Correlation of Metabolic Imaging With Immune Markers in NSCLC Candidate to Immunotherapy.

Carcinoma, Non-Small-Cell Lung Clinical Trial

Official title:

Correlazione Dell'Imaging Metabolico Con l'Espressione Dei Marcatori Immunitari Nei Pazienti Con NSCLC Candidati All'Immunoterapia.

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT03563482
• Other study ID #: 1670
• Status: Recruiting
• Phase: N/A
• Start date: January 1, 2017
• Est. completion date: December 31, 2022

Study information

• Verified date: April 2022
• Source: Istituto Clinico Humanitas
• Contact: Michele Tedeschi, MD
• Phone: +390282241
• Email: michele.tedeschi[@]humanitas.it
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of the present study is to prospectively investigate the correlation between the metabolic parameters on FDG-PET before and during immunotherapy treatment with the immune infiltrate and other tissue or circulating markers in a NSCLC patients candidate to immunotherapy.

Description:

This is an interventional prospective study without medication lasting 36 months, including an estimated period of 18 months for the enrolment and max 18 months of follow-up. All consecutive patients affected by NSCLC and referred for immunotherapy with the anti-PD-1 agent nivolumab, or other checkpoint inhibitors that may become available in the future, will be prospectively enrolled. The study cohort will consist of 40 patients. All patients will undergo the following steps: 1) selection based on eligibility criteria and informed consent; 2) baseline examinations (ceCT and 18F-FDG PET/CT); 3) tumor biopsy and blood sampling; 4) Immunotherapy with check-point inhibitors; 5) response evaluation after 8 weeks of treatment (ceCT and 18F-FDG PET/CT) and second blood sampling; 6) follow up.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 500
• Est. completion date: December 31, 2022
• Est. primary completion date: December 31, 2022
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• patients with pathological diagnosis of NSCLC eligible for immunotherapy;
• obtained informed consent.

Exclusion Criteria:

• age <18 years;
• pregnancy or breast-feeding.

Related Conditions & MeSH terms

• Carcinoma, Non-Small-Cell Lung
• Immunotherapy
• Positron-Emission Tomography

Intervention

Diagnostic Test:
• PET scan
Tumor biopsy at baseline; PET scan performed after 8 weeks of treatment

Locations

Country	Name	City	State
Italy	Istituto Clinico Humanitas	Rozzano	Milano

Sponsors (1)

Lead Sponsor	Collaborator
Istituto Clinico Humanitas

Country where clinical trial is conducted

Italy, 

References & Publications (17)

Aide N, De Pontdeville M, Lopci E. Evaluating response to immunotherapy with (18)F-FDG PET/CT: where do we stand? Eur J Nucl Med Mol Imaging. 2020 May;47(5):1019-1021. doi: 10.1007/s00259-020-04702-4. — View Citation

Aide N, Hicks RJ, Le Tourneau C, Lheureux S, Fanti S, Lopci E. FDG PET/CT for assessing tumour response to immunotherapy : Report on the EANM symposium on immune modulation and recent review of the literature. Eur J Nucl Med Mol Imaging. 2019 Jan;46(1):238-250. doi: 10.1007/s00259-018-4171-4. Epub 2018 Oct 5. Review. — View Citation

Castello A, Carbone FG, Rossi S, Monterisi S, Federico D, Toschi L, Lopci E. Circulating Tumor Cells and Metabolic Parameters in NSCLC Patients Treated with Checkpoint Inhibitors. Cancers (Basel). 2020 Feb 19;12(2). pii: E487. doi: 10.3390/cancers12020487. — View Citation

Castello A, Grizzi F, Toschi L, Rossi S, Rahal D, Marchesi F, Russo C, Finocchiaro G, Lopci E. Tumor heterogeneity, hypoxia, and immune markers in surgically resected non-small-cell lung cancer. Nucl Med Commun. 2018 Jul;39(7):636-644. doi: 10.1097/MNM.0000000000000832. — View Citation

Castello A, Lopci E. Reply: Diagnosis of Hyperprogressive Disease in Patients Treated with Checkpoint Inhibitors Using (18)F-FDG PET/CT. J Nucl Med. 2020 Sep;61(9):1405. doi: 10.2967/jnumed.120.243444. Epub 2020 Mar 13. — View Citation

Castello A, Lopci E. Response assessment of bone metastatic disease: seeing the forest for the trees RECIST, PERCIST, iRECIST, and PCWG-2. Q J Nucl Med Mol Imaging. 2019 Jun;63(2):150-158. doi: 10.23736/S1824-4785.19.03193-5. Epub 2019 Jul 8. Review. — View Citation

Castello A, Lopci E. Update on tumor metabolism and patterns of response to immunotherapy. Q J Nucl Med Mol Imaging. 2020 Jun;64(2):175-185. doi: 10.23736/S1824-4785.20.03251-3. Epub 2020 Feb 27. Review. — View Citation

Castello A, Rossi S, Mazziotti E, Toschi L, Lopci E. Hyperprogressive Disease in Patients with Non-Small Cell Lung Cancer Treated with Checkpoint Inhibitors: The Role of (18)F-FDG PET/CT. J Nucl Med. 2020 Jun;61(6):821-826. doi: 10.2967/jnumed.119.237768. Epub 2019 Dec 20. — View Citation

Castello A, Rossi S, Toschi L, Lopci E. Comparison of Metabolic and Morphological Response Criteria for Early Prediction of Response and Survival in NSCLC Patients Treated With Anti-PD-1/PD-L1. Front Oncol. 2020 Jul 31;10:1090. doi: 10.3389/fonc.2020.01090. eCollection 2020. — View Citation

Castello A, Rossi S, Toschi L, Mansi L, Lopci E. Soluble PD-L1 in NSCLC Patients Treated with Checkpoint Inhibitors and Its Correlation with Metabolic Parameters. Cancers (Basel). 2020 May 27;12(6). pii: E1373. doi: 10.3390/cancers12061373. — View Citation

Castello A, Toschi L, Rossi S, Mazziotti E, Lopci E. The immune-metabolic-prognostic index and clinical outcomes in patients with non-small cell lung carcinoma under checkpoint inhibitors. J Cancer Res Clin Oncol. 2020 May;146(5):1235-1243. doi: 10.1007/s00432-020-03150-9. Epub 2020 Feb 11. — View Citation

Grizzi F, Castello A, Lopci E. Is it time to change our vision of tumor metabolism prior to immunotherapy? Eur J Nucl Med Mol Imaging. 2018 Jun;45(6):1072-1075. doi: 10.1007/s00259-018-3988-1. Epub 2018 Mar 12. — View Citation

Lopci E, Haanen JB. Cancer management in the era of immunotherapy: much more than meets the eye. Q J Nucl Med Mol Imaging. 2020 Jun;64(2):141-142. doi: 10.23736/S1824-4785.20.03252-5. Epub 2020 Feb 27. — View Citation

Lopci E, Toschi L, Grizzi F, Rahal D, Olivari L, Castino GF, Marchetti S, Cortese N, Qehajaj D, Pistillo D, Alloisio M, Roncalli M, Allavena P, Santoro A, Marchesi F, Chiti A. Correlation of metabolic information on FDG-PET with tissue expression of immune markers in patients with non-small cell lung cancer (NSCLC) who are candidates for upfront surgery. Eur J Nucl Med Mol Imaging. 2016 Oct;43(11):1954-61. doi: 10.1007/s00259-016-3425-2. Epub 2016 Jun 1. — View Citation

Monterisi S, Castello A, Toschi L, Federico D, Rossi S, Veronesi G, Lopci E. Preliminary data on circulating tumor cells in metastatic NSCLC patients candidate to immunotherapy. Am J Nucl Med Mol Imaging. 2019 Dec 15;9(6):282-295. eCollection 2019. — View Citation

Rossi S, Castello A, Toschi L, Lopci E. Immunotherapy in non-small-cell lung cancer: potential predictors of response and new strategies to assess activity. Immunotherapy. 2018 Jul;10(9):797-805. doi: 10.2217/imt-2017-0187. Review. — View Citation

Rossi S, Toschi L, Castello A, Grizzi F, Mansi L, Lopci E. Clinical characteristics of patient selection and imaging predictors of outcome in solid tumors treated with checkpoint-inhibitors. Eur J Nucl Med Mol Imaging. 2017 Dec;44(13):2310-2325. doi: 10.1007/s00259-017-3802-5. Epub 2017 Aug 16. Review. — View Citation

* Note: There are 17 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Correlate all defined parameters with response to treatment and outcome	Response assessment and disease outcome	18 months of follow up
Primary	Correlate the tumor expression of immune markers with the metabolic characteristics on FDG-PET in patients with NSCLC candidates to immunotherapy.	Standardized uptake value	Baseline
Secondary	Tumor expression of immune markers with the metabolic characteristics on FDG-PET in patients with NSCLC candidates to immunotherapy.	Metabolic tumor burden	Before treatment
Secondary	Correlate immune markers with the metabolic characteristics on FDG-PET in patients with NSCLC candidates to immunotherapy.	Tumor infiltrate	Baseline
Secondary	Evaluate the variation of metabolic parameters on FDG-PET in patients with NSCLC before and 8 weeks after the first administration of immunotherapy.	Standardized uptake value	After 8 weeks of treatment
Secondary	Quantify the variation of metabolic parameters on FDG-PET in patients with NSCLC before and 8 weeks after the first administration of immunotherapy.	Metabolic tumor burden	After 8 weeks of treatment
Secondary	Evaluate other tissue or circulating markers in patients with NSCLC before and 8 weeks after the first administration of immunotherapy.	Tissue and blood samples	Baseline
Secondary	Evaluate other tissue or circulating markers in patients with NSCLC before and 8 weeks after the first administration of immunotherapy.	Tissue and blood samples	8 weeks after treatment