[18F]-fluoroethyl-L-tyrosine (FET) in glioblastoma (FIG) TROG 18.06 study: protocol for a prospective, multicentre PET/CT trial

Koh, ES; Gan, HK; Senko, C; Francis, RJ; Ebert, M; Lee, ST; Lau, E; Khasraw, M; Nowak, AK; Bailey, DL; Moffat, BA; Fitt, G; Hicks, RJ; Coffey, R; Verhaak, R; Walsh, KM; Barnes, EH; De Abreu Lourenco, R; Rosenthal, M; Adda, L; Foroudi, F; Lasocki, A; Moore, A; Thomas, PA; Roach, P; Back, M; Leonard, R; Scott, AM

Author(s): Koh, ES; Gan, HK; Senko, C; Francis, RJ; Ebert, M; Lee, ST; Lau, E; Khasraw, M; Nowak, AK; Bailey, DL; Moffat, BA; Fitt, G; Hicks, RJ; Coffey, R; Verhaak, R; Walsh, KM; Barnes, EH; De Abreu Lourenco, R; Rosenthal, M; Adda, L; Foroudi, F; Lasocki, A; Moore, A; Thomas, PA; Roach, P; Back, M; Leonard, R; Scott, AM;
Details: Publication Year 2023-08-04,Volume 13,Issue #8,Page e071327
Journal Title: BMJ Open
Publication Type: Research article
Abstract: INTRODUCTION: Glioblastoma is the most common aggressive primary central nervous system cancer in adults characterised by uniformly poor survival. Despite maximal safe resection and postoperative radiotherapy with concurrent and adjuvant temozolomide-based chemotherapy, tumours inevitably recur. Imaging with O-(2-[(18)F]-fluoroethyl)-L-tyrosine (FET) positron emission tomography (PET) has the potential to impact adjuvant radiotherapy (RT) planning, distinguish between treatment-induced pseudoprogression versus tumour progression as well as prognostication. METHODS AND ANALYSIS: The FET-PET in Glioblastoma (FIG) study is a prospective, multicentre, non-randomised, phase II study across 10 Australian sites and will enrol up to 210 adults aged >/=18 years with newly diagnosed glioblastoma. FET-PET will be performed at up to three time points: (1) following initial surgery and prior to commencement of chemoradiation (FET-PET1); (2) 4 weeks following concurrent chemoradiation (FET-PET2); and (3) within 14 days of suspected clinical and/or radiological progression on MRI (performed at the time of clinical suspicion of tumour recurrence) (FET-PET3). The co-primary outcomes are: (1) to investigate how FET-PET versus standard MRI impacts RT volume delineation and (2) to determine the accuracy and management impact of FET-PET in distinguishing pseudoprogression from true tumour progression. The secondary outcomes are: (1) to investigate the relationships between FET-PET parameters (including dynamic uptake, tumour to background ratio, metabolic tumour volume) and progression-free survival and overall survival; (2) to assess the change in blood and tissue biomarkers determined by serum assay when comparing FET-PET data acquired prior to chemoradiation with other prognostic markers, looking at the relationships of FET-PET versus MRI-determined site/s of progressive disease post chemotherapy treatment with MRI and FET-PET imaging; and (3) to estimate the health economic impact of incorporating FET-PET into glioblastoma management and in the assessment of post-treatment pseudoprogression or recurrence/true progression. Exploratory outcomes include the correlation of multimodal imaging, blood and tumour biomarker analyses with patterns of failure and survival. ETHICS AND DISSEMINATION: The study protocol V.2.0 dated 20 November 2020 has been approved by a lead Human Research Ethics Committee (Austin Health, Victoria). Other clinical sites will provide oversight through local governance processes, including obtaining informed consent from suitable participants. The study will be conducted in accordance with the principles of the Declaration of Helsinki and Good Clinical Practice. Results of the FIG study (TROG 18.06) will be disseminated via relevant scientific and consumer forums and peer-reviewed publications. TRIAL REGISTRATION NUMBER: ANZCTR ACTRN12619001735145.
Publisher: BMJ
Keywords: Adult; Humans; Adolescent; *Glioblastoma/diagnostic imaging/therapy/pathology; Positron Emission Tomography Computed Tomography; *Ficus; Tyrosine; Prospective Studies; *Brain Neoplasms/diagnostic imaging/therapy/pathology; Neoplasm Recurrence, Local/diagnostic imaging; Australia; Positron-Emission Tomography; Magnetic Resonance Imaging; Clinical Trials, Phase II as Topic; Multicenter Studies as Topic; Fet; Glioblastoma; chemoradiation; prognostic marker; pseudoprogression
Department(s): Cancer Imaging; Medical Oncology
PubMed ID: 37541751
Publisher's Version: https://doi.org/10.1136/bmjopen-2022-071327
Open Access at Publisher's Site: https://doi.org/10.1136/bmjopen-2022-071327
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2023-10-31 07:04:56

Last Modified: 2023-10-31 07:05:12