apparent diffusion coefficient (ADC) map values for evaluating breast lesions: preliminary results. Acad Radiol. 2010 Apr;17(4):456-63. doi: 10.1016/j.acra.2009.12.004. — View Citation

Kamel IR, Bluemke DA, Eng J, Liapi E, Messersmith W, Reyes DK, Geschwind JF. The role of functional MR imaging in the assessment of tumor response after chemoembolization in patients with hepatocellular carcinoma. J Vasc Interv Radiol. 2006 Mar;17(3):505-12. — View Citation

Kawai A, Sugihara S, Kunisada T, Uchida Y, Inoue H. Imaging assessment of the response of bone tumors to preoperative chemotherapy. Clin Orthop Relat Res. 1997 Apr;(337):216-25. — View Citation

Knight RA, Ordidge RJ, Helpern JA, Chopp M, Rodolosi LC, Peck D. Temporal evolution of ischemic damage in rat brain measured by proton nuclear magnetic resonance imaging. Stroke. 1991 Jun;22(6):802-8. — View Citation

Le Bihan D, Breton E, Lallemand D, Aubin ML, Vignaud J, Laval-Jeantet M. Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging. Radiology. 1988 Aug;168(2):497-505. — View Citation

Le Bihan D, Breton E, Lallemand D, Grenier P, Cabanis E, Laval-Jeantet M. MR imaging of intravoxel incoherent motions: application to diffusion and perfusion in neurologic disorders. Radiology. 1986 Nov;161(2):401-7. — View Citation

Marcus CD, Ladam-Marcus V, Cucu C, Bouché O, Lucas L, Hoeffel C. Imaging techniques to evaluate the response to treatment in oncology: current standards and perspectives. Crit Rev Oncol Hematol. 2009 Dec;72(3):217-38. doi: 10.1016/j.critrevonc.2008.07.012. Epub 2008 Aug 29. Review. — View Citation

Miller JC, Pien HH, Sahani D, Sorensen AG, Thrall JH. Imaging angiogenesis: applications and potential for drug development. J Natl Cancer Inst. 2005 Feb 2;97(3):172-87. Review. — View Citation

Mintorovitch J, Moseley ME, Chileuitt L, Shimizu H, Cohen Y, Weinstein PR. Comparison of diffusion- and T2-weighted MRI for the early detection of cerebral ischemia and reperfusion in rats. Magn Reson Med. 1991 Mar;18(1):39-50. — View Citation

Moseley ME, Kucharczyk J, Mintorovitch J, Cohen Y, Kurhanewicz J, Derugin N, Asgari H, Norman D. Diffusion-weighted MR imaging of acute stroke: correlation with T2-weighted and magnetic susceptibility-enhanced MR imaging in cats. AJNR Am J Neuroradiol. 1990 May;11(3):423-9. — View Citation

Murakami T, Nakamura H, Hori S, Tomoda K, Mitani T, Nakanishi K, Hashimoto T, Tsuda K, Kozuka T, Monden M, et al. Detection of viable tumor cells in hepatocellular carcinoma following transcatheter arterial chemoembolization with iodized oil. Pathologic correlation with dynamic turbo-FLASH MR imaging with Gd-DTPA. Acta Radiol. 1993 Jul;34(4):399-403. — View Citation

Padhani AR, Leach MO. Antivascular cancer treatments: functional assessments by dynamic contrast-enhanced magnetic resonance imaging. Abdom Imaging. 2005 May-Jun;30(3):324-41. Review. — View Citation

Rehman S, Jayson GC. Molecular imaging of antiangiogenic agents. Oncologist. 2005 Feb;10(2):92-103. Review. — View Citation

Szafer A, Zhong J, Gore JC. Theoretical model for water diffusion in tissues. Magn Reson Med. 1995 May;33(5):697-712. — View Citation

Tofts PS, Brix G, Buckley DL, Evelhoch JL, Henderson E, Knopp MV, Larsson HB, Lee TY, Mayr NA, Parker GJ, Port RE, Taylor J, Weisskoff RM. Estimating kinetic parameters from dynamic contrast-enhanced T(1)-weighted MRI of a diffusable tracer: standardized quantities and symbols. J Magn Reson Imaging. 1999 Sep;10(3):223-32. Review. — View Citation

Uhl M, Saueressig U, van Buiren M, Kontny U, Niemeyer C, Köhler G, Ilyasov K, Langer M. Osteosarcoma: preliminary results of in vivo assessment of tumor necrosis after chemotherapy with diffusion- and perfusion-weighted magnetic resonance imaging. Invest Radiol. 2006 Aug;41(8):618-23. — View Citation

Vanel D, Lacombe MJ, Couanet D, Kalifa C, Spielmann M, Genin J. Musculoskeletal tumors: follow-up with MR imaging after treatment with surgery and radiation therapy. Radiology. 1987 Jul;164(1):243-5. — View Citation

Vanel D, Shapeero LG, Tardivon A, Western A, Guinebretière JM. Dynamic contrast-enhanced MRI with subtraction of aggressive soft tissue tumors after resection. Skeletal Radiol. 1998 Sep;27(9):505-10. — View Citation

* Note: There are 38 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Correlation coefficient of Ktrans (DCE MR parameter) and Apparent Diffusion Coefficient (ADC) (DWI MR parameter) with microvessel density obtained from histopathology.	The primary endpoint of this study is to evaluate the correlation of the estimated in vivo Dynamic Contrast Enhanced and Diffusion weighted MRI parameters with ex vivo histopathologic measurements obtained from tumor tissue. Correlation coefficient (range: -1 to 1).	through study completion, an average of 4 weeks

External Links

•   DCE-MRI Technical Committee. DCE-MRI Quantification Profile, Quantitative Imaging Biomarkers Alliance (QIBA). Version 1.0. Publicly Reviewed Version. QIBA.