A Phase 1 Study to Evaluate the Safety and Feasibility of Intraoperative Detection of Clear Cell Renal Cell Carcinoma Using Indium-111-DOTA-girentuximab-IRDye800CW
Overview
- Phase
- Phase 1
- Intervention
- Indium-111-DOTA-Girentuximab-IRDye800CW
- Conditions
- Carcinoma, Renal Cell
- Sponsor
- Radboud University Medical Center
- Enrollment
- 30
- Locations
- 1
- Primary Endpoint
- Fluorescent signal at time of surgery
- Last Updated
- 4 years ago
Overview
Brief Summary
Intraoperative tumor localization and resection can be enhanced using intraoperative fluorescence imaging and radiodetection. Girentuximab specifically recognizes carbonic anhydrase IX expressed on > 95% of renal cell carcinoma (RCC). Therefore Indium-111-DOTA-girentuximab-IRDye800CW is a perfect dual-labeled antibody for dual-modality image-guided surgery in RCC.
The aim of this study is to assess the feasibility and safety of intraoperative dual-modality imaging with Indium-111-DOTA-girentuximab-IRDye800CW in renal cell carcinoma patients.
Detailed Description
In oncologic surgery complete tumor resection is important for treatment outcome and patient survival. Intraoperative tumor localization and resection can be enhanced using intraoperative imaging techniques (e.g. targeted radioguided or fluorescence guided surgery). A powerful synergy can be achieved by combining radiotracers (e.g. Indium-111) and optical tracers (e.g. IRDye 800CW) conjugated to an antibody against a tumor-associated antigen. Girentuximab specifically recognizes carbonic anhydrase IX expressed on \> 95% of renal cell carcinoma (RCC). Therefore Indium-111-DOTA-girentuximab-IRDye800CW is a perfect dual-labeled antibody for dual-modality image-guided surgery in RCC. The concept has been shown in preclinical studies with mice and the investigators will translate this to the clinic. Eligible patients with renal cell carcinoma scheduled for (partial) nephrectomy will receive dual-labeled girentuximab 7 days before surgery. At day 4 or 5 a SPECT/CT of the abdomen will be obtained. Surgery at day 7 will be extended with the use of a near-infrared fluorescence camera and a gamma probe. The aim of this study is to assess the feasibility and safety of intraoperative dual-modality imaging with Indium-111-DOTA-girentuximab-IRDye800CW in renal cell carcinoma.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Clinical diagnosis of clear cell renal cell carcinoma planned for surgery, (partial) nephrectomy
- •Performance status: Karnofsky 70 %
- •Being fit for surgery
- •Minimum age 18 years
- •Signed informed consent
Exclusion Criteria
- •A known subtype other than clear cell RCC
- •Any medical condition present that in the opinion of the investigator will affect patients' clinical status.
- •Administration of a radioisotope within 10 physical half lives prior to study enrollment
- •Pregnancy and lactation
Arms & Interventions
Intraoperative dual-modality imaging
Patients receive a single intravenous dose of Indium-111-DOTA-Girentuximab-IRDye800CW. At day 4 or 5 after antibody injection a whole body planar scan and SPECT/CT scan will be acquired. At day 7 standard of care (partial) nephrectomy will be performed. This will be extended with the use of dual-modality imaging.
Intervention: Indium-111-DOTA-Girentuximab-IRDye800CW
Intraoperative dual-modality imaging
Patients receive a single intravenous dose of Indium-111-DOTA-Girentuximab-IRDye800CW. At day 4 or 5 after antibody injection a whole body planar scan and SPECT/CT scan will be acquired. At day 7 standard of care (partial) nephrectomy will be performed. This will be extended with the use of dual-modality imaging.
Intervention: SPECT/CT
Intraoperative dual-modality imaging
Patients receive a single intravenous dose of Indium-111-DOTA-Girentuximab-IRDye800CW. At day 4 or 5 after antibody injection a whole body planar scan and SPECT/CT scan will be acquired. At day 7 standard of care (partial) nephrectomy will be performed. This will be extended with the use of dual-modality imaging.
Intervention: Intraoperative dual-modality imaging
Outcomes
Primary Outcomes
Fluorescent signal at time of surgery
Time Frame: During surgery
Can the tumor be identified by the fluorescent signal? Yes/No. Can the tumor be distinguished from normal tissue? Yes/No
Secondary Outcomes
- Optimal dose of the dual-labeled antibody preparation(4 weeks)
- Safety of dual-labeled antibody injection as assessed by the number of participants with grade 3 or 4 Adverse Events according to CTCAE v4.0(4 weeks)
- Blood levels of the dual-labeled antibody(60, 120 and 180 minutes after injection and 4 and 7 days after injection)