Determination of the Predictive Value of FDG-PET-CT Scans, Blood Proteins and Blood Cells for the Prognosis for Patients With Lung Cancer Receiving Concurrent Chemo-Radiation
This translational research part is aiming to give more insights in the way radiation injury
and tumour response develops.
It involves three parts:
1. Repetitive FDG-PET-CT scans in order to assess early tumour response monitoring.
2. Blood sampling before, during and after radiotherapy in order to find predictors for
normal tissue injury and for tumour response.
3. Extra staining of tumour biopsies
The FDG-PET-CT scan with i.v. contrast gives information of the tumour metabolism and its
morphology. Therefore, one extra FDG-PET-CT scans will be done during radiotherapy at day 8.
Tumour response will be determined by FDG-PET-CT scans 3 months after radiotherapy.
1. Before radiotherapy, 12 millilitres of blood (EDTA tubes) will be taken according to
serum protocol (appendix 5).
2. At day 7, day 14 during concurrent chemo-radiation, 7 days after the end of this
treatment and 3 months and 9 months after the end of radiotherapy, 12 millilitres serum
(EDTA tube) will be taken to investigate the evolution of the proteins [In the first
place, plasma concentrations of osteopontin and soluble CA9 for hypoxia, CRP and IL-6
for inflammation, total and free VEGF for angiogenesis and total and cleaved
cytokeratin 18 for necrosis/apoptosis will be determined] during and after treatment,
for its kinetics may be important as predictive factors. Standard ELISA tests will be
used to determine these levels.
3. Before radiotherapy, at day 7 and at day 14 during radiation, 7 days after the end of
this treatment and 3 months and 9 months after the end of radiotherapy, 24 millilitres
of blood (EDTA tubes) will be taken to investigate the evolution of circulating cells
and their progenitors during and after treatment.
The tumour biopsies may be stained with markers for proliferation (e.g. KI 67), apoptosis
(e.g. M30), hypoxia (e.g. CA 9, Glut 1 and 3) and others (e.g. EGFR and EGFRvIII), in order
to correlate these measurements with response.
Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Diagnostic
Tumour response, measured with FDG-PET-CT scans 3 months post-radiation. as a function of delta FDG uptake the first week during radiotherapy
9 months post-radiation
Dirk De Ruysscher, MD PhD
MAASTRO, Maastricht Radiation Oncology
Netherlands: The Central Committee on Research Involving Human Subjects (CCMO)