Neoplasms

Skin and Connective Tissue Diseases

All Conditions

Breast Neoplasms

Breast Diseases

Skin Diseases

Orit Goldray, M.Sc.

Prof. Einat Even-Sapir Weizer, MD, PhD

Technetium-99m NC100692 Injection is under development as a diagnostic radiopharmaceutical for targeting angiogenesis associated with diseases such as primary and metastatic cancer, and for targeting active fibrosis in cardiac diseases such as developing heart failure and developing hypertrophic cardiomyopathy.

A principle goal of imaging is identification of disease processes early in their development, at times prior to symptoms. In cancer, angiogenesis is essential for a tumour to exceed approximately 1-2 mm3 in size.As markers of angiogenesis are often expressed early in the growth of a tumour it is postulated that imaging of angiogenesis can assist in early diagnosis of cancer, relapse or spread, and monitoring response to therapy.

Technetium-99m NC100692 Injection will be tested on 3 populations of pts:

1.30 patients at high risk For breast cancer 2.30 patients with breast cancer 3.15 patients with locally advanced breast cancer undergoing treatment.

Angiogenesis is the formation of new blood vessels from the existing vascular bed. Certain integrins are upregulated while angiogenesis and myocardial fibrogenesis. Therefore, targeting an integrin with an imaging agent can be potentially useful for the early diagnosis of angiogenesis and/or fibrogenesis of malignant processes and myocardial remodelling.

Trail design

Arm 1:

Study cohort will include 30 patients. After the IV injection of 630-700 MBq 99mTc-NC100692 each breast will be imaged in CC and oblique views using the MBI system. Scintigarphic findings will be correlated with tissue diagnosis and or/ imaging and clinical follow- up of at least 6 months as well as with MRI, if performed, in order to determine the PPV and the NPV of the technology of MBI with labeled NC100692 for detection of tumors and differentiating benign and malignant breast lesions.

Arm 2 :

Study cohort will include 30 patients with breast cancer referred for 18-FDG PET-CT for staging or re-staging. In addition to the PET-CT study, scintimammography using the MBI system and whole-body scintigraphy using the Infinia gamma-camera will be performed after the IV injection of 630-700 MBq 99mTc-NC100692. Imaging with 99mTc-NC100692 will be take place first followed by 18-FDG PET-CT, on the same day.

Detection of the primary tumor, lymph nodes and remote metastasis by the various modalities and tracers will be correlated.

Arm 3:

Study cohort will include 15 patients with locally advanced breast cancer. Patients will undergo scintimammography with the MBI system (for the breast) and SPECT of the axilla and thorax (for regional lymph nodes) with the Infinia gamma camera, after the IV injection of 630-700 MBq 99mTc-NC100692 prior to treatment and at its end. The results of the follow-up studies will be correlated with histological findings in patients referred for surgery and with MRI in others.

Prior to the exam, patients will answer a detailed questionnaire about medical and family history,findings on other imaging modalities and,therpy.

The patient will be guided by the study coordinator before answering the questionnaire Reading of the 99mTc-NC100692 studies will be in a blinded mode to other imaging data, separately by two nuclear medicine experts and then in consensus. Mammography, US and MRI will be reviewed by a breast imaging.

The Role of the Novel 99mTc-NC100692 Tracer in Patients at High Risk or Known Breast Cancer

Tel-Aviv Sourasky Medical Center

director, R&D Division

Rare Diseases

Glioblastoma

Glioma

Astrocytoma

Neoplasms, Neuroepithelial

Neuroectodermal Tumors

Neuroectodermal Tumors, Primitive

Neoplasms, Germ Cell and Embryonal

Neoplasms by Histologic Type

Neoplasms, Glandular and Epithelial

Neoplasms, Nerve Tissue

Anaplastic Astrocytoma

Neuroepithelioma

Antineoplastic Agents

All Drugs and Chemicals

Temozolomide

MRI examination with i.v. gadolinium contrast to assess blood perfusion in remaining tumor tissue.

Functional MRI (DCE-MRI)

Blood sample

Tumor sample

Hans Petter Eikesdal, MD PhD

The purpose of the current trial is to explore whether the standard treatment with radiotherapy and temozolomide affect the tumor vasculature in patients with high-grade astrocytomas. If vascular effects are identified, future clinical trials can be proposed wherein anti-angiogenic agents are added to increase patient survival.

Today's standard treatment with radiotherapy and temozolomide yields a life expectancy of 1.5-3 years in patients with high-grade astrocytomas. Thus, there is a need for further therapeutic improvements in this patient population. The purpose of the current trial is to explore whether radiotherapy and temozolomide affect the tumor vasculature in patients with high-grade astrocytomas. If vascular effects are identified, future clinical trials can be proposed wherein anti-angiogenic agents are added to increase patient survival. Additionally, stem cells within malignant brain tumors is an important new area of research in this patient population, and investigations herein could contribute to identify new predictive markers and therapeutic targets.

Primary objective: To assess the vascular perfusion and permeability characteristics of high-grade astrocytomas (anaplastic astrocytoma and glioblastoma multiforme) using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in patients receiving radiotherapy and temozolomide. Furthermore to assess whether therapy-induced changes in tumor perfusion is correlated with progression-free survival.

Secondary objectives:

* Analyze circulating endothelial cells in the blood by flow cytometry to explore whether these cells can be used as an indirect estimate of angiogenesis in high-grade astrocytomas
* Analyze tumor specimens from patients that have had their gliomas debulked before commencing therapy

  * immunostaining of the tumor vasculature to assess microvessel density
  * immunostaining for tumor stem cells
  * flow cytometric assessment of dissolved tumor tissue to look for tumor stem cells
* Assess progression-free survival of all patients included in the study, in order to correlate the survival data with the above tissue sampling results.

Tumor samples and blood samples are collected and frozen for future analysis for tumor vascularization and tumor stem cells.

The Effect of Radiotherapy and Temozolomide on the Tumor Vasculature and Stem Cells in Human High-grade Astrocytomas

Only one patient was included before the study was terminated.

University of Bergen

Haukeland University Hospital

MD PhD

Blood and Lymph Conditions

Symptoms and General Pathology

Leukemia

Leukemia, Myeloid

Leukemia, Myelogenous, Chronic, BCR-ABL Positive

Hematologic Diseases

Myeloproliferative Disorders

Bone Marrow Diseases

Chronic Disease

Disease Attributes

Myeloid Leukemia

Chronic Graft Versus Host Disease

Chronic Myeloid Leukemia

Chronic Myeloproliferative Disorders

Amino Acids

Angiogenesis Inhibitors

Tyrosine Kinase Inhibitors

Tyrosine

Samir HENNI, MD

project is a pilot prospective, longitudinal, before-after, open label multicentric study.

Antiangiogenic drugs and tyrosine kinase inhibitor (TKI) represent a new therapeutic issue in the treatment of several neoplasic tumors (colon, kidney, breast, lung, skin) and hemopathy. Antiangiogenic drugs acts through neutralization of the activity (e.g. bevacizumab) or the inhibition of post-receptor tyrosine kinase pathways (e.g. sunatinib, sorafenib), leading to a reduction and inhibition of the tumoral tissular neovascularization. Due to the ubiquitous role of and the systemic administration of the antiangiogenic drugs, almost all of them are responsible for several side effects, many involving the cardiovascular system (e.g. arterial hypertension, cardiomyopathies, proteinuria, bleedings,...) and leading to a reduction of the doses or withdrawal of the treatment. To date, the mechanism and the impact of these cardiovascular effects is not well understood involving structural (i.e. capillary rarefaction) and functional vascular dysfunction (i.e. vasomotor dysfunction, stiffening).

Vascular Dysfunction and Antiangiogenic Therapy

Micro and Macro Vascular Dysfunction Induced by Antiangiogenic Therapy: Identification of New Vascular Biomarkers (DYVA-AAGG)

arterial stiffness, diameter and resistance will be performed using echotracking technologies.

University Hospital, Angers

This is a basic research study. There are no treatments with drugs or devices. Wound healing is being studied in healthy volunteers.

punch biopsy

Herb Hurwitz, MD

The overall goal of this study is to determine the feasibility and the variability of several biomarker assays in normal subjects that are relevant to tumor biology and novel anti-cancer treatments, with the goal of refining these assays for use in future therapeutic studies.

Many physiological processes in normal growth, development, injury, and repair are critical for tumor growth and progression. Usually these processes are deregulated, allowing for the potential of tumor selectivity in targeting many of these processes. In many cases, altered host stromal tissues themselves are critical for many of steps in cancer progression. Stromal endothelial cells and fibroblasts produce many tumor growth factors, which act in paracrine loops. In addition, components of the host tissue matrix and plasma proteins also help promote or inhibit tumor growth. These topics have been extensively reviewed.

A large number of targeted therapies for cancer are also in various stages of clinical development. Due to the likely minimal toxicity and only modest single agent activity of these agents, determining the optimal dose and schedule for these agents will depend upon the identification of biomarkers that can demonstrate proof of target inhibition and/or characterize the downstream consequences of this inhibition.

Despite often robust and durable clinical responses, essentially all patients treated with bevacizumab progress, implying primary or acquired resistance, or both. Treatment related changes in VEGF ligands and receptors have been reported in response to anti-VEGF therapy in preclinical models. Treatment related changes have also been noted for many additional angiogenic factors, including PDGF, bFGF, and IGF, all of which have been shown to potentially mediate sensitivity and resistance to anti-VEGF therapy. Despite the known importance of numerous angiogenic factors in both preclinical models and in patients, there have not yet been a broad and systematic evaluation of either baseline or treatment related changes of multiple angiogenic factors in response to bevacizumab. Similar information is also lacking for essentially all targeted therapies.

Biomarkers to better understand the mechanisms of action, primary and acquired resistance, and toxicity of these agents are urgently needed. The topic has been extensively reviewed and is considered a priority by the NCI. The need for such biomarkers is critical given the increasing number of permutations of targeted therapeutics and the need for biomarkers to guide patient and treatment selection both in clinical trials and in general use of anti-cancer therapy. Assay optimization and defining expected values of each marker or panel of markers is critical before use of such assays in large therapeutic clinical trials designed to target specific patient populations. In addition, understanding the biology and regulation of biomarkers related to tumor growth and tumor angiogenesis is also important. Most candidate biomarkers are themselves cellular growth factors, and are involved in not only tumor promotion and growth, but also in normal growth and development and in normal and abnormal tissues responses to injury. The primary purpose of the proposed project is to help refine new biomarkers and new and evolving technologies to assess them.

A Research Pilot Study in Healthy Volunteers to Evaluate Biomarkers for Novel Anticancer Treatments

A Research Pilot Study in Healthy Volunteers to Evaluate Biomarkers for Novel Anticancer Treatments.

Duke University

Leukemia, Myeloid, Acute

Acute Myeloid Leukemia

Acute Non Lymphoblastic Leukemia

Acute Graft Versus Host Disease

Tiffany Ting-Fang Shih, MD

Tiffany Ting-Fang Shih, M.D.

In malignant or neoplastic disease, angiogenesis is defined as the generation of new capillaries from preexisting blood vessels, e.g. by sprouting or by intusseption. Through the pioneering work of Folkman, it was recognized that angiogenesis plays an important role in tumor development, progression, and metastasis. It is also conceivable that there are forms or developmental stages of leukemia, multiple myeloma, or lymphomas that will progress independently of angiogenesis. Synthesis of angiogenesis activators, such as vascular endothelial growth factor (VEGF) and other angiogenic factors, such as basic fibroblast growth factor (bFGF), has been demonstrated for leukemia cells, non-Hodgkin's lymphoma, and myeloma cells. Microvessel density is also significantly elevated over normal controls with progressive increases according to the stages of myelodysplastic syndrome. Increased microvessel density (MVD) in the bone marrow was found in patients with multiple myeloma in comparison to normal controls and increased MVD is an adverse prognostic marker in multiple myeloma. However, the functional status of the blood vessel (e.g. permeability) cannot be determined by the above mentioned methods.

Bone Marrow Angiogenesis in Acute Myeloid Leukemia - Evaluated by Dynamic Contrast Enhanced Magnetic Resonance (MR) Image

National Taiwan University Hospital

Digestive System Diseases

Carcinoma

Carcinoma, Hepatocellular

Adenocarcinoma

Liver Neoplasms

Gastrointestinal Neoplasms

Digestive System Neoplasms

Gastrointestinal Diseases

Liver Diseases

Doxorubicin

Liposomal doxorubicin

Chlorotrianisene

Sorafenib

Ethiodized Oil

Angiogenesis Inducing Agents

Bilirubin

Protein Kinase Inhibitors

Enzyme Inhibitors

all patients will be treated with sorafenib

All patients will receive Sorafenib (800 mg/day) p.o. beginning two weeks before the first TACE and every day thereafter until patient death or premature withdrawal from study.

TACE will be carried out with doxorubicin (75 - 50 - 25 mg/m2, depending on serum bilirubin levels ≤ 1.5, 1.5 - 3, 3 - 5 mg/dL) : lipiodol (1:1) in a total volume of 20 mL; after administration of doxorubicin:lipiodol, additional embolisation will be carried out with bead block-endospheres. TACE will be repeated every 4 weeks for 3 cycles; additional cycles will be offered if clinically indicated (but no PEI or RF-ablation should be carried out after inclusion into the study)

Transarterial chemoembolisation (TACE)

Markus Peck-Radosavljevic, Prof. Dr.

Hepatocellular carcinoma (HCC) as the third most common cause of cancer-related death has a very poor prognosis. Aim of this open label single arm non randomized pilot trial is the evaluation of the efficacy and safety of sorafenib in combination with TACE in patients with unresectable HCC. Efficacy ad safety will be compared with a historical TACE-only group of a placebo controlled TACE-trial.

Hepatocellular carcinoma (HCC) as the third most common cause of cancer-related death has a very poor prognosis.

Aim 1: Efficacy of Sorafenib in combination with TACE TACE is an established therapy for patients with unresectable HCC and has been shown to significantly improve survival in these patients compared to no treatment. Quite often after cutting off the blood supply through the hepatic artery, the tumor induces active angiogenesis to promote collateral blood vessel growth from liver capsule arteries or collaterals from the gastroduodenal artery leading to tumor recovery and proliferation. Inhibition of this neoangiogenetic and proliferation activity after TACE by the multikinase inhibitor Sorafenib, already approved for HCC, could lead to significantly improvement in tumor control and survival in patients with advanced stage HCC.Safety will be compared with a historical TACE-only group of a placebo controlled TACE-trial.

Aim 2: Safety of Sorafenib in combination with TACE:

So far there are no reports about the safety of Sorafenib in combination with TACE. Here we evaluate the safety and tolerability of this combination until 12 weeks after the last TACE.

Aim 3: PPG-Measurement:

Development of portal hypertension in cirrhosis occurs due to two main pathophysiologic mechanisms: the increase in resistance to portal blood flow resulting from increased intrahepatic resistance and the decreased arteriolar vascular tone in the splanchnic vascular bed leading to increased splanchnic inflow of blood. Very recently, it has been shown that increased splanchnic inflow does not only result from arteriolar vasodilation due to excess NO-production in the splanchnic vascular bed but also from an increase in neoangiogenesis in the splanchnic circulation. Increased neovessel formation occurred within a few days of onset of portal hypertension both in a cirrhotic and an extrahepatic murine model of portal hypertension. Neoangiogenesis was effectively inhibited by either an antibody against VEGF-R2 or an inhibitor of VEGF-R2 autophosphorylation, resulting in a reduction of splanchnic blood flow.

Most recently, a combination of a VEGF and a PDGF blocker further decreased portal pressure in an experimental preclinical model.

As Sorafenib is a VEGF and PDGF blocker, we aim to analyze the influence of Sorafenib on portal hypertension and systemic and hepatic hemodynamics.

Aim 4: Biomarkers for treatment response:

Furthermore, we aim to analyze methylated tumor DNA in serum of patients with HCC undergoing Sorafenib treatment and TACE as possible marker of treatment response.

Sorafenib and Transarterial Chemoembolization for Hepatocellular Carcinoma

Sorafenib as Inhibitor of Collateral Tumor Vessel Growth During Transarterial Chemoembolisation (TACE) for Hepatocellular Carcinoma (HCC)- a Pilot Trial to Evaluate Safety and Biological Response

Medical University of Vienna

Univ. Prof. Dr. Markus Peck-Radosavljevic

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
The Role of the Novel 99mTc-NC100692 Tracer in Patients at High Risk or Known Breast Cancer	NCT01503697	Breast Cancer Tumor Angiogene...		18 Years -	Tel-Aviv Sourasky Medical Center
The Effect of Radiotherapy and Temozolomide on the Tumor Vasculature and Stem Cells in Human High-grade Astrocytomas	NCT00473408	Anaplastic Astr... Glioblastoma Mu... Tumor Angiogene...	Functional MRI ... Blood sample Tumor sample	18 Years -	Haukeland University Hospital
Vascular Dysfunction and Antiangiogenic Therapy	NCT02161978	Solid Tumor Tumor Angiogene... Endothelial Dys... CML (Chronic My...		18 Years -	University Hospital, Angers
A Research Pilot Study in Healthy Volunteers to Evaluate Biomarkers for Novel Anticancer Treatments	NCT00586417	Healthy	punch biopsy	18 Years -	Duke University
Bone Marrow Angiogenesis in Acute Myeloid Leukemia - Evaluated by Dynamic Contrast Enhanced Magnetic Resonance (MR) Image	NCT00172562	Acute Myeloid L...		20 Years - 80 Years	National Taiwan University Hospital
Sorafenib and Transarterial Chemoembolization for Hepatocellular Carcinoma	NCT00768937	Hepatocellular ...	Sorafenib Transarterial c...	18 Years -	Medical University of Vienna
Bone Marrow Angiogenesis in Acute Myeloid Leukemia - Evaluated by Dynamic Contrast Enhanced Magnetic Resonance (MR) Image	NCT00172562	Acute Myeloid L...		20 Years - 80 Years	National Taiwan University Hospital

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