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no accrual
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The purpose of this study is to determine if magnetic resonance imaging (MRI) or positron emission tomography (PET) imaging can be used to help doctors determine how much oxygen a tumor is getting. Hypoxyprobe will be used to determine the levels of oxygen post-surgery in the current study. If the study is successful, then imaging can be used to determine a tumor's oxygen status even in patients who are not getting surgery.
Investigators want to find out how much oxygen is in the participants tumor based on how much pimo is present, and correlate this with the results of their MRI and 18F-fluoromisonidazole (FMISO) PET scan.
This study is also testing the investigational radioactive substance known as FMISO. FMISO is used during PET scans to help doctors see how much oxygen a tumor is getting. Participants might be asked to participate in an optional PET scan using FMISO.
A pilot phase II imaging study to determine hypoxia in melanoma.
About 16 - 24 hours before surgery, participants will be asked to come to the study center to take the investigational agent oral pimonidazole (pimo) by mouth. Pimo is a substance that is able to enter tissue when there are low levels of oxygen present (hypoxia). When the tissue is removed and visualized under a microscope, the amount of pimo present is related to the amount of oxygen in that part of the tissue. The dose of pimo given to the participant will depend on their weight (13 mg pimo/kg body weight).
After surgery, a sample of the participant's tumor tissue will be viewed by doctors under a microscope to determine the amount of pimo present.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Scans, Surgery and Follow-up | Experimental | Pre-surgery scans, surgical resection and post-surgery follow-up. All patients will receive a fluorodeoxyglucose (FDG)-PET scan as part of standard of care. This scan must be completed within 28 days of surgery for the patient to be eligible. All patients will be offered the opportunity to receive an additional 18F-FMISO-PET scan, until 18 such scans are administered. Prior to surgery, patients will be administered a single dose of 0.5 g/m^2 (approximately 13 mg/kg) of oral Hypoxyprobe™-1 (pimonidazole, HCl). |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Pimonidazole hydrochloride (Hypoxyprobe™-1) | Drug | Prior to surgery, patients will be administered a single dose of 0.5 g/m^2 (approximately 13 mg/kg) of oral Hypoxyprobe™-1 (pimonidazole, HCl). |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of Positive Biomarker Staining by Applicable Area | Relationship between MRI and/or FMISO-PET imaging features and pimonidazole staining by immunohistochemical analysis in melanoma metastases. Investigators expect that the correlation between them is at least 0.45. With a 5% significance level, a total of 36 participants will provide 81% power to test a null hypothesis correlation of 0 versus an alternative hypothesis correlation of 0.45 using a two-sided test. | 6 weeks per participant |
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Inclusion Criteria:
Exclusion Criteria:
Women who are pregnant or breastfeeding
Patients who are contraindicated for MRI or gadolinium contrast agents due to:
Patients with known, active (i.e. not adequately treated with curative intent) malignancies other than melanoma
Presence of any other co-existing condition which, in the judgment of the investigator, might increase the risk to the participant
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| Name | Affiliation | Role |
|---|---|---|
| Jonathan Zager, M.D. | H. Lee Moffitt Cancer Center and Research Institute | Principal Investigator |
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| ID | Term |
|---|---|
| D008545 | Melanoma |
| D012878 | Skin Neoplasms |
| ID | Term |
|---|---|
| D018358 | Neuroendocrine Tumors |
| D017599 | Neuroectodermal Tumors |
| D009373 | Neoplasms, Germ Cell and Embryonal |
| D009370 | Neoplasms by Histologic Type |
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| ID | Term |
|---|---|
| C033815 | pimonidazole |
| C031843 | fluoromisonidazole |
| D013514 | Surgical Procedures, Operative |
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| Optional 18F-FMISO PET scan (18F-fluoromisonidazole) | Drug | All patients will be offered the opportunity to receive an additional 18F-FMISO-PET scan, until 18 such scans are administered. |
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| Surgical Resection of Melanoma Metastases | Procedure | Participants will undergo surgical resection of melanoma metastases within 16 - 24 hours of consuming oral pimonidazole. Pimonidazole staining will be done on formalin-fixed and paraffin-embedded (FFPE) tissues for pimonidazole analysis. All participants will be contacted 24-72 hours post-surgery to be assessed for any adverse events (AEs) related to surgery, pimonidazole consumption and 18F-FMISO (when applicable). |
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| D009369 | Neoplasms |
| D009380 | Neoplasms, Nerve Tissue |
| D018326 | Nevi and Melanomas |
| D009371 | Neoplasms by Site |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |