Cancer of the Head and Neck Clinical Trial
Official title:
Non Invasive Imaging of [18F]HX4 With Positron-Emission-Tomography (PET) in Head and Neck Cancer.
The aim of this study is to (i) Determine if tumor hypoxia can be accurately visualised with [18F] HX4 PET imaging in head and neck tumors (ii) correlate the [18F] HX4 PET images with blood and tissue markers and (iii) investigate the quality and optimal timing of [18F] HX4 PET imaging (iv) compare [18F] HX4 PET uptake with [18F] FDG PET uptake before and after treatment.
Tumor hypoxia is the situation where tumor cells are or have been deprived of oxygen.
Hypoxic tumor cells are usually more resistant to radiotherapy and chemotherapy and more
likely to develop metastasis. In head and neck cancer, tumor hypoxia is known to be an
important prognostic factor for long term survival. [18F]HX4 is being developed as a
diagnostic radiopharmaceutical for PET imaging to find a marker for hypoxia that can be used
in standard clinical practice. Current hypoxia tracers lack reliable image quality and
kinetics. Because of the short half life and clearance, we expect that [18F]HX4 will have a
higher tumor to background ratio than current nitro-imidazole hypoxia markers such as
[18F]-misonidazole. The clinical use of a reliable, non-invasive and easy to use hypoxia
imaging agent could allow selection of patients most likely to benefit from hypoxia
modifying therapies.
Included are eligible patients with head and neck squamous cell carcinoma (T2, T3, T4, any
N, M0) with tumor diameter ≥ 2,5 cm of the oral cavity, oropharynx, hypopharynx or larynx,
planned to be treated with curative primary radiation treatment (+/- concurrent
chemotherapy). Before treatment a standard planning [18F]FDG PET-CT will be performed, a
blood sample is drawn and baseline [18F]HX4 PET scans will be performed. 18F-HX4 scans will
be repeated after radiotherapy treatment with 20 +/- 4 Gy (approximately two weeks). Three
months after the end of treatment a [18F]FDG PET scan will be performed.
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