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Carcinoma, Non-Small-Cell LungIBFICNCT05260606

Imaging Biomarkers for Immune Checkpoint Inhibitor Treatment in Patients With Non-small Cell Lung Cancer

An observational study of Carcinoma, Non-Small-Cell Lung and Immune Checkpoint Inhibitors, run by Samsung Medical Center at 1 site in South Korea.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

1. Hypothesis : imaging biomarkers of tumor measured by F-18 fluorodeoxyglucose (FDG) positron emission tomography(PET)/computed tomography(CT) is correlated with immune checkpoint inhibitor (ICI) treatment response and patient prognosis. 2. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
F-18 FDG PET/CT
Type of treatment
Injection or infusion
How many people
100 participants
Where
1 siteSouth Korea
Study dates
9 May 2022to Dec 2025
How long will I take part?
2 Years
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Patients 18 years old or over with non-small cell lung cancer who will be treated with immune checkpoint inhibitors

Who may be able to join

  • 18 years old or over
  • pathologically proven non-small cell lung cancer: adenocarcinoma or squamous cell carcinoma
  • patients to be treated with immune checkpoint inhibitors (nivolumab or pembrolizumab or atezolizumab)
  • ECOG performance status ≤ 2
  • A person who have heard the detailed explanation of this clinical trial and are willing to voluntarily decide to participate and sign the informed consent form

Who cannot join

  • subjects without measurable lesion: They must have at least one measurable lesion with a diameter of 10 mm by spiral CT or multi-detector CT (MD CT) or 20 mm or larger by conventional CT.
  • subjects with a history of other malignant diseases within the past 5 years, except for treated basal cell carcinoma of the skin, carcinoma in situ of the cervix, cured thyroid cancer, and early gastric cancer
  • subjects with clinically significant uncontrolled seizures, central nervous system disease, or psychiatric disorders that, in the investigator's judgment, interferes with or is likely to interfere with the understanding of informed consent
  • subjects with uncontrolled diabetes
  • subjects with severe uncontrolled infection
  • subjects who underwent major surgery within 4 weeks prior to the start of the clinical trial or who have not fully recovered from the effects of major surgery
Show all 9Show fewer
  • pregnant or lactating patients
  • subjects who have not received a pregnancy test or have a positive result during the basic test (menopause women with amenorrhea period of at least 12 months or longer are considered infertile subjects)
  • women or men of childbearing potential who are unwilling to use contraception during the clinical trial period

Trial locations and contacts

1 site in 1 country.

Seung hwan Moon, M.D., Ph.D. contact

+82-2-3410-6293

seunghwan.moons.moon@samsung.com

South Korea1 site, 1 recruiting
  • Samsung Medical Center

    Seoul, 06351

    Seung hwan Moon, MD., Ph.D., +82-2-3410-6293, seunghwan.moons.moon@samsung.com

    Recruiting

Other trials in South Korea

About this study

Official title: Imaging Biomarkers for Immune Checkpoint Inhibitor Treatment in Patients With Non-small Cell Lung Cancer: Prospective Observational Study

  1. Hypothesis : imaging biomarkers of tumor measured by F-18 fluorodeoxyglucose (FDG) positron emission tomography(PET)/computed tomography(CT) is correlated with immune checkpoint inhibitor (ICI) treatment response and patient prognosis.
  2. Purpose: To evaluate the association between metabolic imaging parameters measured by F-18 FDG PET/CT and clinical outcomes in patients with non-small cell lung cancer treated with ICIs.
  3. Study subject: patients with non-small cell lung cancer who will be treated with ICIs.
  4. Study design: prospective observational study
  5. Intervention: F-18 FDG PET/CT
Read the detailed description
  1. Study purposes
  2. Primary purpose: To evaluate the association between metabolic imaging parameters measured by F-18 FDG PET/CT and treatment response in non-small cell lung cancer (NSCLC) patients treated with ICIs.
  3. Secondary purpose: To evaluate the association between PET imaging parameters, patient prognosis, CT imaging parameters, and other biomarkers, and to compare treatment response evaluation criteria.
  4. Background: development of ICIs opened a new paradigm for cancer treatment. It enables long-term survival of patients with advanced cancers, which could not be expected to be effective with conventional chemotherapy. Therapeutic response and prognosis to ICIs have unique characteristics which are different from those of conventional cytotoxic or targeted therapies. Even if the initial response rate is not high, if the treatment effect is effective, the effect is long-lasting and enabling long-term survival. With the evaluation criteria based on the change in tumor size, it is difficult to differentiate between an atypical response of ICIs and disease progression. Therefore, a new type of approach is required. F-18 FDG PET/CT is an imaging method that is currently used for many cancers. In recent studies on the response evaluation of ICIs using FDG PET/CT, FDG PET/CT has shown potential as a predictive tool of therapeutic response and prognosis. However, despite the potential, most of the related studies are retrospective design and small in scale. Additionally, it is not known which PET imaging features are suitable for predicting treatment response and prognosis. A novel image analysis method based on image informatics has been tried. After extracting image features from imaging modalities such as PET, CT, MRI, they are fused with clinical information and genetic information and analyzed through an artificial intelligence-based platform. It has been reported that a predictive model based on CT image features can predict the treatment response to ICI. However, the efficacy of imaging biomarkers for predicting ICI treatment response has not yet been proven, and further prospective studies are needed. Therefore, patients with NSCLC to be treated with ICI will receive FDG PET/CT before and during treatment in this study. In addition, PET images will be comprehensively analyzed together with other image data, biomarkers, and clinical data, and will be used as basic data for future ICI prediction models.
  5. Study design: single institution, single-arm, prospective observational study
  6. Study population: NSCLC patients who are scheduled to receive ICI in our institution
  7. Recruitment: clinical referrals
  8. Target number: 100 patients available for analysis.
  9. Intervention: F-18 FDG PET/CT scan
  10. Study protocol
  11. Study participants will have FDG PET/CT before and during ICI Tx.
  12. There is no difference from the treatment schedule performed in usual clinical setting except for an additional F-18 FDG PET/CT scan. Detailed plan of ICI treatment and patient management (dose, administration date, treatment period, and follow-up) follows the standard protocol of our institution in this study.
  13. Scans: 1st scan (pre-treatment), 2nd scan (interim), 3rd scan (Optional)
  14. Variables
  15. Death status, date of death
  16. Disease progression status, date of disease progression
  17. ICI type and dose
  18. First day of ICI treatment, end day of ICI treatment, ICI treatment cycle
  19. Hospital visit dates
  20. Neutrophil to lymphocyte ratio (NLR)
  21. Immunochemical staining results [PD-L1: Combined positive score (CPS) and tumor proportion score (TPS)]
  22. Other blood and biopsy results
  23. FDG PET/CT imaging parameters [Standard uptake value (SUV)max, SUVpeak, metabolic tumor volume (MTV), total lesion glycolysis (TLG), spleen to liver ratio (SLR), etc]
  24. CT imaging parameters
  25. PET-based treatment response: positron Emission Tomography Response Criteria in Solid Tumors (PERCIST) criteria/ immune PERCIST (iPERCIST)/ Deauville score
  26. CT-based treatment response: response Criteria in Solid Tumors (RECIST v1.1) criteria / immune RECIST (iRECIST) criteria / immune-modified RECIST (imRECIST)
Being tested
F-18 FDG PET/CT
Medical subject headings
Carcinoma, Non-Small-Cell Lung

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • F-18 FDG PET/CTDiagnostic test

    1. 1st scan: pre-Tx, ICI Tx must be started within 35 days after 1st scan.
    2. 2nd scan: interim
    • Pembrolizumab or atezolizumab: after the 2nd Tx cycle to before the start of the 3rd Tx cycle
    • Nivolumab: after the 3rd Tx cycle to before the start of the 4th Tx cycle
    1. 3rd scan: optional (3rd scan can be performed when disease progression is suspected)
    2. Imaging
    • Fasting: at least 6 hours
    • Blood glucose level: < 200 mg/dL
    • F-18 FDG 0.14 mCi/kg (IV)
    • Image acquisition: 1 hr after FDG injection, CT images are acquired. After CT scan, PET images are acquired and attenuation-corrected PET images are reconstructed based on the CT image data.
    • PET/CT: Discovery MIDR or MI (GE Healthcare, Chicago, Illinois, USA)
    • First and second scans have to be performed with same scan.
Study groups in NCT05260606
Study groupRoleWhat they receive
Patients with NSCLC who will have FDG PET/CT before and during ICI TxThere is no difference from the treatment schedule performed in usual clinical setting except for an additional F-18 FDG PET/CT scan. Detailed plan of ICI treatment and patient management (dose, administration date, treatment period, and follow-up) follows the standard protocol of our institution in this study.
Receives: Diagnostic Test: F-18 FDG PET/CT

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Correlation between metabolic imaging parameters and treatment response

    • Analyze the correlation between metabolic imaging indicators (SUVmax, SULpeak, MTV, TLG, SLR of tumor lesions on 1st scan, % change of SUVmax, % change of SULpeak, % change of MTV, % change of TLG, % change of SLR between 1st and 2nd scans) and treatment response.
    • Treatment response: If the patient maintains a stable disease state or above based on the CT response evaluation criteria for more than 6 months, it is considered to have a response.
    • % change = [((Value of SCAN2 - value of SCAN1)/value of SCAN1) X 100]
    • Analysis model: point-biserial correlation analysis (Two-tailed test)

    Measured: The primary analysis can be performed when all study subjects have elapsed more than 6 months after the start of treatment.

Secondary outcomes (7)
  1. Correlation between metabolic imaging parameters and patient prognosis

    • Analyze the correlation between the metabolic imaging indicators and patient's overall survival (OS) and progression free survival (PFS) using Cox proportional hazard model

    Measured: The primary analysis can be performed when all study subjects have elapsed more than 12 months after the start of treatment.

  2. Comparison of clinical outcome according to FDG PET/CT evaluation criteria (PERCIST vs. iPERCIST)

    • Compare clinical outcome according to the FDG PET/CT evaluation criteria (PERCIST vs. iPERCIST) using Pearson chi-square test

    Measured: The primary analysis can be performed when all study subjects have elapsed more than 12 months after the start of treatment.

  3. Correlation between metabolic imaging parameters and CT imaging parameters obtained from contrast-enhanced CT

    • Analyze the correlation between PET parameters and contrast CT parameters using Pearson or Spearman correlation analysis

    Measured: Analysis can be performed at the time when all target subjects underwent pre-treatment and interim F-18 FDG PET/CT scans.

  4. Comparison of FDG PET/CT evaluation criteria with CT evaluation criteria (iRECIST and imRECIST)

    • Compare FDG PET/CT evaluation criteria and CT evaluation criteria using Pearson chi-square test

    Measured: Analysis can be performed at the time when all target subjects underwent pre-treatment and interim F-18 FDG PET/CT scans.

  5. Correlation between imaging markers and non-imaging biomarkers

    • Analyze correlation between imaging parameters and non-imaging biomarker such as NLR using Pearson or Spearman correlation analysis/ biserial correlation analysis

    Measured: Analysis can be performed at the time when all target subjects underwent pre-treatment and interim F-18 FDG PET/CT scans.

  6. Correlation between biomarkers and treatment response

    • Analyze correlation between biomarkers and treatment response using Point-biserial correlation analysis

    Measured: The primary analysis can be performed when all study subjects have elapsed more than 6 months after the start of treatment.

  7. Correlation between biomarkers and patient prognosis

    • Analyze the correlation between biomarkers and prognosis (OS, PFS) using Cox proportional hazard model

    Measured: The primary analysis can be performed when all study subjects have elapsed more than 12 months after the start of treatment.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted2 Mar 2022
  2. Study start9 May 2022
  3. Primary completionDec 2025 (estimated)
  4. Study completionDec 2025 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
100 participants (estimated)
Target duration
2 Years
IDs, dates and publications
ClinicalTrials.gov ID
NCT05260606
Sponsor's protocol ID
SMO1220071
Acronym
IBFIC
Status last verified
Apr 2024
First submitted
18 Feb 2022
Last updated
17 Apr 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
Undecided

Publications

  • Takada K, Toyokawa G, Yoneshima Y, Tanaka K, Okamoto I, Shimokawa M, Wakasu S, Haro A, Osoegawa A, Tagawa T, Oda Y, Nakanishi Y, Mori M. 18F-FDG uptake in PET/CT is a potential predictive biomarker of response to anti-PD-1 antibody therapy in non-small cell lung cancer. Sci Rep. 2019 Sep 16;9(1):13362. doi: 10.1038/s41598-019-50079-2.

    PubMed 31527660
  • Goldfarb L, Duchemann B, Chouahnia K, Zelek L, Soussan M. Monitoring anti-PD-1-based immunotherapy in non-small cell lung cancer with FDG PET: introduction of iPERCIST. EJNMMI Res. 2019 Jan 29;9(1):8. doi: 10.1186/s13550-019-0473-1.

    PubMed 30694399
  • Humbert O, Cadour N, Paquet M, Schiappa R, Poudenx M, Chardin D, Borchiellini D, Benisvy D, Ouvrier MJ, Zwarthoed C, Schiazza A, Ilie M, Ghalloussi H, Koulibaly PM, Darcourt J, Otto J. 18FDG PET/CT in the early assessment of non-small cell lung cancer response to immunotherapy: frequency and clinical significance of atypical evolutive patterns. Eur J Nucl Med Mol Imaging. 2020 May;47(5):1158-1167. doi: 10.1007/s00259-019-04573-4. Epub 2019 Nov 23.

    PubMed 31760467
  • Seban RD, Mezquita L, Berenbaum A, Dercle L, Botticella A, Le Pechoux C, Caramella C, Deutsch E, Grimaldi S, Adam J, Ammari S, Planchard D, Leboulleux S, Besse B. Baseline metabolic tumor burden on FDG PET/CT scans predicts outcome in advanced NSCLC patients treated with immune checkpoint inhibitors. Eur J Nucl Med Mol Imaging. 2020 May;47(5):1147-1157. doi: 10.1007/s00259-019-04615-x. Epub 2019 Nov 21.

    PubMed 31754795

Questions about this trial

What is this clinical trial studying?

An observational study of Carcinoma, Non-Small-Cell Lung and Immune Checkpoint Inhibitors, run by Samsung Medical Center at 1 site in South Korea.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 17 Apr 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in South Korea. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Seung hwan Moon, M.D., Ph.D. (+82-2-3410-6293, seunghwan.moons.moon@samsung.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Correlation between metabolic imaging parameters and treatment response (time frame: The primary analysis can be performed when all study subjects have elapsed more than 6 months after the start of treatment.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05260606, which also lists 4 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 Apr 2024.

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