A Phase I/II Study to Evaluate the Safety and Feasibility of Multi-modality Imaging Using Indium-111-DOTA-labetuzumab-IRDye800CW in Patients With Peritoneal Carcinomatosis of Colorectal Origin
Overview
- Phase
- Phase 1
- Intervention
- Indium-111-DOTA-Labetuzumab-IRDye800CW injection
- Conditions
- Peritoneal Carcinomatosis
- Sponsor
- Radboud University Medical Center
- Enrollment
- 29
- Locations
- 1
- Primary Endpoint
- Fluorescent signal at time of surgery
- Last Updated
- 6 years ago
Overview
Brief Summary
Intraoperative tumor localization and resection can be enhanced using intraoperative fluorescence imaging and radiodetection. Labetuzumab specifically recognizes CEA which is is expressed on > 95% of colorectal cancers.. Therefore Indium-111-DOTA-labetuzumab-IRDye800CW is a perfect dual-labeled antibody for dual-modality image-guided surgery in peritoneal carcinomatosis of colorectal cancer.
Detailed Description
In oncologic surgery complete tumor resection is important for treatment outcome and patient survival. When performing cytoreductive surgery (CRS) for peritoneal carcinomatosis of colorectal origin it can sometimes be difficult to distinguish tumor deposits from adhesions and scar tissue. 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. Labetuzumab specifically recognises CEA which is expressed on \> 95% of all colorectal cancers. Therefore Indium-111-DOTA-labetuzumab-IRDye800CW is a perfect dual-labeled antibody for dual-modality image-guided surgery in peritoneal carcinomatosis of colorectal origin. The concept has been shown in preclinical studies with mice and the investigators will translate this to the clinic. Eligible patients with peritoneal carcinomatosis of colorectal origin scheduled for CRS + HIPEC will receive dual-labeled labetuzumab 6-7 days before surgery. At day 4 or 5 a SPECT/CT of the abdomen and thorax will be obtained. Cytoreductive 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-labetuzumab-IRDye800CW in peritoneal carcinomatosis of colorectal cancer.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Clinical diagnosis of peritoneal carcinomatosis of colorectal origin
- •Scheduled for cytoreductive surgery and HIPEC.
- •Age over 18 years
- •Signed informed consent
Exclusion Criteria
- •Any medical condition present that in the opinion of the investigator will affect patients clinicals status
- •Administration of a radionuclide within 10 physical half-lives prior to study enrollment
- •Pregnancy or lactation
- •Patients with very high (\>500ng/ml serum CEA levels
- •Known CEA negative tumor
Arms & Interventions
Intraoperative multi-modality imaging
Patients receive a single intravenous dose of Indium-111-DOTA-Labetuzumab-IRDye800CW. At day 4 or 5 after antibody injection a SPECT/CT scan will be acquired. At day 6 or 7 standard of care cytoreductive surgery will be performed. This will be extended with the use of dual-modality imaging.
Intervention: Indium-111-DOTA-Labetuzumab-IRDye800CW injection
Intraoperative multi-modality imaging
Patients receive a single intravenous dose of Indium-111-DOTA-Labetuzumab-IRDye800CW. At day 4 or 5 after antibody injection a SPECT/CT scan will be acquired. At day 6 or 7 standard of care cytoreductive surgery will be performed. This will be extended with the use of dual-modality imaging.
Intervention: SPECT/CT scan
Intraoperative multi-modality imaging
Patients receive a single intravenous dose of Indium-111-DOTA-Labetuzumab-IRDye800CW. At day 4 or 5 after antibody injection a SPECT/CT scan will be acquired. At day 6 or 7 standard of care cytoreductive surgery will be performed. This will be extended with the use of dual-modality imaging.
Intervention: CRS extended with dual-modality imaging
Outcomes
Primary Outcomes
Fluorescent signal at time of surgery
Time Frame: During cytoreductive surgery
Can the tumor be identified by the fluorescent signal? Yes/No. Can the tumor be distinguished from normal tissue? Yes/No
Secondary Outcomes
- Safety of dual-labeled antibody (labetuzumab) as assessed by the number of participants with grade 3 or 4 Adverse Events according to CTCAE v4.0(4 weeks)
- Optimal dose of the dual-labeled antibody preparation(4 weeks)
- Blood levels of the dual-labeled antibody(60, 120 and 180 minutes after injection and 4 and 7 days after injection)