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A Pilot Study to Evaluate PBR PET in Brain Tumor Patients Treated With Chemoradiation or Immunotherapy

Study Purpose

This research study is studying the changes in primary and metastatic brain tumor inflammation using positron emission tomography (PET) imaging using a radioactive substance called [11C] PBR28a, which is also known as peripheral benzodiazepine receptors (PBR), or PBR-PET.

Recruitment Criteria

Accepts Healthy Volunteers

Healthy volunteers are participants who do not have a disease or condition, or related conditions or symptoms

No
Study Type

An interventional clinical study is where participants are assigned to receive one or more interventions (or no intervention) so that researchers can evaluate the effects of the interventions on biomedical or health-related outcomes.


An observational clinical study is where participants identified as belonging to study groups are assessed for biomedical or health outcomes.


Searching Both is inclusive of interventional and observational studies.

Interventional
Eligible Ages 18 Years and Over
Gender All
More Inclusion & Exclusion Criteria

Inclusion Criteria:

  • - Participants must have evidence of metastatic melanoma to the brain for Cohort A or histologically confirmed GBM for Cohorts Band C.
  • - Those with newly diagnosed GBM but suspected to have pseudoprogression after completion of chemoradiation can enroll in Cohort C.
  • - Participants must have measurable brain disease, defined as at least one lesion that is 10 mm in diameter.
  • - Age > 18 years.
  • - ECOG performance status ≤2 (Karnofsky ≥60%, see Appendix A) - Life expectancy of greater than 3 months.
  • - Participants must have normal organ and marrow function as defined below: - leukocytes ≥3,000/mcL.
  • - absolute neutrophil count ≥1,500/mcL.
  • - platelets ≥100,000/mcL.
  • - total bilirubin within normal institutional limits.
  • - AST(SGOT)/ALT(SGPT) ≤2.5 × institutional upper limit of normal.
  • - creatinine within normal institutional limits.
--- OR.
  • - creatinine clearance ≥60 mL/min/1.73 m2 for participants with creatinine levels above institutional normal.
  • - For Cohort A, only patients with metastatic melanoma to the brain for whom their treating physician has planned to give immunotherapy as monotherapy are eligible for this study.
This can be in the setting of a clinical trial or not.
  • - For Cohort B, only patients with GBM for whom their treating physician has planned to give immunotherapy are eligible for this study.
This can be in the setting of a clinical trial or not.
  • - For Cohort C, patients with newly diagnosed GBM who have completed standard temozolomide + radiation and have suspected pseudoprogression within the first 3 months of completing chemoradiation can enroll.
  • - Patient must be able to undergo MRI and PET scans.
  • - Patient must be maintained on a stable corticosteroid regimen for 5 days prior each MR-PET scan.
  • - High or mixed affinity binders (Ala/Ala or Ala/Thr) based on genotyping result from PBR affinity test.
This blood test will be performed as part of the screening process after consent has been obtained.
  • - The effects of PBR on the developing human fetus are unknown.
For this reason and because radiopharmaceuticals agents are known to be teratogenic, women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately. Radiopharmaceutical agents are known to be teratogenic.
  • - Ability to understand and the willingness to sign a written informed consent document.

Exclusion Criteria:

  • - History of allergic reactions attributed to compounds of similar chemical or biologic composition to PBR.
  • - Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
  • - Pregnant women are excluded from this study because PBR is a radiopharmaceutical agent with the potential for teratogenic or abortifacient effects.
Because there is an unknown but potential risk for adverse events in nursing infants secondary to exposure of the mother to PBR, breastfeeding should be discontinued. These potential risks may also apply to other agents used in this study.
  • - HIV-positive participants are excluded because their immune system is compromised and may affect the interpretation of the imaging data.
  • - Patients who are not suitable to undergo MRI or PET or use gadolinium contrast due to: - Claustrophobia.
  • - Presence of metallic objects or implanted medical devices in body (i.e. cardiac pacemaker, aneurysm clips, surgical clips, prostheses, artificial hearts, valves with steel parts, metal fragments, shrapnel, tattoos near the eye, or steel implants) The craniotomy patients will all have titanium but this is MRI compatible.
  • - Sickle cell disease.
  • - Renal failure.
- Reduced renal function, as determined by creatinine clearance < 30 mL/min based on a serum creatinine level obtained within 28 days prior to registration

Trial Details

Trial ID:

This trial id was obtained from ClinicalTrials.gov, a service of the U.S. National Institutes of Health, providing information on publicly and privately supported clinical studies of human participants with locations in all 50 States and in 196 countries.

NCT02431572
Phase

Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans.

Phase 2: Studies that gather preliminary data on effectiveness (whether the drug works in people who have a certain disease or condition) and additional safety data.

Phase 3: Studies that gather more information about safety and effectiveness by studying different populations and different dosages and by using the drug in combination with other drugs.

Phase 4: Studies occurring after FDA has approved a drug for marketing, efficacy, or optimal use.

N/A
Lead Sponsor

The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data.

Massachusetts General Hospital
Principal Investigator

The person who is responsible for the scientific and technical direction of the entire clinical study.

Elizabeth Gerstner, MD
Principal Investigator Affiliation Massachusetts General Hospital
Agency Class

Category of organization(s) involved as sponsor (and collaborator) supporting the trial.

Other
Overall Status Completed
Countries United States
Conditions

The disease, disorder, syndrome, illness, or injury that is being studied.

Intracranial Tumors, Glioblastoma, Melanoma
Additional Details

This research study is a Pilot Study, which is the first time investigators are examining this study intervention. The purpose of a pilot study is to obtain the preliminary data needed to justify performing a larger clinical trial on the effectiveness of an investigational intervention. Standard treatment for the subjects' disease includes chemoradiation and immunotherapy. In PET scans, a radioactive substance is injected into the body. The scanning machine finds the radioactive substance, which tends to go to cancer cells and areas of inflammation. For the PET scans in this study, the investigators are using a radioactive substance called [11C]PBR28. The investigators would like to see if this tracer can be used to detect changes in inflammation during tumor treatment. PBR-PET scans will be performed at screening before therapy and then several weeks/months after the start of therapy, depending on the type of therapy used. No diagnostic decisions or clinical treatment decisions will be made based on any results obtained from these PET scans, and there will be no change in care. The information from these studies may help the investigators design methods that could be used in larger studies to more completely understand the role of inflammation in the treatment of cancer.

Arms & Interventions

Arms

Experimental: Metastatic Melanoma to the Brain (Cohort A)

- Assess Inflammation (PBR PET) - Immunotherapy - Assess Inflammation (PBR PET)

Experimental: Primary Brain Tumor (Cohort B)

- Assess Inflammation (PBR PET) - Immunotherapy - Assess Inflammation (PBR PET)

Experimental: Primary Brain Tumor (Cohort C)

- Chemoradiation - Assess inflammation (PBR PET) - Follow Patients

Interventions

Other: - PBR PET

Biological: - Cancer Immunotherapy

Subjects who are to be treated with immunotherapy for glioblastoma or melanoma brain metastases will be eligible for 2 of the 3 arms.

Radiation: - Radiation and chemotherapy

Subjects with glioblastoma will receive or will have received treatment with chemotherapy and radiation per the standard of care.

Contact a Trial Team

If you are interested in learning more about this trial, find the trial site nearest to your location and contact the site coordinator via email or phone. We also strongly recommend that you consult with your healthcare provider about the trials that may interest you and refer to our terms of service below.

Dana Farber Cancer Institute, Boston, Massachusetts

Status

Address

Dana Farber Cancer Institute

Boston, Massachusetts, 02215

Massachusetts General Hospital, Boston, Massachusetts

Status

Address

Massachusetts General Hospital

Boston, Massachusetts, 02215