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TerminatedNCT03302156Updated Sep 5, 2023Results posted

PSMA PET and MRI in Gynecological Cancers

A Phase 2 interventional study of PSMA-based 18F-DCFPyL PET tracer in Gynecologic Cancer, sponsored by University of Wisconsin, Madison. Terminated at 1 site in United States. Open to female participants aged 18 Years to 99 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2023-09-05.

Sponsored by University of Wisconsin, Madison · Phase 2, Interventional, and Diagnostic

Why this study was terminated
Slow accrual following suspension per COVID-19
Phase
Phase 2
Study type
Interventional
Enrollment
15
Allocation
Non-randomized
Ages
18 Years to 99 Years
Sex
Female
01

Study summary

The goal of this research is to determine the accuracy of PSMA positron emission tomography (PET) and multi-parametric magnetic resonance (MR) imaging to detect the presence of gynecological cancer cells in the body.

Read the detailed description

The investigators will evaluate a novel second-generation low-molecular-weight prostate specific membrane antigen (PSMA)-based positron emission tomography (PET) agent, 18F-DCFPyL, to determine the presence or absence of cancer, the accurate distribution of cancer and the normal biodistribution of PSMA in the abdomen and pelvis on PET imaging.

PSMA, also known as folate hydrolase 1 and glutamate carboxypeptidase II, is an enzyme associated with prostate cancer but has been also found to be expressed in the tumor neovasculature of many different types of non-prostate cancer tumors. PSMA-based 18F-DCFPyL PET demonstrates very high tumor-to-background ratio when studied in other tumors, including prostate tumors.

MR imaging is a highly sensitive and specific imaging modality that can be used for gynecologic cancers. MR images can be obtained in conjunction with PSMA PET, adding additional anatomic and multi-parametric MRI information without the need for a second imaging appointment.

02

Conditions studied

  • Gynecologic Cancer

Keywords

  • Uterine cancer
  • Ovarian cancer
  • Hysterectomy
  • Salpingo-oophorectomy
03

Who can participate

Ages eligible
18 Years to 99 Years
Sexes eligible
Female
Accepts healthy volunteers
Yes

Eligibility criteria

Inclusion Criteria for healthy female controls N=12 (includes up to 6 Dosimetry participants):

  • Women with no suspected gynecological cancer.
  • No contraindications for MR or PET imaging.
  • Greater than or equal to 18 years of age.
  • Scheduled to undergo a hysterectomy and/or salpingo-oophorectomy

Inclusion Criteria for female controls (Dosimetry):

  • Women with or without suspected gynecological cancer.
  • No contraindications for MR or PET imaging.
  • Greater than or equal to 18 years of age.

Inclusion Criteria for gynecological cancer patients (N=40):

  • Women with known or suspected gynecological cancer
  • No contraindications for MR or PET imaging.
  • Greater than or equal to 18 years
  • Have had or are scheduled to undergo a hysterectomy and/or salpingo-oophorectomy

Exclusion Criteria:

  • Women that are pregnant or breast-feeding.
  • Age \<18
  • Inability to provide informed consent on their own behalf
  • Severe kidney dysfunction (GFR \<30 mL/min/1.73m2)
04

Study design

Phase
Phase 2
Primary purpose
Diagnostic
Allocation
Non-randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
15 participants (actual)

Study arms

  • Other
    Healthy Control Non-Dosimetry Group

    The control group will consists of women with no imaging evidence of gynecological cancer, who are undergoing hysterectomy and salpingo-oophorectomy. Women will receive PSMA-based 18F-DCFPyL tracer and PET/MR imaging. n=6

    Drug: PSMA-based 18F-DCFPyL PET tracer

  • Other
    Patient Group

    The patient group will consist of women with suspected gynecological cancers who are undergoing hysterectomy and salpingo-oophorectomy. Women will receive standard of care PSMA-based 18F-DCFPyL tracer and PET/MR imaging. n=40

    Drug: PSMA-based 18F-DCFPyL PET tracer

  • Other
    Dosimetry Group

    Women with or without suspected gynecological cancer. Women will receive PSMA-based 18F-DCFPyL tracer and PET/CT imaging, PET/MR imaging as needed. n=6

    Drug: PSMA-based 18F-DCFPyL PET tracer

Interventions

  • DrugPSMA-based 18F-DCFPyL PET tracer

    PSMA-based 18F-DCFPyL PET tracer that will be used to determine the presence or absence of cancer

    Also known as: PSMA

05

What researchers measure

Primary outcomes

  1. Diagnostic Accuracy

    Estimate the frequency with which PSMA PET and MR imaging and final IHC staining disagree in their classifications of presence of disease.

    Time frame: up to 1 day

Secondary outcomes

  1. Biodistribution of PSMA Measured by SUVmax in Normal Tissue

    Record the normal biodistribution of PSMA as detected in normal tissue controls, by the resulting PET imaging.

    Time frame: up to 1 day

  2. Biodistribution of PSMA Measured by SUVmax in Cancer Tissue

    Record the biodistribution of PSMA as detected in cancer tissue, by the resulting PET imaging.

    Time frame: up to 1 day

  3. Radiodosimetry of PSMA

    The radiodosimetry of PSMA-based 18F-DCFPyL will be measured in normal female controls via the resulting PET images.

    Time frame: up to 1 day

  4. Sensitivity and Specificity of PSMA-based PET/MR

    Record the distribution of PSMA in cancer tissue.

    Time frame: up to 1 day

06

Results

Posted Aug 9, 2023
Limitations and caveats
Calculating accuracy, sensitivity and specificity relies on the IHC staining as the gold standard. IHC staining was not done because the study was terminated due to low recruitment and loss of funds. Because the IHC staining was not performed, there is no gold standard by which to perform accuracy, sensitivity and specificity analysis.

Participant flow

15 participants were consented from November 2017 to December 2019. Research was suspended in March 2020 per the COVID-19 pandemic. The study opened to enrollment again in June 2022; there were no more participants consented. The investigator terminated the study in January 2023 due to slow accrual of patients with ovarian cancer and due to lack of funding. No participants were enrolled in the Dosimetry group.

Participant flow — Overall Study
MilestoneHealthy Control Non-Dosimetry GroupPatient GroupDosimetry Group
Started2130
Analysis population2120
Participants with confirmed ovarian cancer with psma uptake010
Completed2120
Not completed010
Withdrew: No visible evidence of tumor on mri010

Outcome measures

PrimaryDiagnostic Accuracy

Estimate the frequency with which PSMA PET and MR imaging and final IHC staining disagree in their classifications of presence of disease.

Time frame:
up to 1 day

No measurements were reported for this outcome.

SecondaryBiodistribution of PSMA Measured by SUVmax in Normal Tissue

Record the normal biodistribution of PSMA as detected in normal tissue controls, by the resulting PET imaging.

Time frame:
up to 1 day
Reported as:
Mean · SUVmax
Biodistribution of PSMA Measured by SUVmax in Normal Tissue
SUVmaxHealthy Control Non-Dosimetry GroupPatient GroupDosimetry Group
Aorta at carina2.0 ± 0.11.7 ± 0.5—
Liver - Right Lobe12.1 ± 5.410.0 ± 0.5—
Myometrium2.2 ± 0.42.9 ± 0.5—
Endometrium5.9 ± 1.84.8 ± 0.5—
Cervix4.0 ± 1.13.3 ± 0.5—
Right Ovary1.5 ± 1.73.0 ± 0.5—
Corpus Luteum6.3 ± NA5.9 ± 0.5—
Left Ovary1.7 ± 1.42.3 ± 0.5—
SecondaryBiodistribution of PSMA Measured by SUVmax in Cancer Tissue

Record the biodistribution of PSMA as detected in cancer tissue, by the resulting PET imaging.

Time frame:
up to 1 day
Reported as:
Mean · SUVmax
Biodistribution of PSMA Measured by SUVmax in Cancer Tissue
SUVmaxHealthy Control Non-Dosimetry GroupPatient GroupDosimetry Group
Biodistribution of PSMA Measured by SUVmax in Cancer Tissue—10.5 ± NA—
SecondaryRadiodosimetry of PSMA

The radiodosimetry of PSMA-based 18F-DCFPyL will be measured in normal female controls via the resulting PET images.

Time frame:
up to 1 day

No measurements were reported for this outcome.

SecondarySensitivity and Specificity of PSMA-based PET/MR

Record the distribution of PSMA in cancer tissue.

Time frame:
up to 1 day

No measurements were reported for this outcome.

Adverse events

Collected over during research visit, up to 3 hours. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Healthy Control Non-Dosimetry Group0/2 (0%)0/2 (0%)0/2 (0%)
Patient Group0/12 (0%)0/12 (0%)0/12 (0%)

Baseline characteristics

study terminated early, no participants enrolled in dosimetry group

Age, Continuous
Age, Continuous(years)Healthy Control Non-Dosimetry GroupPatient GroupTotal
Mean53.5 (39 to 68)57.3 (36 to 86)56.7 (36 to 86)
Sex: Female, Male
Sex: Female, Male(Participants)Healthy Control Non-Dosimetry GroupPatient GroupTotal
Female21214
Male000
Race and Ethnicity Not Collected
Race and Ethnicity Not Collected(Participants)Healthy Control Non-Dosimetry GroupPatient GroupTotal
Count of participants——0
Region of Enrollment
Region of Enrollment(participants)Healthy Control Non-Dosimetry GroupPatient GroupTotal
United States21214
Suspected Participant Diagnosis
Suspected Participant Diagnosis(Participants)Healthy Control Non-Dosimetry GroupPatient GroupTotal
Healthy Controls202
Ovarian Cancer088
Endometrial Cancer033
Cervical Cancer000
Other Cancer011
07

Study locations

1 site
  • University of Wisconsin, Madison
    Madison, Wisconsin 53705, United States
08

References and documents

Study documents

  • Protocol and statistical analysis plan · Jun 8, 2020

Documents are hosted by the registry — open the source record to download them.

09

Registry details

Key details

Study ID
NCT03302156
Lead sponsor
University of Wisconsin, Madison
Responsible party
Sponsor
First posted
Oct 4, 2017
Start date
Nov 15, 2017
Primary completion
Jan 20, 2020
Completion
Jan 20, 2020
Results posted
Aug 9, 2023
Last update
Sep 5, 2023

Study contacts

Steve Cho, MD
principal investigator · University of Wisconsin, Madison
Elizabeth Sadowski, MD
principal investigator · University of Wisconsin, Madison

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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