This pilot research trial studies how well fluorodeoxyglucose F-18 (FDG) positron emission tomography/computed tomography (PET/CT) works in measuring early response to treatment with pembrolizumab in patients with melanoma that has spread to other places in the body. Diagnostic procedures, such as FDG PET/CT, may help show if melanoma tumors are responding to treatment within the first few weeks of starting pembrolizumab.
Study sponsor and potential other locations can be found on ClinicalTrials.gov for NCT02791594.
PRIMARY OBJECTIVES:
I. To determine the distribution of changes from baseline in tumor FDG uptake on PET/CT at 3 weeks and > 10 weeks after initiation of pembrolizumab.
II. To evaluate the ability of FDG PET/CT to serve as an early measure of objective response to therapy in patients with melanoma on pembrolizumab.
SECONDARY OBJECTIVES:
I. Based on changes in tumor FDG uptake at 3 weeks, determine which patients have FDG “flare” (an early increase in tumor FDG PET/CT uptake), and assess whether FDG “flare” is predictive of progression-free survival and overall survival in patients with melanoma on pembrolizumab.
II. To collect tumor tissue pre- and post- treatment with pembrolizumab for correlation with changes in FDG uptake and objective response to therapy, and for studies of mechanism of action of programmed cell death protein 1 (PD-1) blockade with pembrolizumab.
III. To measure immune biomarkers in blood from subjects before and at serial time points after treatment with pembrolizumab, for correlation with changes in FDG uptake and objective response to therapy, and for studies of mechanism of action of PD-1 blockade with pembrolizumab.
IV. To correlate changes in tumor FDG uptake (including a “flare” response), serum immune biomarkers, and tissue immune biomarkers with objective response to therapy, progression-free survival, and overall survival; changes in FDG uptake within immune related tissues (lymph nodes, spleen, bone marrow, and thymus) will also be correlated with serum and tissue immune biomarkers, and response.
OUTLINE:
Patients receive fluorodeoxyglucose F-18 intravenously (IV) and then undergo FDG PET/CT scan at baseline, approximately 3 weeks, and more than 10 weeks after the start of pembrolizumab.
Trial PhaseNo phase specified
Trial Typediagnostic
Lead OrganizationUniversity of Pennsylvania/Abramson Cancer Center
Principal InvestigatorMichael David Farwell