Imaging CXCR4 Expression in Subjects With Cancer Using 64 Cu-Plerixafor

Summary

In mouse models and in patients, expression of the chemokine receptor CXCR4 on various cancers has been correlated with aggressive biological behavior, including increased rates and certain sites of metastasis, and decreased survival. Plerixafor (Mozobil ; Genzyme; Cambridge, MA) has been identified as a specific inhibitor of CXCR4, and it is currently approved by the Food and Drug Administration as a stem-cell mobilizing agent in combination with granulocyte colony-stimulating factor in the treatment of non-Hodgkin's lymphoma and multiple myeloma. Our group has recently shown that plerixafor can be labeled with the positron-emitting radionuclide copper-64((64)Cu) to form (64)Cu-plerixafor, which can be used to visualize CXCR4-positive tumor xenografts in mice using small-animal positron emission tomography (PET). Determining CXCR4 expression in tumors using (64)Cu-plerixafor and PET/computerized tomography (CT) scanning could be useful in predicting tumor behavior and responses to current and experimental therapies, including therapies targeting CXCR4, which could lead to more effective personalized cancer treatments.

This study s primary objective is to evaluate (64)Cu-plerixafor as an imaging agent for quantifying CXCR4 expression in subjects (greater than or equal to 18 years of age) with cancer; at least 1 detectable solid tumor of greater than or equal to 2 cm in diameter found outside of the lymph nodes, bone marrow, liver, gallbladder, kidney, bladder, and brain; and preexisting biopsies of the tumors obtained since the first detection of the current occurrence/recurrence of disease. The secondary objectives are to correlate (64)Cu-plerixafor standardized uptake value in the target lesion with the level of CXCR4 expression detected via immunohistochemistry and to calculate human dosimetry for (64)Cu-plerixafor.

Preexisting tumor biopsies from less than or equal to 75 subjects recruited from the National Cancer Institute and the Georgetown University Hospital will be evaluated for CXCR4 expression via immunohistochemistry. Subjects who meet the eligibility criteria will continue onto the study. Five subjects with CXCR4-positive tumor biopsies will be administered an initial intravenous infusion of (64)Cu-plerixafor (8 +/-0.8 mCi ; 0.48+/- 0.048 rem; not to exceed 5 microg of (64)Cu -plerixafor) over 2 minutes. They will then undergo an initial low-dose transmission CT scan followed by 3 consecutive torso PET scans as soon as practical after the infusion, and 2 additional PET/CT scans at 4 hours +/- 1 hour and 24 hours +/- 2 hours post-infusion. Human dosimetry will be calculated based on these results, and a maximum dose will be used, not to exceed the calculated limit of a total effective dose of 5 rem, or the radiation exposure limit for each organ. The remaining subjects with CXCR4-positive (n=15) and CXCR4-negative (n=5) tumor biopsies will be administered 64Cu-plerixafor at the same, or a newly calculated dose, and will undergo 1 PET/CT scan between 1 and 4 hours post-infusion, depending on the dosimetry results. All subjects will undergo one comprehensive final study visit between study days 19 and 23 (11-17 days after injection with (64)Cu -plerixafor). Additionally, blood will be collected 2 more times between study days 13-16 and study days 26-30 to measure blood cell counts.

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Conditions

• Cancer

Interventions

DRUG

64-Cu-plerixafor

Five subjects with CXCR4-positive tumor sample(s) will be administered an initial intravenous (IV) infusion of 64Cu-plerixafor of up to 8+0.8 mCi (0.48+0.048 rem) not to exceed 5 g of 64Cu-plerixafor at Day 0. These subjects will undergo an initial lowdose CT scan followed by 3 consecutive torso PET scans as soon as practical after the infusion, and 2 additional PET/CT scans at 4 hours +/- 1 hour and 24 hours +/- 2 hours post-infusion. Human dosimetry will be calculated based on these results, and a maximum dose will be used, not to exceed the calculated limit of a total effective dose of 5 rem, or the radiation exposure limit for each organ. The remaining subjects with CXCR4-positive (n=15) and CXCR4-negative (n=5) tumor sample(s) will be administered 64Cu-plerixafor at the same or a newly calculated dose and will undergo 1 PET/CT scan between 1 and 4 hours post-infusion.

Sponsors & Collaborators

• Lombardi Comprehensive Cancer Center

  collaborator OTHER

• National Institute of Allergy and Infectious Diseases (NIAID)

  lead NIH

Principal Investigators

• Joshua M Farber, M.D. · National Institute of Allergy and Infectious Diseases (NIAID)

Study Design

Allocation

NA

Purpose

DIAGNOSTIC

Masking

NONE

Model

SINGLE_GROUP

Eligibility

Min Age

18 Years

Max Age

99 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2014-02-20

Primary Completion

2018-07-10

Completion

2018-07-10

FDA Drug

Yes

Countries

• United States

Study Locations