Integrated Imaging Strategy to Phenotype Progression of Liver Tumors During and After Chemoembolization

• Status: Completed
• Trial end date: 2018-03-07
• Target enrollment: 0
• Participant gender: All

Summary

Background:

• Treatment for liver cancer can include surgery, transplant, and chemotherapy. It can also include other minimally invasive tumor treatments such as transarterial chemoembolization (TACE). TACE treatment for liver cancer helps control the cancer but is not considered a cure. Researchers want to learn more about the effects of TACE on liver tumors and surrounding tissue. To do this, they will use a positive emission test (PET) and a radioactive tracer called [18F] FMISO.

Objectives:

• To see if [18F] FMISO is useful for evaluating what happens to liver tumors and surrounding tissue after TACE.

Eligibility:

• People age 18 and older with liver cancer who have been approved to have TACE.

Design:

• Participants will meet with a study researcher to see if they can take part in the study.

• Participants will have TACE under a separate NCI protocol or at a hospital other than the NIH Clinical Center.

• Before and after TACE, participants will have a CT and MRI of the abdomen. For these scans, they will lie in a machine that takes pictures of their body. They will also have blood tests and a physical exam.

• The [18F] FMISO imaging study will be performed at NIH only.

• Participants will have an intravenous catheter placed in their arm (if they do not have one). The [18F] FMISO tracer will be injected.

• Participants will have PET-CT scans. Each scan will take about 30 minutes.

• Some participants will also have [18F] FMISO and PET-CT scans before TACE.

• As part of standard care for TACE, participants will have CT and MRI scans at regular intervals. This will evaluate tumor response.

• Phase: Phase 2
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: National Institutes of Health Clinical Center (CC)

Criteria

• INCLUSION CRITERIA:

• Patients must have confirmed inoperable primary hepatic malignancy or hepatic dominant metastatic - neoplastic disease evidenced by histology or cytology, or characteristic enhancement pattern on CT or MRI together with an abnormal serum alpha-fetoprotein >200mg/dl in the case of hepatocellular carcinoma.

• Patients with hepatocellular carcinoma should conform to intermediate stage disease according to the BCLC(16) staging system (Stage A4 or B) and be otherwise eligible to receive TACE treatment.

• Patients must have had no chemotherapy or radiotherapy to the liver therapy for, their malignancy for at least 2 weeks (or until response can be adequately assessed) prior to treatment and must have recovered from all clinically significant side effects of therapeutic and diagnostic interventions.

• Serum creatinine less than or equal to 2.0 mg/dl unless the measured creatinine clearance is greater than 60ml/min

• Age greater than or equal to18 years

• Ability of subject to understand and willingness to sign a written informed consent document

• Patient must be able to lie still for the procedure

• ECOG status less than or equal to 2

• In addition, for patients receiving TACE outside NIH:

• Patient must have physician willing to collaborate with NIH PI by providing required medical record and digital MR/ CT scan documentation pre and post TACE procedure.

• Patient must be willing to sign an Authorization for the Release of Medical Information form

EXCLUSION CRITERIA:

• Patients who have received prior TACE treatment

• History of allergic reactions attributed to compounds of similar chemical or biologic composition to misonidazole or other agents used in study.

• Patients with known brain metastases should be excluded from this clinical trial because of their poor prognosis and because they often develop progressive neurologic dysfunction that would confound the evaluation of neurologic and other adverse events.

• 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.

• Patients of childbearing age must not be pregnant. The effects of [(18)F]FMISO on the developing human fetus are unknown. Pregnancy is a contraindication for TACE.