FAPI: 68 Gallium-Fibroblast Activating Protein Inhibitors-46 Positron Emission Tomography - Computerized Tomography for Molecular Assessment of Fibroblast Activation and Risk Assessment in Solid Tumors

Sponsor
Istituto Scientifico Romagnolo per lo Studio e la cura dei Tumori (Other)
Overall Status
Recruiting
CT.gov ID
NCT06136065
Collaborator
(none)
50
1
1
24.4
2.1

Study Details

Study Description

Brief Summary

Phase II, open label, single arm, single center, prospective diagnostic trial to evaluate the Fibroblast Activating Protein (FAP) positivity in patients with solid tumors

Condition or Disease Intervention/Treatment Phase
  • Diagnostic Test: 68 Gallium -Fibroblast Activating Protein Inhibitor -46 Positron emission tomography / Computerized tomography
Phase 2

Detailed Description

The growth and spread of the tumor is determined not only by the tumor cells but also by the non-malignant constituents of the malignant lesion, which contributes to what is commonly referred to as the "tumor microenvironment". In particular, a subpopulation of fibroblasts called cancer-associated fibroblasts are involved in tumor growth, migration and progression. Therefore, these cells represent an attractive target for both diagnosis and anticancer therapy.

A distinctive feature of cancer-associated fibroblasts is the expression of the fibroblast activating protein, a type II membrane-bound glycoprotein. Fibroblast Activating Protein plays a role in normal developmental processes during embryogenesis and in tissues modeling.

The presence of Fibroblast Activating Protein in cancer-associated fibroblasts in many solid tumors and the fact that overexpression is associated with a worse prognosis in cancer patients has led to the hypothesis that Fibroblast Activating Protein plays a fundamental role in the development of cancer, in the migration of cancer cells, and in the spread of cancer. Therefore, the targeting of this enzyme for imaging and endo-radiotherapy can be seen as a promising strategy for detecting and treating malignant tumors.

Study Design

Study Type:
Interventional
Anticipated Enrollment :
50 participants
Allocation:
N/A
Intervention Model:
Single Group Assignment
Intervention Model Description:
A total of 50 patients will be enrolled. The proportion of 68-Gallium-Fibroblast Activating Protein Inhibitor-46 Positron Emission Tomography /Computerized Tomography positive patients or lesions will be calculated as well as 95% confidence intervals (CI). Median and ranges or mean and standard deviation, as appropriate, will be used to describe 68-Gallium-Fibroblast Activating Protein Inhibitor-46 (68Ga-FAPI-46) uptake. The number and percentage of treated patients undergoing grade 1 to 4 adverse events will be tabulated according to CTCAE version 5.0.A total of 50 patients will be enrolled. The proportion of 68-Gallium-Fibroblast Activating Protein Inhibitor-46 Positron Emission Tomography /Computerized Tomography positive patients or lesions will be calculated as well as 95% confidence intervals (CI). Median and ranges or mean and standard deviation, as appropriate, will be used to describe 68-Gallium-Fibroblast Activating Protein Inhibitor-46 (68Ga-FAPI-46) uptake. The number and percentage of treated patients undergoing grade 1 to 4 adverse events will be tabulated according to CTCAE version 5.0.
Masking:
None (Open Label)
Primary Purpose:
Diagnostic
Official Title:
68Ga-FAPI-46 Positron Emission Tomography - Computerized Tomography for Molecular Assessment of Fibroblast Activation
Actual Study Start Date :
Aug 21, 2023
Anticipated Primary Completion Date :
Aug 1, 2025
Anticipated Study Completion Date :
Sep 1, 2025

Arms and Interventions

Arm Intervention/Treatment
Experimental: Arm 1

50 patients with solid tumor and 18-Fluorine-2-fluoro-2-deoxy-D-glucose fluorodeoxyglucose Positron emission tomography / Computerized tomography scan dubious

Diagnostic Test: 68 Gallium -Fibroblast Activating Protein Inhibitor -46 Positron emission tomography / Computerized tomography
68 Gallium -Fibroblast Activating Protein Inhibitor -46 Positron emission tomography / Computerized tomography scan

Outcome Measures

Primary Outcome Measures

  1. Sensitivity of 68-Gallium -Fibroblast Activating Protein Inhibitor - 46 Positron emission tomography / Computerized tomography [30 months]

    ratio between the number of 68 Gallium -Fibroblast Activating Protein Inhibitor -46 Positron emission tomography / Computerized tomography positive patients and the number of patients with solid tumors presenting with Fluorodeoxyglucose Positron Emission Tomography/Computerized Tomography scan dubious or inconclusive.

Secondary Outcome Measures

  1. Detection rate of lesions, stratified by tumor histology [30 months]

    Proportion of positive patients on total number who underwent 68 Gallium -Fibroblast Activating Protein Inhibitor -46 Positron emission tomography / Computerized tomography stratified for tumor histotypes

  2. Detection rate of stratified lesions for different lesion sites [30 months]

    Proportion of positive patients on total number who underwent 68 Gallium -Fibroblast Activating Protein Inhibitor -46 Positron emission tomography / Computerized tomography stratified for different lesion sites

  3. Assessment early response to immunotherapy [30 months]

    to evaluate changes in Fibroblast Activating Protein Inhibitor uptake in patients and correlate it with clinical response to immunotherapy or other therapy

  4. Safety (number of patients) [30 months]

    safety is defined as the number of treated patients undergoing grade 1 to 4 adverse events

  5. Safety (percentage of patients) [30 months]

    safety is defined as the percentage of treated patients undergoing grade 1 to 4 adverse events

Eligibility Criteria

Criteria

Ages Eligible for Study:
18 Years and Older
Sexes Eligible for Study:
All
Accepts Healthy Volunteers:
No
Inclusion Criteria:
  1. Patients must have histologically or cytologically solid tumors at any stage

  2. 18-Fluorine-2-fluoro-2-deoxy-D-glucose fluorodeoxyglucose Positron emission tomography / Computerized tomography scan dubious or inconclusive

  3. Male or Female, aged>18 years

  4. Eastern Cooperative Oncology Group (ECOG) performance status <2 (see Appendix A)

  5. If female of childbearing potential highly effective birth control methods, according to guideline "Recommendation related to contraception and pregnancy testing in clinical trials", (2020_09_21 section 4.1) (See Appendix D) are mandatory. Highly effective birth control methods are required beginning at the screening visit and continuing at least 6 months following last treatment with study drug. Negative serum pregnancy test for females of childbearing potential the day before treatment. Male patient and his female partner who is of childbearing potential must use 2 acceptable methods of birth control (1 of which must include a condom as a barrier method of contraception) starting at screening and continuing throughout the study period and for 6 months after final study drug administration. Two acceptable methods of birth control thus include Condom (barrier method of contraception) and one of the following is required ( established use of oral, or injected or implanted hormonal method of contraception by the female partner; placement of an intrauterine device (IUD) or intrauterine system (IUS) by the female partner; additional barrier method like occlusive cap with spermicidal foam/gel/film/cream/suppository in the female partner; tubal ligation in the female partner; vasectomy or other procedure resulting in infertility (eg., bilateral orchiectomy), for more than 6 months.

  6. Participant is willing and able to give informed consent for participation in the study.

Exclusion Criteria:
  1. Participation in another clinical trial with any investigational agents within 30 days prior to study entry or 5 half lives of the study drug.

  2. Medical or psychological conditions that would not allow the participant to understand, or sign the informed consent

  3. History of allergic reactions attributed to compounds of similar chemical or biologic composition to Fibroblast Activating Protein Inhibitor or other agents used in the study.

  4. Inability to remain still for the entire duration of the exam

  5. Life expectancy < 6 months

  6. Eastern Cooperative Oncology Group (ECOG) performance status > 2

  7. Patient with compromised renal function (Creatinine> 2 mg/ml)

  8. Patient with altered hepatic function (AST and Alanine Aminotransferase > 2.5 respect to upper normal limits)

  9. Pregnancy and lactation

  10. Subject deprived of its freedom by administrative or legal decision or who is under guardianship

Contacts and Locations

Locations

Site City State Country Postal Code
1 IRCCS Istituto ROmagnolo per lo Studio dei Tumori "Dino Amadori"-IRST S.r.l. Meldola Forlì Cesena Italy 47014

Sponsors and Collaborators

  • Istituto Scientifico Romagnolo per lo Studio e la cura dei Tumori

Investigators

None specified.

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.
Responsible Party:
Istituto Scientifico Romagnolo per lo Studio e la cura dei Tumori
ClinicalTrials.gov Identifier:
NCT06136065
Other Study ID Numbers:
  • IRST 100.59
  • 2022-003786-38
First Posted:
Nov 18, 2023
Last Update Posted:
Nov 18, 2023
Last Verified:
Nov 1, 2023
Individual Participant Data (IPD) Sharing Statement:
No
Plan to Share IPD:
No
Studies a U.S. FDA-regulated Drug Product:
No
Studies a U.S. FDA-regulated Device Product:
No

Study Results

No Results Posted as of Nov 18, 2023