E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
This trial investigates a new tracer substance for PET scan of hepatocellular carcinoma in patients with liver disease. The condition investigated is a hepatocellular carcinoma in patients with liver cirrhosis. In a subset of patients, the PET scan will be repeated during tumor specific therapies to evaluate changes in tracer accumulation after therapy. |
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E.1.1.1 | Medical condition in easily understood language |
This trial investigates a new tracer substance for PET scan of hepatocellular carcinoma in patients with liver cirrhosis. |
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E.1.1.2 | Therapeutic area | Analytical, Diagnostic and Therapeutic Techniques and Equipment [E] - Diagnosis [E01] |
MedDRA Classification |
E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The primary objective is to evaluate accumulation of [68Ga]NODAGA-RGD tracer in HCC compared to the surrounding liver parenchyma and to correlate the tumor volume measured by [68Ga]NODAGA-RGD-PET to the tumor volume measured by CT/MRI. |
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E.2.2 | Secondary objectives of the trial |
To evaluate safety and tolerability of [68Ga]NODAGA-RGD in patients with liver disease.
To evaluate if tracer accumulation changes after systemic (Sorafenib) or locoablative (TACE, RFA) therapies. Results obtained by PET can be compared to results obtained by CT/MRI to test if PET is superior in diagnosis of vital tumor parenchyma as compared to CT/MRI.
Furthermore we want to determine [68Ga]NODAGA-RGD whole body biodistribution (organ exposure to substance) and pharmacokinetics and the radiation dosimetry of [68Ga]NODAGA-RGD (organ exposure to radiation)
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
• Yet untreated HCC due to liver cirrhosis Child Pugh class A or class B. The diagnosis of HCC hast to be confirmed by multiphasic CT or MRI according to EASL/EORTC guidelines.
• Written informed consent
• Age 18 or above
• In women, pregnancy must be excluded and contraception must be performed
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E.4 | Principal exclusion criteria |
• Decompensated liver cirrhosis Child Pugh class C
• Uncontrolled complications of portal hypertension (refractory ascites, advanced hepatic encephalopathy or large esophageal varices)
• Advanced renal insufficiency with an eGFR below 30 ml/min
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E.5 End points |
E.5.1 | Primary end point(s) |
Tracer accumulation in HCC expressed as ratio of standardised uptake values (SUV) within HCC regions divided by SUV in liver tissue unaffected by HCC |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
Changes in tracer accumulation after anti-tumor therapies (Sorafenib, TACE or RFA). |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
A maximum of 3 PET scans between month 3 and 12 under anti-tumor therapy. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | Yes |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | Yes |
E.7.1.1 | First administration to humans | Yes |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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The trial will include 30 patients. After the first 10 patients, an interim analysis will be carried out. If the tracer substance does not accumulate within HCC tissue, the trial will be terminated.
If tracer accumulates in HCC, further 20 patients will be included and changes in tracer accumulation will be studied over a maximum period of 12 months.
The study will be terminated prematurely if any severe or serious side effect related to the study drug occurs.
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 3 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 3 |
E.8.9.2 | In all countries concerned by the trial months | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |