Quantitative Assessment of Radiation-induced Neuroinflammation - A Proof of Principle Study

Brain Tumor Clinical Trial

Official title:

Quantitative Assessment of Radiation-induced Neuroinflammation - A Proof of Principle Study

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05128903
• Other study ID #: QARIN1
• Status: Recruiting
• Phase: Phase 2
• Start date: July 5, 2022
• Est. completion date: December 31, 2025

Study information

• Verified date: February 2024
• Source: St. Jude Children's Research Hospital
• Contact: Asim Bag, MD
• Phone: 866-278-5833
• Email: referralinfo[@]stjude.org
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

QARIN 1 is a study of [18F]DPA-714 Translocation Protein (TSPO) Positron Emission Tomography (PET) for longitudinal, quantitative assessment of brain neuroinflammation following whole brain radiation therapy. This TSPO PET, uses a radioactive tracer. An optional MRI (magnetic resonance imaging) will also be performed to monitor brain microstructure damages induced by neuroinflammation.

Primary Objectives

• Assessment of temporal and regional variability of uptake of translocator protein (TSPO) positron emission tomography (PET) tracer.

• Regional variability will be assessed in medial temporal lobe, frontal lobe, and in white matter

• Temporal variability will be assessed by scanning each subject four-times: at baseline (before or within 2 weeks of start of radiation therapy), before start of chemotherapy, at 1 year from the initiation of the radiation therapy, and at 1.5-2 years from the initiation of the radiation therapy

• Correlation of radiation dose in specific brain regions with radiation induced neuroinflammation as measured by uptake of TSPO PET tracer.

Exploratory Objectives

• Assessment of radiation-induced brain microstructure injuries (RIBMI) in specific brain regions (medial temporal lobe, frontal lobe, and in white matter) using advanced magnetic resonance imaging (MRI) techniques.

• Association of radiation dose with MRI measures of RIBMI in these specific brain regions.

• Association of PET measures of RIN with MRI measures of RIBMI.

• Association of PET measure of RIN and MRI measures of RIBMI in specific regions of interest (ROI) with specific domain of neuro-cognition. For example, to investigate whether PET measure of RIN and MRI measures of RIBMI in hippocampal ROI have strongest association with episodic memory; whether frontal lobe cortical ROI are associated with attention and executive function.

• Association of a novel MRI based technique for assessment of RIN with TSPO PET.

• Association of the PET and MRI measure of neuroinflammation within 2- years of completion of radiation with delayed cognitive outcome that will be measured at 3, 4 and 5 years from the completion of radiation

Description:

The participant will have 4 PET scans using a novel PET tracer that will help the investigators to quantify when and where in brain neuroinflammation happens following radiation therapy. The participant will receive the first PET scan either before your first dose of radiation therapy or within 2 weeks of the start of radiation therapy. The second PET scan will be obtained before starting chemotherapy. The third scan will be after 1 year of treatment.The final scan will be 1 and a half to 2 years after the start of treatment.The scan process will begin an hour or so after the participant has been given tracer by injection. The entire PET scan process lasts about 2 hours.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 22
• Est. completion date: December 31, 2025
• Est. primary completion date: October 26, 2025
• Accepts healthy volunteers: No
• Gender: All
• Age group: 8 Years to 39 Years

Eligibility

Inclusion Criteria

• Participant is at least 8 years of age

• Participants with histologically confirmed medulloblastoma and are scheduled to receive 36 Gy craniospinal irradiation

• Participant and/or guardian can understand and is willing to sign a written informed consent document according to institutional guidelines

• Subjects have either have high-affinity or mixed-affinity TSPO binding sites as determined by the single-nucleotide polymorphism (SNP) rs6971 in the TSPO gene.

Exclusion Criteria:

• Participants with a large pseudomeningocele (>4 cm in size) at the surgical site, complications from ventricular access (evidenced by hemorrhage and/or enhancement along the catheter), large subdural effusion in the supra-tentorial compartment (>1 cm in the maximum transverse dimension). All of these are expected to induce inflammation.

• Female participants of childbearing age must not be lactating due to theoretical potential harm to the infant from exposure to radiation.

• Subjects with low-affinity TSPO binding sites as determined by the single-nucleotide polymorphism (SNP) rs6971 in the TSPO gene.

• Pregnant subjects.

• Patients needing sedation for the PET scans.

Related Conditions & MeSH terms

• Brain Tumor
• Medulloblastoma

Intervention

Drug:
• [18F]DPA714
Intravenous injection Before or within 2 weeks of starting radiation therapy Before starting chemotherapy 1 year after the start of radiation therapy Timing cont. 1.5 to 2 years after the start of radiation therapy

Locations

Country	Name	City	State
United States	St.Jude Children's Research Hospital	Memphis	Tennessee

Sponsors (1)

Lead Sponsor	Collaborator
St. Jude Children's Research Hospital

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	SUVr	SUVr values for dorsolateral prefrontal cortex comparing baseline vs. follow up 1	follow up 1: up to 13 weeks after radiation therapy
Primary	SUVr	SUVr values for medial prefrontal cortex comparing baseline vs. follow up 1	follow up 1 : up to 13 weeks after radiation therapy
Primary	SUVr	SUVr values for hippocampus comparing baseline vs. follow up 1.	follow up 1 : up to 13 weeks after radiation therapy
Primary	SUVr	SUVr values for Corpus callosum comparing baseline vs. follow up 1.	follow up 1 : up to 13 weeks after radiation therapy
Primary	SUVr	SUVr values for corticospinal tract comparing baseline vs. follow up 1.	follow up 1 : up to 13 weeks after radiation therapy
Primary	SUVr	SUVr values for superior longitudinal fasciculus comparing baseline vs. follow up 1	follow up 1 : up to 13 weeks after radiation therapy
Primary	SUVr	SUVr values for dorsolateral prefrontal cortex comparing baseline vs. follow up 2.	follow up 2: up to 53 weeks after radiation therapy
Primary	SUVr	SUVr values for medial prefrontal cortex comparing baseline vs. follow up 2.	follow up 2: up to 53 weeks after radiation therapy
Primary	SUVr	SUVr values for hippocampus comparing baseline vs. follow up 2.	follow up 2: up to 53 weeks after radiation therapy
Primary	SUVr	SUVr values for Corpus callosum comparing baseline vs. follow up 2.	follow up 2: up to 53 weeks after radiation therapy
Primary	SUVr	SUVr values for corticospinal tract comparing baseline vs. follow up 2.	follow up 2: up to 53 weeks after radiation therapy
Primary	SUVr	SUVr values for superior longitudinal fasciculus comparing baseline vs. follow up 2.	follow up 2: up to 53 weeks after radiation therapy
Primary	SUVr	SUVr values for dorsolateral prefrontal cortex comparing baseline vs. follow up 3.	follow up 3: up to 2 years after radiation therapy
Primary	SUVr	SUVr values for medial prefrontal cortex comparing baseline vs. follow up 3.	follow up 3: up to 2 years after radiation therapy
Primary	SUVr	SUVr values for hippocampus comparing baseline vs. follow up 3.	follow up 3: up to 2 years after radiation therapy
Primary	SUVr	SUVr values for Corpus callosum comparing baseline vs. follow up 3	follow up 3: up to 2 years after radiation therapy
Primary	SUVr	SUVr values for corticospinal tract comparing baseline vs. follow up 3.	follow up 3: up to 2 years after radiation therapy
Primary	SUVr	SUVr values for superior longitudinal fasciculus comparing baseline vs. follow up 3.	follow up 3: up to 2 years after radiation therapy

External Links

•   Clinical Trials Open at St. Jude
•   St. Jude Children's Research Hospital