E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
The disease we will be studying is medullary thyroid carcinoma. This type of thyroid carcinoma constitutes approximately 10% of all thyroid cancers. Treatment consists of a total thyroidectomy and central lymph node compartment dissection, possibly with additional lateral neck dissection depending on disease extent. To establish disease extent at diagnosis or to evaluate for progression, PET imaging is used. This study aims to identify whether the 18F-PSMA tracer could be used for this. |
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E.1.1.1 | Medical condition in easily understood language |
Medullary thyroid cancer. |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
• To evaluate whether the 18F-PSMA tracer is capable of detecting medullary thyroid carcinoma lesions in patients with biochemically active and cytological/histological proven medullary thyroid cancer. |
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E.2.2 | Secondary objectives of the trial |
• To compare the patient-based, regional-based and lesion-based sensitivity of 18F-PSMA PET/CT with the 18F-FDG PET/CT in patients with MTC. • To perform a quantitative comparison of tracer uptake (18F-FDG versus 18F-PSMA) in MTC lesions (using Standardized Uptake Values). • To evaluate the association between 18F-PSMA uptake on PET scanning and clinical parameters.
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
In order to be eligible to participate in this study, a subject must meet all of the following inclusion criteria: - At least 18 years of age - Histological or cytological proven MTC - Biochemical evidence of disease activity (elevated/increasing calcitonin and/or CEA) - Clinical indication for an 18F-FDG PET/CT - Able to follow instructions to participate in the study - Able to give informed consent
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E.4 | Principal exclusion criteria |
A potential subject who meets any of the following criteria will be excluded from participation in this study: - Patients with prostate cancer or renal cell carcinoma - Pregnant patients - Recent neck surgery (<3 months ago)
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E.5 End points |
E.5.1 | Primary end point(s) |
The performance of 18F-PSMA PET for the indication medullary thyroid carcinoma. This will be evaluated through the following parameters: - Patient-based sensitivity of 18F-PSMA PET/CT for MTC - Lesion-based sensitivity of 18F-PSMA PET/CT for MTC - Region-based sensitivity of 18F-PSMA PET/CT for MTC
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
An interim analysis will be performed after 5 patients.
The final analysis will take place after all 15 patients have undergone the 18F-PSMA PET/CT and 18F-FDG PET/CT. |
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E.5.2 | Secondary end point(s) |
- Comparison of the performance of the 18F-PSMA PET/CT and the 18F-FDG PET/CT in terms of: o Patient-based sensitivity o Lesion-based sensitivity o Region-based sensitivity - Quantification of: o 18F-FDG uptake in tumor lesions (expressed as Standardized Uptake Values) o 18F-PSMA uptake in tumor lesions (expressed as Standardized Uptake Values) o Comparison of the 18F-FDG uptake and 18F-PSMA uptake in tumor lesions (comparison of Standardized Uptake Values) - Association between 18F-PSMA uptake in tumor lesions (expressed as Standardized Uptake Values) and clinical parameters (see below).
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
After all patients have undergone the 18F-PSMA PET/CT and 18F-FDG PET/CT. |
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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 | No |
E.6.5 | Efficacy | No |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
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) | No |
E.7.1.1 | First administration to humans | No |
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
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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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We intend to include 15 patients. Therefore, the study will end when the last patient, number 15, has undergone the 18F-PSMA PET/CT. However, an interim analysis will be performed after 5 patients. If there is no 18F-PSMA uptake in MTC lesions, we will terminate the study. If there is uptake in (a) lesion(s) suspicious for MTC on 18F-PSMA PET/CT imaging, we will continue inclusion until 15 patients have been included.
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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 | |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |