FAPI-Glioma

  • Research type

    Research Study

  • Full title

    Assessing Response to Therapy in Malignant Glioma using 68Ga-FAPI PET-MRI: A Pilot Study

  • IRAS ID

    287633

  • Contact name

    Fraioli Francesco

  • Contact email

    francesco.fraoili@nhs.net

  • Clinicaltrials.gov Identifier

    Z6364106/2021/02/93, UCL DPN

  • Duration of Study in the UK

    2 years, 0 months, 1 days

  • Research summary

    There has been little improvement in survival over the past 20 years in patients suffering from the most common type of brain cancer (malignant glioma) with patients continuing to die soon after diagnosis from the complications of this rapidly progressive disease even with optimal treatment.

    Current methods of diagnosis and monitoring response to treatment are therefore inadequate in the majority of patients with standard MRI having difficulty separating patients who will progress from those that will show a good response to treatment and hence longer survival.

    With new methods of radiotherapy (RT) becoming available (e.g. proton beam therapy) there is a growing need for higher precision in diagnostics to differentiate between tumour and adjacent healthy tissue or necrotic tissue. This is directly relevant for target volume definition for RT and thus impacts tumour recurrence patterns and toxicity to healthy tissue. Current methods of diagnosis and monitoring response to treatment are unfortunately inadequate in the majority of patients with standard MRI having difficulty separating patients who will progress from those that will show a good response to treatment and hence longer survival.

    Cancer related fibroblasts (CAFs) are cells seen in large numbers due to the increased growth that occurs in cancer. Fibroblast activation protein (FAP) is overexpressed by CAFs of several cancer entities, including malignant glioma, while FAP expression in healthy tissue is relatively low. Positron emission tomography (PET) utilising the radiotracer FAP-inhibitor (68Ga-FAPI) is able to image CAFs non-invasively.

    In our study we want to:
    1) Confirm that FAPI PET produes high contrast tumour imaging compared to conventional MRI findings.
    2) Investigate the utility of FAPI PET-MRI to precisely detect and innovatively delineate malignant glioma for RT planning and compare it with the participant's actual RT plan based on standard MRI.
    3) Correlate FAPI PET uptake with other MRI measurements including perfusion and using another type of MRI looking at the concentration of sodium within the tumour, which give information about blood flow and metabolic activity (related to aggressiveness) of the cancer.

  • REC name

    London - Brighton & Sussex Research Ethics Committee

  • REC reference

    22/LO/0693

  • Date of REC Opinion

    16 Nov 2022

  • REC opinion

    Further Information Favourable Opinion