Measuring Treatment Response in Metastatic Renal Cell Cancer Using FPIA PET/CT

Last updated: April 29, 2025
Sponsor: Imperial College London
Overall Status: Completed

Phase

N/A

Condition

N/A

Treatment

PET/CT

Clinical Study ID

NCT04802824
20CX6143
  • Ages > 18
  • All Genders

Study Summary

Renal cell carcinoma (RCC) is the most prevalent and lethal malignancy of the kidney. At the time of diagnosis, as many as a fifth of patients have metastatic disease (mRCC). Despite advances in treatment, long-term survival rates remain poor. 18F-fluoropivalate ([18F]FPIA) is a new tracer that images short chain fatty acid (SCFA) uptake in tumours, a key component of fatty acid oxidation.

The aim of the study is to investigate longitudinal changes in [18F]FPIA uptake at baseline, at 4-6 weeks and at 12 weeks following treatment initiation in patients using tyrosine kinase inhibitors (TKI's), chemotherapy, immunotherapy, or combinations of these.

The investigators hypothesise that the import of [18F]FPIA-detectable SCFA into tumours is high and decreases with effective treatment.

Eligibility Criteria

Inclusion

Inclusion Criteria:

Patients with radiological and/or histological evidence of evidence of mRCC who are either:

A. Treatment naïve or newly relapsed (not currently on treatment)

or

B. Progressing on standard of care systemic therapy

and

C. That fulfil the following criteria:

  1. Age ≥18

  2. Target metastases size ≥ 1cm (outside of the liver).

  3. The subject has an available diagnostic tumour biopsy of the primary and/ormetastatic lesion taken within 3 months of the first [18F]FPIA PET/CT.

  4. WHO performance status 0 - 2.

  5. If female, the subject is either post-menopausal (>1 year), or surgically sterilized (has had a documented bilateral oophorectomy and/or documented hysterectomy, >2years), or if of childbearing potential, must have a negative urine pregnancy testat initial screening and/or within 2 hours prior to injection of imaging agent.

  6. eGFR of ≥30 within 3 months of [18F]FPIA injection

  7. The subject is able and willing to comply with study procedures, and a signed anddated informed consent is obtained.

  8. The subject is not scheduled to start cancer treatment prior to the first studyPET/CT scan.

Exclusion

Exclusion Criteria:

  1. Pregnant or lactating women

  2. Evidence of significant medical condition or laboratory finding which, in theopinion of the Investigator, makes it undesirable for the patient to participate inthe trial

  3. The subject is receiving or has received chemotherapy, immunotherapy, biologictherapy or investigational therapy within 14 days or five half-lives of a drug (whichever is longer) prior to the first dose of [18F]FPIA injection.

  4. The subject is scheduled to have a nuclear medicine or contrast scan within 24 hoursof the administration of [18F]FPIA.

  5. Participants with claustrophobia or who are unable to comfortably tolerate thescanning procedure.

Study Design

Total Participants: 10
Treatment Group(s): 1
Primary Treatment: PET/CT
Phase:
Study Start date:
May 25, 2021
Estimated Completion Date:
June 30, 2023

Study Description

24 evaluable patients with radiological and/or histological evidence of mRCC and due to receive systemic therapy will be enrolled. The patients invited to participate in the study will provide written informed consent. Patients will only undergo [18F]FPIA positron emission tomography (PET)/computed tomography (CT) imaging once they have satisfied the inclusion and exclusion criteria. Once these have been satisfied, eligible patients will proceed to [18F]FPIA PET/CT. Patients will have three imaging visits at baseline, 4-6 weeks and 12 weeks post the commencement of treatment. Patients will have been treated as per standard of care, which may have included TKI's, chemotherapy, immunotherapy or combinations of these. Data will be considered complete when patients have all three analysable scans. In the event of dropout, additional subjects will be recruited to reach a total number of 24 evaluable subjects.

On each day of imaging the patients will have a blood test and a urine sample collected to measure concentrations of carnitine. For each scan, a single dose of [18F]FPIA (maximum 370 MBq) IV will be administered to the participant. The participant will then rest in a quiet place for an uptake period and undergo whole body PET/CT scanning from 60 minutes.

Archival tumour biopsies (primary or metastatic lesion), taken within 3 months of the 1st [18F]FPIA PET/CT scan will be retrieved for analysis where possible.

Connect with a study center

  • Imperial College Healthcare NHS Trust/Imperial College London

    London, W12 0HS
    United Kingdom

    Site Not Available

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