Phase IIa Clinical Trial: Feasibility Study on Non-Invasive Simultaneous Hyperpolarized [1-13C]Pyruvate Magnetic Resonance Spectroscopy and 18F-FDG PET (hyperPET) for Metabolic Imaging in Patients with Cancer

2024-516131-28-00 Therapeutic exploratory (Phase II) Ongoing, recruiting

Start 18 Apr 2022 · Status Ongoing, recruiting · 1 EU/EEA countries · 1 sites

Overview

Sponsor-declared trial summary

Phase Therapeutic exploratory (Phase II)
Status Ongoing, recruiting
Participants planned 15
Countries 1
Sites 1

Breast cancer, neuroendocrine neoplasms, lymphomas, sarcomas

Proof-of-concept for the feasibility of simultaneous hyperpolarized [1-13C]Pyruvate Magnetic Resonance Spectroscopy Imaging and radiolabeled 18-Flouro-deoxy-glucose Positron Emission Tomography imaging in a PET/MR scanner in cancer patients

Key facts

Sponsor
Rigshospitalet
Participant type
Patients
Age range
18-64 years, 65+ years
Gender
Male and Female
Therapeutic area
Analytical, Diagnostic and Therapeutic Techniques and Equipment [E] - Investigative Techniques [E05]
Trial duration
18 Apr 2022 → ongoing
Decision date (initial)
2024-08-28
Transition trial
Yes
Low-intervention
No
Rare-disease indication
No
Vulnerable population
No

External identifiers

EU CT number
2024-516131-28-00
EudraCT number
2021-004996-14

Trial design

CTIS Part I — objectives, methods, condition coding

Main objective

Scope: Pharmacokinetic, Efficacy

Proof-of-concept for the feasibility of simultaneous hyperpolarized [1-13C]Pyruvate Magnetic Resonance Spectroscopy Imaging and radiolabeled 18-Flouro-deoxy-glucose Positron Emission Tomography imaging in a PET/MR scanner in cancer patients

Secondary objectives 2

  1. Quantification and comparison of the tumor and healthy tissue uptake of 18-Flouro-deoxy-glucose and [1-13C]Pyruvate to [1-13C]Lactate conversion.
  2. If possible, tissue samples/biopsies from tumor tissue will be collected from the included patients, allowing us to analyze the expression of biomarkers associated with intracellular metabolism using conventional molecular biology methods (immunohistochemicy / ELISA / qPCR and microRNA) and to correlate the findings with the results obtained from the PET/MR scans.

Conditions and MedDRA coding

Breast cancer, neuroendocrine neoplasms, lymphomas, sarcomas

VersionLevelCodeTermSystem organ class
27.0 LLT 10068916 Pancreatic neuroendocrine tumor metastatic 10029104
20.0 LLT 10077560 Gastroenteropancreatic neuroendocrine tumor disease 10029104
20.0 PT 10057270 Neuroendocrine carcinoma 100000004864
27.0 PT 10071542 Neuroendocrine carcinoma metastatic 100000004864
15.1 HLGT 10041299 Soft tissue sarcomas 10029104
20.0 HLT 10039498 Bone sarcomas 10029104
20.0 LLT 10006192 Breast cancer NOS 10029104
21.0 LLT 10067518 Pancreatic neuroendocrine tumor 10029104
20.0 HLT 10039499 Cartilage sarcomas 10029104
21.0 LLT 10062476 Neuroendocrine tumor 10029104
20.0 HLGT 10025323 Lymphomas NEC 10029104

Eligibility criteria

Principal inclusion / exclusion criteria as submitted by sponsor

Inclusion criteria 1

  1. Diagnosed with one of the following cancers: breast cancer, neuroendocrine neoplasm, lymphoma or sarcoma with a tumor size of at least 1.5 cm.

Exclusion criteria 6

  1. Pregnancy
  2. Breast-feeding
  3. Weighs more 140 kg and/or with abdominal circumference exceeding the gantry of the PET/MR coils
  4. History of allergic reaction attributable to compounds of similar chemical or biologic composition to 18F-FDG or pyruvate
  5. Unable to lie in the PET/MR scanner for up to 90 minutes
  6. MR contraindications: Pace-maker, metal implantations within the past 6 weeks, non-MR compatible implants, claustrophobia

Endpoints

Primary and secondary outcome measures (English text)

Primary endpoints 2

  1. Quantification of tumor [1-13C]Pyruvate to [1-13C]Lactate conversion measured through dynamic conversion factors and signal ratios.
  2. Quantification of tumor uptake of 18-Flouro-deoxy-glucose measured as dynamic glucose influx (Ki) and static standardized uptake values (SUV).

Secondary endpoints 1

  1. Correlation between tumor 18-Flouro-deoxy-glucose uptakes and [1- 13C]Pyruvate to [1-13C]Lactate conversion and ex-vivo non-quantitative and quantitative expression of biomarkers involved in intracellular metabolism.

Investigational products

Investigational medicinal products (IMPs), comparators, placebo, auxiliary

Test 1

Hyperpolarized [1-13C]pyruvate

PRD10284730 · Product

Active substance
Pyruvic Acid
Pharmaceutical form
INJECTION
Route of administration
INTRAVENOUS
Max daily dose
0.24 mmol/kg millimole(s)/kilogram
Max total dose
0.24 mmol/kg millimole(s)/kilogram
Max treatment duration
1 Day(s)
Authorisation status
Not Authorised
MA holder
AARHUS UNIVERSITY
Paediatric formulation
No
Orphan designation
No

Comparator 1

Fluor-18-FDG, 400 MBq-210 GBq, injektionsvreske Fludeoxyglucose (18F)

PRD3209304 · Product

Active substance
Fludeoxyglucose (18F)
Substance synonyms
FLUDEOXYGLUCOSE F 18, FLUORODEOXYGLUCOSE F18, ALPHA-D-GLUCOPYRANOSE, 2-DEOXY-2-(FLUORO-18F), 18F-FLUDEOXYGLUCOSE
Pharmaceutical form
SOLUTION FOR INJECTION
Route of administration
INTRAVENOUS
Max daily dose
500 MBq megabecquerel(s)
Max total dose
500 MBq megabecquerel(s)
Max treatment duration
1 Day(s)
Authorisation status
Authorised
ATC code
V09IX04 — -
Marketing authorisation
DK R 14
MA holder
CYKLOTRON & RADIOCHEMISTRY, UNIT 3982, RIGSHOSPITALET
MA country
Denmark
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Sponsors and contacts

Sponsor organisations, regulatory contacts, third parties

Rigshospitalet

Sponsor organisation
Rigshospitalet
Address
Blegdamsvej 9
City
Copenhagen Oe
Postcode
2100
Country
Denmark

Scientific contact point

Organisation
Rigshospitalet
Contact name
Mathias Loft

Public contact point

Organisation
Rigshospitalet
Contact name
Mathias Loft

Third parties 1

OrganisationCity, countryDuties
Frederiksberg Hospital
ORG-100028217
Frederiksberg, Denmark On site monitoring

Locations

1 EU/EEA country · 1 investigational sites

By country

CountryMS statusPlanned subjectsSites
Denmark Ongoing, recruiting 15 1
Rest of world 0

Investigational sites

Denmark

1 site · Ongoing, recruiting
Rigshospitalet
Department of Clinical Physiology and Nuclear Medicine, Blegdamsvej 9, 2100, Copenhagen Oe

Country notifications

Trial-start, recruitment-start, end and early-termination notifications submitted per Member State

Country Trial startTrial end Recruitment startRecruitment end Early termination
Denmark 2022-04-18 2022-04-26

Results and documents

Annex IV summary of results, Annex V layperson summary, and all documents registered in CTIS for this trial

Documents 5 files

Public protocol annexes, IB summaries, regulatory submissions and post-authorisation documents registered in CTIS.

TypeTitleVersion
Protocol (for publication) D1_Protocol 2024-516131-28 6
Recruitment arrangements (for publication) K1_Recruitment arrangements 1
Subject information and informed consent form (for publication) L1_SIS and ICF 4
Summary of Product Characteristics (SmPC) (for publication) G2_SmPC Fluor-18-FDG 1
Synopsis of the protocol (for publication) D1_Protocol synopsis_DK 2024-516131-28 4

Application history

1 submissions — initial application plus substantial / non-substantial modifications

#TypeCodeSubmittedReference MSConclusionDecision date
1 INITIAL IN 2024-08-08 Denmark Acceptable
2024-08-27
2024-08-28