Clinical trial NCT03563482: Correlation of Metabolic Imaging With Immune Markers in NSCLC Candidate to Immunotherapy.
Official title: Correlazione Dell'Imaging Metabolico Con l'Espressione Dei Marcatori Immunitari Nei Pazienti Con NSCLC Candidati All'Immunoterapia.
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Carcinoma, Non-Small-Cell Lung
Positron-Emission Tomography
Immunotherapy
Lead sponsor: Istituto Clinico Humanitas
Sponsor class: OTHER
First posted: 2018-06-20
Enrollment: 500
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: DIAGNOSTIC

Brief 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.

Detailed 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.

Eligibility criteria: Inclusion Criteria:

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

Exclusion Criteria:

* age \<18 years;
* pregnancy or breast-feeding.

Primary outcomes:
measure: Correlate the tumor expression of immune markers with the metabolic characteristics on FDG-PET in patients with NSCLC candidates to immunotherapy.
timeFrame: Baseline
Secondary outcomes:
measure: Tumor expression of immune markers with the metabolic characteristics on FDG-PET in patients with NSCLC candidates to immunotherapy.
timeFrame: Before treatment
measure: Correlate immune markers with the metabolic characteristics on FDG-PET in patients with NSCLC candidates to immunotherapy.
timeFrame: Baseline
measure: Evaluate the variation of metabolic parameters on FDG-PET in patients with NSCLC before and 8 weeks after the first administration of immunotherapy.
timeFrame: After 8 weeks of treatment
measure: Quantify the variation of metabolic parameters on FDG-PET in patients with NSCLC before and 8 weeks after the first administration of immunotherapy.
timeFrame: After 8 weeks of treatment
measure: Evaluate other tissue or circulating markers in patients with NSCLC before and 8 weeks after the first administration of immunotherapy.
timeFrame: Baseline
measure: Evaluate other tissue or circulating markers in patients with NSCLC before and 8 weeks after the first administration of immunotherapy.
timeFrame: 8 weeks after treatment
Other outcomes:
measure: Correlate all defined parameters with response to treatment and outcome
timeFrame: 18 months of follow up
Locations:
city: Rozzano
country: Italy
facility: Istituto Clinico Humanitas
state: Milano
Study officials:
affiliation: Istituto Clinico Humanitas
name: Egesta Lopci
role: PRINCIPAL_INVESTIGATOR
References:
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.
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. No abstract available.
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.
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.
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.
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.
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.
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 18F-FDG PET/CT. J Nucl Med. 2020 Jun;61(6):821-826. doi: 10.2967/jnumed.119.237768. Epub 2019 Dec 20.
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.
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):487. doi: 10.3390/cancers12020487.
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.
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):1373. doi: 10.3390/cancers12061373.
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.
citation: Castello A, Lopci E. Reply: Diagnosis of Hyperprogressive Disease in Patients Treated with Checkpoint Inhibitors Using 18F-FDG PET/CT. J Nucl Med. 2020 Sep;61(9):1405. doi: 10.2967/jnumed.120.243444. Epub 2020 Mar 13. No abstract available.
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. No abstract available.
citation: Aide N, De Pontdeville M, Lopci E. Evaluating response to immunotherapy with 18F-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. No abstract available.
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.