Adult Glioblastoma Clinical Trial
Official title:
Multicenter, Phase II Assessment of Tumor Hypoxia in Glioblastoma Using 18F-Fluoromisonidazole (FMISO) With PET and MRI
This phase II trial is studying how well positron emission tomography (PET) scan using 18F-fluoromisonidazole works when given together with magnetic resonance imaging (MRI) ) in assessing tumor hypoxia in patients with newly diagnosed glioblastoma multiforme (GBM). Diagnostic procedures, such as MRI and PET scan using 18F-fluoromisonidazole (FMISO), may help predict the response of the tumor to the treatment and allow doctors to plan better treatment.
PRIMARY OBJECTIVES:
I. To determine the association of baseline FMISO PET uptake (hypoxic volume [HV]), highest
tumor:blood ratio [T/Bmax]) and MRI parameters (Ktrans, CBV) with overall survival (OS) in
participants with newly diagnosed GBM.
SECONDARY OBJECTIVES:
I. To determine the association of baseline FMISO PET uptake (HV, T/Bmax) and MRI parameters
(Ktrans, CBV) with time to progression (TTP) and 6-month progression free survival (PFS-6) in
participants with newly diagnosed GBM.
II. To assess the reproducibility of the baseline FMISO PET uptake parameters by implementing
baseline "test" and "retest" PET scans (performed within 1 to 7 days of each other).
III. To assess the correlation between highest tissue:cerebellum ratio [T/Cmax] and T/Bmax at
baseline.
IV. To assess the correlation between other MRI parameters (for example Gadolinium-enhanced
T1-weighted (T1Gd), vessel caliber index (VCI), , CBV-S, apparent diffusion coefficient (ADC)
, N-acetylaspartate (NAA) to choline (Cho) ratio, blood oxygenation level-dependent (BOLD),
T2) and OS, TTP, and PFS-6.
OUTLINE: This is a multicenter study.
Two weeks before initiation of chemoradiotherapy with temozolomide, patients undergo MRI and
PET scan using FMISO. A subset of 15 patients undergo FMISO PET scans approximately 1 week
before chemoradiotherapy. Blood samples are collected at baseline and periodically during
study to compare image measures of tissue uptake of FMISO to blood concentrations. Tumor
samples are collected from diagnostic biopsy or surgery for analysis of tumor hypoxic markers
and methylguanine methyl transferase by immunohistochemical and Polymerase chain reaction
(PCR) assays.
After completion of study therapy, patients are followed up every 3 months for up to 5 years.
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