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Medical Imaging of Cachexia

Not Applicable
Recruiting
Conditions
Cancer Cachexia
Interventions
Diagnostic Test: 18F-FDG PET + Dexa Scan
Registration Number
NCT04127981
Lead Sponsor
Olivia Newton-John Cancer Research Institute
Brief Summary

This is a pilot trial using 18F-FDG PET and DXA scans to determine whether these investigations are objective tools to assess cachexia.

Detailed Description

This pilot study will establish the differences in BAT uptake of 18F-FDG in cachectic and non-cachectic cancer patients using PET imaging.

Patients willbe assessed for sarcopenia using a dual energy X-ray absorptiometry or bone densitometry scan (DXA). Given the variables which may affect uptake of BAT in cancer patients, this study will standardise patient preparation and PET scan procedure in order to obtain the most reliable assessment of BAT activity in all patients on study.

It is hypothesisd that use of this PET imaging technique, which is part of standard care to assess cancer progression, may assist clinicians in early identification of metabolic changes in a patient, with potential for early intervention and utility in monitoring success of treatments of cachexia.

A total of 40 patients will be evaluated, 20 patients with advanced/metastatic colorectal, non-small cell lung cancer (NSCLC) or pancreatic cancer without cachexia, and 20 patients with advanced/metastatic colorectal, non-small cell lung cancer (NSCLC), or pancreatic cancer with documented cachexia, all of whom are referred for standard of care 18F-FDG PET scans.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
40
Inclusion Criteria
  • Patients with malignant disease;
  • ECOG Performance score of 0-2;
  • Age ≥ 18 years;
  • Life expectancy of >4 months at screening;
  • Cachexia patient group only: Fulfils diagnostic criteria for cachexia: unintentional weight loss more than 5% over the previous 6 months, or more than 2% in individuals with a decreased body-mass index of <20kg/m2, or skeletal muscle wasting (sarcopenia).
Exclusion Criteria

Patients with uncontrolled Diabetes Mellitus;

  • Psychological unstable persons presumed unfit to perform the investigations;
  • Persons unable to lie or sit still for 1-2 hours;
  • Pregnant patients;
  • Patients who received high doses of radiotherapeutic radiation of the neck and/or upper chest in their medical history limiting nutritional intake;
  • Patients who are receiving any chemotherapeutic agents which is limiting nutritional intake;
  • Persons that received cervical or thoracic sympathectomy or have a nerve dysfunction which is likely to influence sympathetic nerves;
  • The use of medication that influences the sympathetic nerve system: ß-blockers, α-blockers, central anti-hypertensives, certain anti-depression drugs (MAO inhibitors, tricyclic antidepressives), reserpine, cocaine, calcium channel blockers, labetalol, and certain tranquillizers (fenothiazines).

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Patients without cancer cachexia18F-FDG PET + Dexa Scan20 patients with advanced/metastatic colorectal, non-small cell lung cancer (NSCLC) or pancreatic cancer without cachexia.
Patients with cancer cachexia18F-FDG PET + Dexa Scan20 patients with advanced/metastatic colorectal, non-small cell lung cancer (NSCLC), or pancreatic cancer with documented cachexia.
Primary Outcome Measures
NameTimeMethod
Correlation of a clinical diagnosis of cachexia with the metabolic activity of brown adipose tissue, bone density and muscle mass.7 days post enrollment

Quantitation of the metabolic activity of brown adipose tissue, bone density and muscle mass using 18F-FDG uptake and bone densitometry will be correlated with a diagnosis of clinical cachexia.

Secondary Outcome Measures
NameTimeMethod
To quantify change from normal of inflammatory blood biomarkers7 days post enrollment

To validate change from normal laboratory range of inflammatory blood based proteins and enzymes in cachectic vs non-cachectic patients.

Optimization of PET scanning methods for imaging of brown adipose tissue.7 days post enrollment

Optimization of the patient environment (ie. ambient temperature) and metabolic state (ie. Heart rate, dietary state) to minimize the impact of these factors and allow direct comparison of metabolic activity of brown adipose tissue between cachectic and non-cachectic patients.

To quantify change from normal of immune blood biomarkers7 days post enrollment

To validate change from normal laboratory range immune blood based proteins and enzymes in cachectic vs non-cachectic patients.

Trial Locations

Locations (1)

Austin Health

🇦🇺

Heidelberg, Victoria, Australia

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